Arthralgia: a brief overview of existing types and methods of treating the disease

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• Joint pain. Question answer. Topic: Encyclopedia of diseases
• Joint pain Topic: Encyclopedia of diseases

Title

• Major diseases
• Myths and facts
• Diagnostics
• Treatment methods

Joint pain can be mild in intensity or severe and debilitating. Over the course of their lives, up to 85% of the adult population will experience joint pain in one way or another. The cause of joint pain can be hundreds of diseases, in which joint damage can be either primary or secondary (due to intoxication with metabolic products).

The following diseases are most often accompanied by joint pain:

• Osteoarthritis
• Rheumatoid arthritis
• Rheumatism
• Reactive arthritis
• Psoriatic arthritis
• Bursitis
• Gout
• Myeloma
• Lyme disease
• Osteomyelitis
• Systemic lupus erythematosus
• Scleroderma
• Lymphoblastic leukemia
• Sarcoidosis
• Kawasaki disease
• Crohn's disease
• Still's disease
• Bone metastases
• Septic arthritis

Statistically, 4 diseases with the presence of arthralgia (joint pain) deserve the most attention.

Osteoarthritis

Arthritis (inflammation of the joint) is the most common cause of joint pain and a very large number of people suffer from this disease. Osteoarthritis is sometimes called degenerative, meaning that the cartilage tissue lining the surfaces of the joint undergoes degenerative changes over time and damaged cartilage injures each other, causing symptoms such as joint pain, inflammation, stiffness and limited mobility. Osteoarthritis affects approximately 27 million people in the United States. Symptoms usually begin after age 40 and progress slowly. And after the age of 60, up to half of people experience this disease to one degree or another. Osteoarthritis most often affects large joints that are subject to greater stress (hips, knees and ankles). Increased weight increases the risk of this disease. It has been noted that people with increased weight (both men and women) are three times more likely to develop this disease compared to people with normal weight (the same age and gender group).

Rheumatoid arthritis

An autoimmune disease that causes pain and stiffness in the joints. Most often it occurs in women aged 20 to 50 years. There are about 1.5 million patients with this diagnosis in the United States. In patients with this disease, due to disruption of the immune system, antibodies are formed to their own tissues (including joint tissues), which causes inflammatory processes and manifests itself as damage to joints and other internal organs. Inflammation in the joints leads to rapid wear, pain and limited mobility. Due to the fact that the disease is systemic and autoantibodies spread throughout the body, joint damage is symmetrical (joints on the right and left are affected). Small joints (in the hand and foot) are often affected, as well as large joints.

Features of childhood arthralgia

Diagnosis of arthralgia in childhood

due to the presence of an acute infectious process. In such a situation, pain localized in the articular and periarticular tissues gradually increases and is aggravated by a feverish state, as well as general intoxication of the body.

Arthralgia in children requires special attention and treatment approach.

There are cases of multiple childhood arthralgia, which is accompanied by changes in the shape of the nail and finger phalanges, which may indicate the presence of serious malfunctions in the functioning of the heart, lungs or other internal organs.

It is important that a pathology of this kind that occurs in childhood requires a particularly careful approach, because if the diagnosis is incorrect or the existing symptoms are ignored, the pathology can become irreversible.

Bursitis

This disease is often confused with arthritis, although with bursitis it is not the joint that is inflamed, but the joint capsule. Bursitis can cause discomfort, stiffness and pain in the joint area. Symptoms are associated with inflammation of the synovial membranes of the joint, usually caused by improper movement, compression or injury. Most often, bursitis develops in the shoulder, knee or hip joints. One type of bursitis, called maid's knee, develops due to prolonged pressure on the knee joint on a hard surface.

Gout

Gouty joints usually involve paroxysmal episodes of pain, stiffness, inflammation and redness in the joints. The reason for this lies in the excess production of uric acid, which is not completely utilized by the kidneys and is deposited in the form of crystals in the joints, which leads to inflammation. As a rule, this disease develops after 50 years. Therefore, it must be remembered that with age, the excretory function of the kidneys may decrease, which can lead to gout. Gout usually affects the feet, but if left untreated, other joints can also be affected.

