Joint Pain - Causes, Symptoms and Treatment .MF .
pain joint medical language called arthralgia .This is a very important symptom for the diagnosis of multiple diseases, it is one of the first symptoms, which reflects the joint defeat at the organic level (usually irreversible biochemical and immunological disorders), with the subsequent development of arthritis (except for medicinal and meteopaticheskie arthralgia).
Possible causes pain in the joints.
Arthralgia is the result of irritation neuroreceptors that are in all the joint structures, a variety of factors, depending on the underlying disease.One of the causes of pain in the joint may be a joint injury and hematoma formation, not visible to the eye.
main diseases in which there is pain in the joints.
Osteoarthritis - the most common chronic disease of the joints (often of the hip, knee, interphalangeal joints of hands), which is based on degenerative - degenerative disorders (metabolic disorder) articular cartilage, bone, synovial membranes and ligaments of the joint (old age,overweight
symptoms - pain and stiffness in the joint, aggravated by physical activity and decreasing at rest (with mechanical pain), constant dull night pain - disappear in the morning with active movements (vascular pain), starting pain - quickly appear and disappear at the beginning of the loadand returning at an intense and prolonged stress, the blockade of pain - blockage or impairment of the affected cartilage between the joint surfaces.
soft tissue edema, and local temperature rise in the joints.Characteristic symptoms Heberden's nodes and Bouchard's (small solid education) in the interphalangeal joints of the hands.
Ankylosing spondylitis (ankylosing spondylitis-Marie) - chronic inflammation of the axial skeleton joints (vertebral, sacroiliac, edge-vertebrates) based on the immuno - inflammatory process in the body, followed by the formation of joint scar fibrinous tissue, whichdeposited trace elements and salts, thus limiting the mobility of the joint.Symptoms - the first emerge at a young age, nagging persistent pain in the buttocks, sacrum and lower back, worse at night.
Chest pain in the ribs attach to the spine, worse when breathing deeply, coughing.
Stiffness of muscles of the back, emerging at night and at rest, decreases with active movements.
Violation of posture - posture petitioner.
sweating during the day.
low-grade fever - 37,0-37,5.
defeat of the internal organs (heart, aorta, kidneys, eyes).
Reactive arthritis - acute inflammatory joint disease (mainly lower limb joints).The reason - there after undergoing an acute infection (intestinal, SARS, acute respiratory diseases, urogenital).Symptoms.Constant sharp pain in the joint aggravated by movement, swelling and hyperemia (redness) of the soft tissue over the joint, fever (38.6 - 40.0).Extra-articular manifestations - eye disease (conjunctivitis), heart disease (myocarditis, pericarditis, arrhythmias), CNS (neuritis, encephalopathy), damage to the kidneys (pyelonephritis), violation trophism nails, skin and mucous membranes (onychodystrophy, keratoderma, erosion).
Regarding infection, arthralgia may be a symptom of the virus Zika.
Disease Reiter (separate type of reactive arthritis with genetic predisposition) - appears after undergoing intestinal or chlamydial infection.Manifested reactive arthritis (mainly the joints of the lower limbs), pain in the joints, characteristic of extra-articular manifestations (urethritis or prostatitis, conjunctivitis and uveitis, skin lesions and mucous membranes - ulcerative stomatitis, erosive balanitis,), the defeat of the cardiovascular system (arrhythmias, blockades,aortitis), fever (38.6 - 40.0).
Rheumatoid arthritis - a chronic, progressive systemic inflammation of the connective tissue (autoimmune inflammation in the joints).It affects mainly the small joints of the hands and feet, sometimes knee and elbow.The symptoms - joint pain constant deformation of joints, joint swelling, stiffness in the joints in the morning, the symmetry of joint damage, weakness, fatigue, weight loss, fever, and over the joint area, persistent joint deformity, rheumatoid nodules on the extensor surfaces of defeatbones (bone pain and fractures), skin lesions (dryness, pallor, subcutaneous haemorrhage, hot pink or bluish skin color, small-focal necrosis of soft tissue under the nail plate), nail infections (fragility, striation of the nail plate), lymphadenopathy (increase in submandibular,neck, groin and elbow lymph nodes), Felty's syndrome (joint disease with a combination of splenomegaly - an increase in the spleen and leukopenia - reducing the number of leukocytes in peripheral blood), the defeat of the broncho-pulmonary system (interstitial fibrosis of lung tissue, unilateral pleural effusion, rheumatoid nodules in the lungs), the defeat of the gastrointestinal tract (associated with taking medicines in the treatment of the underlying disease without protection of the gastric mucosa -lekarstvenny gastritis), heart disease (myocarditis, endocarditis, pericarditis, coronary artery, aorta, arrhythmias), kidney disease (amyloidosis, glomerulonephritis, drugkidney), nerve damage (neuropathy with sensory or motor disturbances), eye disease (scleritis, keratoconjunctivitis).
