Why do my joints hurt?
Arthralgia can have a number of causes, such as:
- toxic syndrome in acute infectious processes;
- acute or recurrent arthritis of various etiologies;
- progressive degenerative-dystrophic changes in cartilage, damage to the synovial membranes;
- residual effects after an inflammatory process or injury;
- pseudoarthralgia (psychosomatic simulation of joint pain - Ed.).
If one joint hurts, first of all we can assume an injury, an infectious process or the deposition of salt crystals in the joint (microcrystalline arthritis). For young people, arthralgia is most likely to be associated with injury, infection, or a primary inflammatory disease (eg, rheumatoid arthritis). At the same time, in older people, the most likely causes are osteoarthritis or microcrystalline arthritis.
When it comes to arthropathy involving multiple joints, the most common causes are systemic inflammatory diseases, as well as microcrystalline arthritis, osteoarthritis and infections.
Rare causes of arthralgia include synovitis of various etiologies, hemorrhages into the joint cavity due to blood clotting disorders, tumor processes, and side effects after taking medications (for example, angiotensin-converting enzyme inhibitors or proton pump inhibitors).
It is important to remember that the appearance of pain can be associated with damage to the periarticular tissues - bursitis, tendinitis, fasciitis, epicondylitis and tenosynovitis. Sometimes joint pain is a consequence of disorders of the musculoskeletal system (for example, flat feet) or neuralgia and myalgia of other origins.
“Difficult” client – see a doctor!
Joint pain that persists for a long time or is accompanied by unusual symptoms is a reason to consult a doctor. There are alarming symptoms (“red flags”) that require special attention:
- redness in the joint area, swelling, increased temperature in the joint area, decreased range of motion;
- combination of acute arthralgia and fever;
- joint pain in combination with skin damage and signs of inflammation of adipose tissue;
- indications of a history of bleeding disorders or use of anticoagulants;
- the presence of extra-articular or systemic manifestations (weakness, weight loss, sweating);
- night pain, awakening due to pain;
- previous trips to tropical countries.
In each such case, therapy should be determined only by the attending physician.
We are locals ourselves
Often patients suffering from joint pain prefer topical medications for treatment. The pharmaceutical industry offers several basic dosage forms - ointments, gels, creams, solutions for topical application (including in the form of sprays), as well as patches.
First of all, let us recall the method of application common to this entire group of drugs.
A small amount of the product is applied to dry and clean skin, gently rubbed in with clean hands, which should be washed after applying the product. Avoid contact of the product with mucous membranes and damaged areas of the skin. In general, the use of local agents under sealed occlusive dressings, which promote enhanced absorption of components, is not recommended.
Ibuprofen, cortisone or paracetamol? What will help in the fight against coronavirus
The French Ministry of Health said that when infected with coronavirus, it is strictly forbidden to use a number of anti-inflammatory drugs, as they can only worsen the patient’s condition. We are working with Russian experts to find out whether such medications can really cause complications and in what cases it is necessary to take paracetamol.
Dangerous drugs?
French Health Minister Olivier Veran said on his Twitter page that taking a number of anti-inflammatory drugs like ibuprofen or cortisone can be a factor that worsens the infection. “If you have a fever, take paracetamol,” he advised.
However, some Russian experts do not share this opinion. In particular, clinical virologist Georgy Vikulov, in a dialogue with Moscow 24, said that to date there are no studies confirming this. “Ibuprofen and paracetamol are non-steroidal anti-inflammatory drugs. They are allowed in certain dosages as antipyretics, recommended by WHO and leading specialized organizations both abroad and in Russia.”
“, the specialist explained. Regarding COVID-19, there are no studies whose results would indicate that ibuprofen and paracetamol should not be used.
Vikulov added that paracetamol and ibuprofen are allowed both in the treatment of children and pregnant women. “When an antipyretic effect is required, nothing is more effective than non-steroidal anti-inflammatory drugs”
, the expert believes.
At the same time, the virologist confirmed the negative consequences for the body after using cortisone. “Cortisone, corticosteroids, and cortisone-related substances are not recommended because they cause significant immune suppression.”
, says Vikulov.
According to the specialist, any hormonal drugs are dangerous for any viral infections. And COVID-19 is no exception.
When and how can you take paracetamol?
Today, people often abuse antipyretic and anti-inflammatory drugs because such drugs are actively advertised, experts believe. At the same time, the decision on the use of such drugs and their dosage should be made by the attending physician, emphasized clinical virologist Georgy Vikulov. Paracetamol can only be used as prescribed by a doctor. If there are indications for use, he will recommend non-steroidal anti-inflammatory drugs with antipyretic or anti-inflammatory effects, depending on what is required.
Professor of the Department of Hospital Therapy of the First Moscow State Medical University named after I.M. Sechenov Sergey Yakovlev
said that antibiotics are used to combat bacterial pneumonia. But if pneumonia is caused by viruses, including coronavirus, then antibiotics are useless. Antibiotics have no effect on the virus. And to prevent this coronavirus, you don’t need to take any medications, they are pointless.