Systemic lupus erythematosus

Systemic lupus erythematosus is an autoimmune disease. The etiology of this disease is not yet known. A certain genetic determination is assumed. Provoking factors may be infections, stress, sun exposure, ultraviolet radiation, changes in hormone levels during pregnancy or when taking contraceptives. The reason for the formation of autoantibodies is unclear. Women get sick 9 times more often than men and, as a rule, the onset occurs at fertile age. SLE is characterized by alternating exacerbations and remissions, and these periods can be of varying lengths. During an exacerbation, there may be a rise in temperature, inflammation and pain in the joints. Periods of remission can be long and during this period up to 20% of patients do not require treatment. With SLE, damage to other organs and systems (kidneys, heart, skin) is possible.

Symptoms of arthralgia

The disease belongs to a category whose course is almost impossible to predict. Each case is individual and requires certain measures.

The disease is extremely variable. The main symptom of arthralgia is pain

, which can be fixed in a specific place or dynamically move. At the same time, it is important to note that the pain sensation can be of a different nature:

• aching/throbbing;
• sharp/blunt;
• intense/weak.

Myths and facts

Myth N1

All joint pain is associated with arthritis. Although there are at least 50 types of arthritis, inflammation and pain in the joints does not mean the presence of arthritis. Pain in the joint area may be associated with damage to soft tissue or synovial membranes (bursitis). Therefore, a doctor’s consultation is necessary to make a diagnosis.

Myth N2

Clicking your joints causes arthritis. As far as we know, the click when extending a joint is associated only with the vacuum effect and nothing more.

Myth N3

Physical exercise causes joint pain. Exercise is beneficial for both people with arthritis and healthy people. Only if you have pain, you should forget about intense exercise and limit yourself to light gymnastics or exercise on exercise bikes and swimming. It must be remembered that the more a person moves throughout his life, the better. For joints, exercises help maintain range of motion. We must remember the motto “what doesn’t work, perishes.”

Myth N4

It is impossible to stop the process of destruction of joints due to arthritis. Modern drugs (NSAIDs, steroids, antirheumatic drugs) can reduce inflammation, relieve pain and, thus, inhibit destructive processes in the joint. When patients refused treatment for joints, irreversible, pronounced changes in the joints were noted, and, sometimes, in a very short period of time (3-6 months). Therefore, it is better to listen to the advice of your doctor - this will help maintain your quality of life.

Fact N1

Patients with arthritis are weather sensitive. They do not tolerate wet weather well and thrive in dry, clear weather. This is due to the sensitivity of these patients to atmospheric pressure.

Fact N2

Diet may be a factor in preventing arthritis. Yes and no. As you gain weight, your risk of osteoarthritis increases, especially affecting the hips and knees. But for other forms of arthritis, the effectiveness of the diet is not so obvious.

General clinical recommendations

Persons who have had acute infectious arthritis or suffer from chronic infectious arthritis must:

• lead an active healthy lifestyle, quit smoking and alcohol abuse;
• eat properly and fully;
• exclude heavy physical activity and injuries;
• engage in therapeutic exercises, swimming and feasible sports;
• treat infections promptly;
• carry out doctor's orders; in the chronic course of the disease, conduct courses of anti-relapse treatment.

Prevention

Infectious arthritis can be prevented by doing hardening, sports without heavy physical activity, eating right and treating all infections in a timely manner.

We combine proven techniques of the East and innovative methods of Western medicine.
Read more about our unique method of treating arthritis

Arthritis

It is a misconception that arthritis only affects older people. These diseases occur in any age group. Arthritis is a disease characterized by inflammation of the joints and affects both children and adults. The typical manifestation of arthritis is pain and stiffness in the joints, which limits movement and sometimes these symptoms are resistant to treatment. Often, it is possible to achieve a therapeutic effect with the help of exercise, medication and lifestyle changes. About 46 million adults in the United States have been diagnosed with a form of arthritis, and that number is trending upward. But arthritis did not appear today and has been bothering people for hundreds of years (typical changes in bone structures discovered during excavations indicate this). It’s just that over the past 100 years there has been a sharp increase in the diagnosis of diseases of the musculoskeletal system and the immune system. Scientists have identified at least 100 types of arthritis and, as it turns out, many conditions accompanied by fever and a malfunction of the immune system are somehow related to the joints.