psoriatic arthritis - arthritis develops in genetically predisposed patients with psoriasis, arthritis exacerbation coincides with the exacerbation of psoriasis.Symptoms.Pain in the joints (mainly affects interphalangeal joints of the hands and feet), purple-bluish skin with swelling over the joint area, asymmetrical joint lesions, pain in the lumbosacral spine, heel pain (talalgiya), skin psoriatic plaques, nail infections (brittleness, striation and clouding of nail plates).
Gout (gouty arthritis) - microcrystalline arthritis, hereditary disease which is based on a violation of metabolism (in violation of the diet), namely, purine metabolism, resulting in the deposition of urate crystals (uric acid) in the periarticular and articular tissues.Symptoms.Joint pain (usually in the first metatarsophalangeal joint of the foot), bright hyperemia (redness), swelling and peeling of the skin over the joint, fever, increased local temperature of the affected area of the joint and skin manifestations in the ears, elbows, feet, hands, in the form oftophi (local accumulation of urate salt crystals surrounded by granulomatous tissue), heart disease (myocarditis, endocarditis, pericarditis, coronary artery, aorta, arrhythmias), kidney disease (amyloidosis, glomerulonephritis).
Pseudogout - (psevdopodagrichesky arthritis) microcrystalline arthritis, a disease which is based on metabolic disease (local abnormal calcium pyrophosphate metabolism in tissues of the joint), namely calcium metabolism, resulting in the deposition of crystals of calcium pyrophosphate (calcium salt) inperiarticular and articular tissues.Symptoms.Pain in the joints (often affects the knee joints), bright hyperemia (redness), swelling of the skin over the joint, fever, increased local temperature field of the affected joint, joint deformation.Internal organs and other systems is not affected.
Drug arthralgia - a temporary condition characterized by aching in the joints (especially small joints) against the reception of certain drugs in high daily doses.It is not a disease, and not classified in ICD-10 WHO.Groups of drugs can cause arthralgia drug - penicillin antibiotics, barbiturates and light sleeping pills and tranquillizers (chemical-based), antihypertensive drugs, contraceptives and anti-TB drugs, proton pump inhibitors. Reasons, pathogenesis, clinical manifestations, and diagnosis of this condition is not examined in connection with the active promotion of drugs on the pharmacological market and the lack of severity of the condition with respect to the functional disorders of the joint and individual tolerance of drugs.
The same can be said about meteopaticheskih arthralgia (joint pain arising from meteopaticheskih people who are sensitive to the atmospheric pressure).
Survey for joint pain.
CBC in most cases, evidence of different deviations depending on the nature of joint damage and its degree, increased erythrocyte sedimentation rate, reflecting the level of the inflammatory process in the normal amount of white blood cells characteristic of the rheumatic diseases.Increasing the number of leukocytes in inflammatory diseases of the spine and joints may indicate the presence of the infection in the body, etc.Biochemical analysis of blood for diagnosis of some inflammatory diseases of joints and spine, are important determination of the content of C - reactive protein (CRP) in the blood serum, diphenylamine reaction (DPA), the determination of total protein and fibrinogen, seromucoid, etc. Although all of these tests.do not indicate the specificity of the pathological process, when compared with other clinical and radiographic data they assist in the diagnosis in the early stages of musculoskeletal diseases - the propulsion system and allow us to judge the level of activity of the process.Great importance is attached to change the content of lysosomal enzymes (acid phosphatase, acidic proteinase, deoxyribonuclease, cathepsins) in serum and synovial fluid is often observed in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis.
Immunological studies.For the early diagnosis of rheumatoid lesions of particular importance rheumatoid factor - antiglobulin antibody.It is formed in lymph nodes, spleen, synovium lymphoplasmacytic cells.For detection of rheumatoid factor in the serum and synovial fluid Vaaler reaction - Rose considered positive if the concentration of 1:28 or more.Rheumatoid factor is detected in 75-85% of patients with rheumatoid arthritis.In the early stages and form of seronegative rheumatoid arthritis for the isolation of rheumatoid factor on lymphocyte reaction immunotsitoaderentnosti level use.