In addition, Yakovlev
reminded that any medicine can have side effects. Starting from allergic reactions and ending with damage to the liver, kidneys and other organs. Therefore, you should not abuse self-medication. The main thing is to remember about hand hygiene and follow the recommendations of the Ministry of Health and Rospotrebnadzor on the prevention of coronavirus.
Virologist Georgy Vikulov also added that antibiotics should be prescribed only by doctors after examination and consultation. “The sale of antibiotics in a pharmacy without a doctor’s prescription is a violation of the federal program to combat the spread of antibiotic resistance in the Russian Federation until 2030,” the specialist emphasized. Moreover, if you use antibiotics with or without reason, then at the moment when such a medicine is really needed, it simply will not work. Professor of the Department of Hospital Therapy at the First Moscow State Medical University named after I.M. Sechenov Sergei Yakovlev explained that in case of severe fever (temperature more than 39 degrees), it is necessary to reduce the temperature, especially in children. “Paracetamol in this regard is the most neutral and safe, so it will be optimal”
, says Yakovlev. However, he also emphasized that a doctor should prescribe the medicine.
More details: https://www.m24.ru/articles/obshchestvo/18032020/156530?utm_source=CopyBuf
Classification of drugs
Let's consider the main groups of local remedies for joint pain:
Non-steroidal anti-inflammatory drugs (NSAIDs) for topical use: Phenylbutazone, Etofenamate, Piroxicam, Ketoprofen, Ibuprofen, Diclofenac, Indomethacin, Meloxicam and Nimesulide.
Local agents with irritating effects:
a) Capsaicin and similar agents:
Capsaicin is fat-soluble, therefore, if necessary, products containing this drug can be removed from the skin or mucous membranes using petroleum jelly or vegetable oil.
- Capsicum fruit tincture;
- Capsicum fruit tincture + Camphor;
- Capsicum fruit extract;
- Capsaicin + Ethylnicotinate;
- Camphor;
- Carnation flowers oil + Camphor + Chinese cinnamon bark oil + Peppermint leaves oil + Eucalyptus leaves oil + Levomenthol;
- Camphor + Gum turpentine + Eucalyptus leaf oil + Levomenthol;
- Camphor + Salicylic acid + Gum turpentine + Viper venom;
- Camphor + Peppermint leaves oil / Levomenthol + Eucalyptus rodentum leaves oil;
- Camphor + Salicylic acid + Gum turpentine + Viper poison;
- Pepper patch.
b) Propyl nicotinate (salicylic acid derivatives in combinations):
- Methyl salicylate + Racementol;
- Methyl salicylate + Cobra venom;
- Methyl salicylate + Bee venom;
- Methyl salicylate + Levomenthol + Eucalyptus oil + Turpentine oil.
Preparations containing dimethyl sulfoxide:
- Sodium heparin + Dexpanthenol + Dimethyl sulfoxide;
- Dimethyl sulfoxide + Camphor + Turpentine oil + Benzyl nicotinate + Nonivamide.
Other drugs
- Nicoboxil + Nonivamide;
- Benzocaine + Procaine + Racementol;
- Glucosamine + Chondroitin sulfate;
- Formic alcohol;
- Titanium glycerosolvate aquacomplex;
- Menthol + Novocaine + Anestezin.
Anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) suppress inflammation and reduce pain and swelling. Drugs in this group are generally well tolerated, but are not recommended in cases of hypersensitivity to NSAIDs (including bronchial asthma), erosive lesions of the gastrointestinal tract, as well as during pregnancy and breastfeeding (a number of drugs can penetrate the placental barrier) . In addition, the use of NSAIDs is associated with the risk of local and systemic allergic reactions, the possible development of increased sensitivity to light (photosensitivity), especially when used together with cosmetics containing octocrylene sunscreen. Therefore, topical use of NSAIDs on areas with damaged skin, as well as use without protection from direct sunlight, is not recommended. If necessary, these products can be removed from the skin with plenty of water.
Salicylic acid derivatives (for example, methyl salicylate), which are included in various combinations of medicinal substances, have similar effects.
Irritants
A fundamentally different group of drugs from non-steroidal ones are painkillers with a local irritant effect, often used for joint pain. Products based on capsicum extract containing capsaicin are widely used. This alkaloid irritates and warms the skin and increases local blood flow in the area of application. In addition, it affects pain receptors, which leads to a local analgesic effect. Products containing capsaicin should also not be used for damaged skin. The question of use in pregnant and lactating women should be decided by a doctor. We should not forget about the possibility of developing allergic reactions.
Other substances of plant origin act in a similar way, for example, mustard oil and its derivatives (allyl isothiocyanate), camphor, menthol (which also has a “cooling” effect), extracts of cloves, eucalyptus, peppermint, and gum turpentine. The use of these products may also cause allergic reactions.
Keep away from children!
It is important to avoid accidental ingestion of any topical medications, which is especially important for families with young children.