Arthritis is characterized by pain, stiffness and swelling in the joints, as well as a decrease in the range of movement in them. There are various forms of arthritis, incl. secondary (gout, SLE, fibromyalgia). Arthritis can be divided into three groups:

• Osteoarthritis. Also called degenerative joint disease, it is the most commonly diagnosed form of arthritis. Osteoarthritis occurs when the process of disintegration of cartilage tissue in joints begins. This form of arthritis most often affects the hip, knee, ankle and shoulder joints. It most often develops over the age of 40 years.
• Rheumatoid arthritis. This type of arthritis occurs when the surfaces lining a joint are damaged, causing pain and inflammation. Small joints (feet, fingers) are most often affected. Rheumatoid arthritis is an autoimmune disease that typically develops in women between the ages of 30 and 50.
• Juvenile arthritis. This group includes all arthritis that develops before the age of 18 years. It is not clear what causes the development of arthritis at a young age, but JA occurs more often in girls than in boys. Juvenile arthritis can involve various joints (ankle, knee, hip, shoulder, wrist). There are many types of juvenile arthritis, but juvenile rheumatoid arthritis is the most common.

Diagnosis of arthritis

As soon as symptoms of arthritis appear, namely joint pain, you should consult a doctor. A number of diagnostic tests may be required for diagnosis:

• A physical examination that allows you to see the presence of swelling of the joint, pain on palpation, and limited mobility in the joint.
• Determining the intensity of pain and nature.
• Blood tests - general, blood fractions, rheumatic tests, presence of antibodies, etc.
• X-ray examination of the affected joint
• MRI or CT of the joint
• Densitometry
• Ultrasound of the joint
• Arthroscopy (a procedure in which an endoscope equipped with a video camera is inserted into the joint cavity in order to visualize the pathology)
• Joint puncture with laboratory testing of punctate

Not all tests can be used for diagnosis, but only a combination that allows for the most accurate diagnosis. If test results are positive, you may need to consult a rheumatologist.

Given that arthritis is different, diagnosis will require a different amount of research and different time. For example, diagnosing osteoarthritis is straightforward, whereas diagnosing rheumatoid arthritis requires imaging and blood tests, and only a combination of tests can make the diagnosis (similar to putting together a puzzle). For other joint lesions, additional research methods may be required. For example, psoriatic arthritis, as a complication of a disease called psoriasis, or reactive arthritis, which accompanies infectious diseases. In some cases, the underlying disease dominates the clinical picture and interferes with the diagnosis of arthritis. For example, with polymyalgia rheumatica or with ankylosing spondylitis (ankylosing spondylitis).

Frequently asked questions about the disease

What is the difference between infectious and reactive arthritis?

An infectious inflammatory process develops when an infection enters a joint, and a reactive inflammatory process develops against the background of some kind of general infection in the absence of a pathogen in the joint cavity. Read more about reactive arthritis in this article.

Which doctor treats you?

Nonspecific infectious processes - a surgeon or traumatologist, specific ones - a surgeon and another specialist - an infectious disease specialist, a dermatovenerologist, a phthisiatrician. When transitioning to a chronic course, a rheumatologist.

What is the prognosis for treatment of infectious arthritis?

Depends on the infection that caused the disease. Most acute arthritis ends in recovery. The outcome of specific infections depends on the course of the underlying disease: viral arthritis ends in complete recovery, while tuberculosis arthritis does not always have a favorable outcome.

Infectious arthritis can be severe with unpredictable consequences. Therefore, it is very important to treat it promptly and correctly. They know how to do this.