Test with antistreptolisin O (ASL-O) reflects the immunological reactivity to streptococcal infection.The increase in titer of ABL-0 is observed in patients with rheumatic fever, an infectious-allergic arthritis.
braking reaction migration of leukocytes.Normally, the leukocytes are able to migrate into the environment to form conglomerates.If there is a sensitization of an organism to a specific antigen, then at a meeting with the sensitized leukocyte antigen lymphocytes secrete an inhibitory factor inhibiting leukocyte migration.This reaction is positive for rheumatism, rheumatoid arthritis and other rheumatic diseases.
Blood on HLA system - the possibility of early diagnosis of ankylosing spondylitis, great importance is the definition of HLA B-27.HLA-complex is found in the cell membrane and excreted via immunological methods.
study of synovial fluid - any pathological process that occurs in the joint, inflammatory, degenerative or traumatic, synovium responds and can produce at the same time large amounts of exudate.It is mixed with the ever-contained in the cavity of the synovial fluid of joints, in connection with which it acquires new immunobiohimicheskie and histochemical properties.Changing the histological, biochemical and physical properties of the synovial fluid of lesions depends on the nature, severity and stage of the pathological process.Of particular importance is the study of synovial fluid in the differential diagnosis of inflammatory and degenerative joint disease.Acute inflammation is accompanied by the increase in the number of blood cells in the synovial fluid.
immuno - identifies immunoglobulin classes A, G, M, which are of great importance for the development of the pathological process of rheumatoid arthritis.
Radiography - a reliable method for studying the joints.In fact, without it, a doctor can not make a diagnosis and differential diagnosis.X-rays to determine the stage and prognosis of the disease, and in the dynamics objectively evaluate the effectiveness of therapy.It is necessary to compare the radiological findings with the clinical picture, disease duration and age of the patient.
Tomography can more accurately determine the focal lesions or individual segments of the vertebrae.
Myelography - contrasting spine research method, using this method, you can specify the location of the pathological process, especially in cases where it is necessary surgery.
intraosseous venography - for the study of venous blood flow epidural space.This method gives an indication of circulation condition in the paravertebral space and indirectly on the possible degenerative lesions.
Arthroscopy - study method, allowing you to view the visual structure of the knee and take a biopsy of the desired area, detected contours, coloring and capillary network of the synovial membrane, cruciate ligaments, menisci and fat pad.
Discography - the introduction of contrast medium into the intervertebral disc followed by X-ray diffraction makes it possible to judge the state of the intervertebral discs, the location and extent of damage.
Radionuclide scanning - an important objective method for early diagnosis of joint damage.
Arthrography - via intra-articular injection of various contrast media can more accurately identify pathology in low-lying parts of the joint.
Biopsy synovium - biopsy material in various diseases of the joints is crucial in the diagnosis of early forms of ankylosing spondylitis, Reiter's disease, gouty arthritis.
Symptomatic treatment: how to remove joint pain
do not recommend self-treatment and treatment of folk remedies in any joint pains to posing a provisional or definitive diagnosis by the attending physician due to incorrect self-assessment of their condition, which can lead to persistent irreversible functionaljoint disorders - ankylosis, stiffness, contractures (and this is a danger symptom).Today, the most popular means to relieve pain in the joints are the drugs from the group of NSAIDs.They are really effective, but have a number of contraindications and are not recommended for long-term use.
addition to for a successful fight against joint pain appointed chondroprotectors.Such preparations successfully protect cartilage, but they need to take courses.One of the most effective chondroprotectors - glucosamine.He is a member of almost all drugs of osteoarthritis.However, not all glucosamine forms are equally useful.For example, the glucosamine hydrochloride - the substance is of unproven efficacy, and is available mainly in the form of dietary supplements.While stable crystalline glucosamine sulphate - the only form of glucosamine, has successfully passed clinical trials.For example, on the basis of a stable form of glucosamine is designed Dona drug that not only relieves symptoms, but also slows down the progression of the disease, which significantly improves the patient's quality of life and postpone the need for joint replacement.
To which the doctor ask for pain in the joints
Physician, surgeon, orthopedics, traumatology, arthrology, rheumatologist.