If this does happen, then in the case of NSAIDs you should rinse the stomach. If locally irritating drugs are ingested, vomiting should not be caused due to the risk of inhalation. For example, inhalation of camphor followed by laryngospasm can lead to death. Instead, you need to take enveloping antacids and/or sorbents, and consult a doctor. There is a synthetic analogue of capsaicin with an identical mechanism of action - nonivamide. Nonivamide is usually used in combination with nicoboxil, a substance with vasodilating activity ( expands the lumen of blood vessels - Ed.).
). The application of these drugs to areas of skin with increased permeability, to the neck, lower abdomen and inner thighs is contraindicated.
Another representative of this group, propyl nicotinate, also has an irritating effect. When applied, propyl nicotinate is broken down to form nicotinic acid, which increases local blood flow and blocks nerve endings, which leads to the development of local anesthesia and hyperthermia. This painkiller can be used for joint pain only if it is non-inflammatory in origin, for example due to injury. Using a large amount of the drug over a large area can lead to a decrease in blood pressure and bradycardia, and the entry of propyl nicotinate into the oral cavity is fraught with respiratory failure, increased blood pressure, and the development of cardiovascular failure.
It is also not recommended to use propyl nicotinate simultaneously with other locally irritating agents (local medications, warming physiotherapy) due to the risk of skin irritation and lowering blood pressure. Benzyl nicotinate works similarly.
Poisons
Often, topical products contain venoms of hymenoptera and reptiles. Bee venom has an analgesic and anti-inflammatory effect, and may also have an antibacterial effect. The venoms of snakes - vipers, vipers, cobras - act similarly. If such products are used, allergic reactions may develop.
Dimethyl sulfoxide
An important component of many compounds used for arthralgia is dimethyl sulfoxide. It improves the penetration of medicinal substances into tissues by increasing the permeability of cell membranes, and also has its own local anti-inflammatory and analgesic effect. Dimethyl sulfoxide, with long-term use, improves the absorption of ethanol from the gastrointestinal tract, can enhance the effect of insulin, and increases sensitivity to anesthesia drugs. The drug should not be used if you are hypersensitive to it, pregnant or lactating women, or children under 12 years of age. An additional limitation on its use may be a specific odor reminiscent of garlic.
Other
Metal compounds can also be used in the treatment of joint pain. Thus, there are preparations based on titanium compounds, for which anti-inflammatory and antimicrobial effects, anti-edematous and local analgesic effects are described.
Another option is the use of local anesthetics, for example, novocaine and anesthesin in combination with menthol, which provides both an analgesic effect and a cooling sensation in the sore joint.
Many of the listed drugs are included in various combination drugs and enhance each other’s effect.
Medicines for muscles
Myositis is an inflammatory process in muscle tissue that develops against the background of systemic infectious diseases, as a result of hypothermia. The pathology is manifested by muscle weakness, stiffness of movement, muscle pain. What medications are used to treat myositis?
Drugs for the treatment of myositis
If myositis occurs against the background of a bacterial infection, antibacterial drugs are used:
- Amoxiclav,
- Amoxicillin,
- Amosin,
- Sumamed.
If the cause of muscle pain is autoimmune pathologies, glucocorticoid drugs are used:
- Kenalog,
- Prednisolone.
Myositis can develop against the background of infection of the body with helminths. In this case, the patient is prescribed anthelmintic drugs:
- Pirantel.
To relieve pain and discomfort, analgesic drugs are used:
- Analgin,
- Baralgin,
- Ketanov,
- Ketanol,
- Moment,
- Pentalgin,
- Sedalgin.
Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain, relieve inflammation, swelling, and effectively reduce elevated body temperature:
- Diclofenac,
- Ibuklin,
- Indomethacin,
- Nurofen,
- Ortofen.
Medicines for external use
Preparations for external use are various warming ointments and creams that promote blood flow to inflamed muscle tissue. Such medications increase blood circulation, stimulate metabolic processes and improve the restoration of damaged muscle tissue:
- Apisatron,
- Viprosal,
- Nicoflex,
- Finalgon.
Other medicines for treating muscle disorders
Often muscle pain appears after increased physical activity, sports, or prolonged stay in one position. Pain and discomfort in the muscles in this case occurs as a result of the accumulation of lactic acid in them.
Lactic acid is removed from muscles when blood circulation is stimulated and when warmed. For these purposes, you can use the special warming ointments mentioned above. To remove lactic acid, it is advisable to use ointments based on NSAIDs:
- Indomethacin ointment,
- Orthophen ointment.
Severe muscle pain and discomfort can be relieved with the following analgesic medications:
- Analgin,
- Tempalgin,
- Nise.
Muscle cramps or convulsive contractions occur mainly in the evening and at night. To prevent seizures and for the purpose of general strengthening of the body, various vitamin complexes are used: vitamins B and E.
What medications can be used for muscle dystrophy? Currently, there are no drugs that can cure the disease completely. But to maintain muscle tone, as well as to delay pathological changes in muscle tissue, corticosteroids (Prednisone) are used.
Special Additives
Athletes who want to build muscle mass use special nutritional supplements for this purpose. It is not recommended to take such drugs on your own; the feasibility and dosage of such drugs must be agreed upon with a trainer and nutritionist. Example of muscle building supplements:
- Whey Protein,
- Glutamine,
- Creatine.
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