Bibliography:

1. Belov B. S. // Bacterial (septic) arthritis and infection of the prosthetic joint: modern aspects. — [b.m.]: Modern rheumatology., 2010.
2. Parvizi J Jacovides C, Antoci V, et all, // Diagnosis of periprosthetic joint infection:. — [b.m.]: J Bone Joint Surg AM, 2012..
3. Isaacs J. Oxford textbook of rheumatology. – Oxford University Press, 2013.
4. Slobodin G. et al. Acute sacroiliitis //Clinical rheumatology. – 2021. – T. 35. – No. 4. – pp. 851-856.

Themes

Arthritis, Joints, Pain, Treatment without surgery Date of publication: 03/04/2021 Date of update: 03/15/2021

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Treatment of arthritis

Has undergone great changes recently. At one time, treatment for arthritis consisted of prescribing aspirin, thermal procedures, and immobilization of damaged joints using various orthopedic orthoses. It turned out that immobilization, supposedly to relieve pain, does more harm than good. Currently, joints are given less time to rest and constant mobility in them is the key to preserving its functions. Current treatment for osteoarthritis consists of a combination of exercise, physical therapy, medications, intra-articular injections and weight loss. There is an obvious connection between excess weight and damage to large joints (knees, hips). And weight loss is very beneficial in these cases.

There has also been progress in the treatment of rheumatoid arthritis. In the mid-20th century, prednisolone was first used and the first results of treatment were very encouraging. But it turned out that steroids have no less side effects than therapeutic ones. Certain hopes are associated with the recently discovered selective immunosuppressants Adalimumab (Humira) and others. Time will tell their effectiveness.

Drug treatment

Currently, there is a whole group of drugs: aspirin, indomethacin, ibuprofen, naproxen, COX-2 inhibitors (Celebrex), steroids, tramatodol, methotrexate, penicillamine, various creams and gels, chondroitin sulfate.

All medications have, to one degree or another, a number of side effects and their prescription, dosage and duration are the exclusive prerogative of the doctor.

Physiotherapy. Modern physiotherapeutic techniques help in some cases to reduce swelling in the joint, increase mobility, and reduce pain. But sometimes even long courses of physiotherapy do not produce an effect.

Physical exercise

Patients with joint pain try to avoid physical exercise so as not to injure them. And it would seem that such types of activity as long walking, bicycle ergometry or treadmill exercise are the lot of only healthy people. But reasonable loads with a gradual increase in the volume of exercises performed have a very beneficial effect on patients with arthritis. Along with medications and orthoses, physical exercise helps improve the following parameters: reduce joint stiffness and pain, increase the elasticity of muscles and ligaments of the joint, improve blood supply to cartilage tissue, improve overall well-being (sleep, mood), and reduce weight.

Naturally, not every exercise is suitable for patients with arthritis. And even the selected exercise does not always work. Exercises for arthritis are a type of various gymnastics (yoga, qi gong) and physical activity (swimming, walking, cycling). Depending on the presence of pain, the intensity of the load may change, but not stop.

Secondary joint pain:

Tendinitis

inflammation of the ligaments and tendons of the legs. The joints of the legs are fixed by a large number of ligaments and tendons, so with tendinitis, both the ligaments and the joints themselves hurt. Typically, pain appears when moving and pressing on the tendon, accompanied by redness and increased temperature of the skin. With tendinitis, the strength of the tendons decreases, which causes the mobility of the legs to be impaired, and painful tendon ruptures and joint dislocations can occur.

Diseases of the lumbosacral spine

The sciatic nerve, which is responsible for the sensitivity of the legs, is attached to the sacral spine, so diseases of the sacrum and lower back cause pain in the legs. The appearance and mobility of the joints remain normal, but pain occurs simultaneously in all joints, more intense in the hip and weaker in the joints of the feet. Pain in diseases of the spine is constant, does not subside during rest and intensifies with prolonged sitting. In this case, there are sensations of numbness and “goosebumps” on the skin, coldness of the limb, a feeling of weakness and heaviness in the legs.