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

Do your joints hurt? There is a risk of developing a disease such as arthralgia.

Arthralgia

– this is a set of painful sensations that arise due to predominantly organic damage to the joints. The presence of pain syndromes can be a harbinger of joint diseases, including the initial stages of arthrosis and arthritis.

Arthralgia is characterized by pain in the joints

Arthralgia syndrome - what is it?

Arthralgia

– these are pain sensations that can occur in one or several joints of the human musculoskeletal system. The disease is secondary and can be observed in diseases of infectious or autoimmune origin, as well as in the presence of excess body weight.

Joint pain is predominantly “volatile” in nature and usually appears unexpectedly and suddenly.

Painful sensations during arthralgia can occur without the influence of external irritating factors, which usually include increased loads and stress.

An attack of pain can last several minutes, or can last up to several hours. Everything is individual and depends solely on the area of ​​progression of organic damage to the joint, as well as the pain threshold and, of course, the general health of the patient.

Often the pain goes away without the use of medications, however, there are cases when the use of analgesics is required.

The manifestation of the syndrome is distinguished according to factors such as:

• location;
• number of lesions;
• intensity and nature of pain;
• duration of pain;
• rhythmicity of discomfort.

Prevention

No one is one hundred percent protected, so prevention will not be unnecessary for anyone. It is important to always keep your body in good shape and give it moderate physical activity - do morning exercises, take breaks at work, try to walk more in the fresh air, spend less time sitting.

When walking, you not only warm up most of the muscles in the body, but also saturate it with oxygen, which is necessary for normal blood circulation and absorption of substances in the body. If possible, go swimming, jogging, and take mineral and mud baths. In summer, spend more time by the sea, go to a sanatorium.

Pay attention to your diet. Eliminate all foods harmful to the body, add vitamins and minerals. Eat healthy, easy-to-digest foods. It is very important for bones and joints to fill the body with calcium, so consume more dairy products.

Elena Belenko in the program “Doctor I” on TVC. Myalgia

Classification of arthralgia

Key challenge in the treatment of arthralgia

lies in the difficulties of diagnosing it, which is due to the large number of variations in its manifestation and clinical picture.

According to known data, arthralgia is divided into several classifications:

• infectious type

  – the occurrence is provoked by general intoxication;

• intermittent

  – accompanied by acute and recurrent arthritis;

• long lasting

  – characteristic of exceptionally large joints (arthralgia of the knee or hip joint);

• oligo- or polyarthralgia

  – the causes are inflammation of the joint, as well as destruction of cartilage tissue;

• post-traumatic

  – appears as a residual manifestation of inflammation;

• false

  .

It is important to note that each type is accompanied by a certain type of pain.

Arthralgia in children

Arthralgia in a child can be caused by age-related changes.
Sometimes arthralgia of the knee joint develops in children. This is due to the active growth of the student, so the process is considered natural. However, the syndrome may indicate diseases:

• malignant tumor;
• osteomyelitis;
• muscle inflammation;
• Osgood-Schlatter disease.

If your child complains of knee pain, contact a specialist and conduct a full examination. Without the necessary treatment, damage to joint tissues and destruction of the structure of the knees are possible. Take care to prevent such consequences.

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.

Treatment of the disease

Arthralgia is a disease that requires serious diagnosis and a long course of treatment. If the first syndromes do not go away within three days from the moment of the first manifestation, you should immediately contact a rheumatologist.

Drug therapy

The goal of drug treatment is to eliminate or correct the symptoms of arthralgia that were detected as a result of diagnosis. For these purposes, analgesic and anti-inflammatory medications such as Paracetamol or Aspirin are used.

In some cases, physical therapy may have to be used. It may include magnetic therapy, laser therapy, and heat treatment. In addition, compresses and ointments are used (Ketonal, Neuralgin, Finalgon, etc.).

Arthralgia in children has a slightly different character. Most of the drugs are contraindicated for children, so therapy is prescribed individually depending on the age and degree of the disease. Most often this is physical therapy, as well as simple normalization of the daily routine and an appropriate diet. However, in more acute forms, anti-inflammatory drugs are used only in extreme cases. If you start treatment on time, you can rid your child of the disease within 2-3 weeks.

ethnoscience

The first thing worth noting is that folk remedies are not aimed at eliminating arthralgia, but only at combating its symptoms and generally strengthening the body. Therefore, first of all, you need to consult a doctor and, with his permission, resort to using traditional methods.

One of the famous recipes is tincture of birch buds. For half a liter of boiling water you need to add two tablespoons of birch buds and let it brew for at least two hours. You should take this tincture half a glass twice a day.

Remember that it is not recommended to self-medicate without consulting a doctor, so as not to aggravate your condition and prevent the disease from developing quietly. This is especially important if we are talking about a child; you should not put him in danger - carry out treatment only as directed by a doctor.

Causes of arthralgia

Timely and competent identification of the causes of the disease is the basis for differential diagnosis of an existing health problem.

With the development of arthralgia it is quite difficult, one might say that it is almost impossible to notice visible changes on X-ray images. In addition, there are no symptoms of joint disease as such, including: swelling and crunching when moving.

Symptoms of arthralgia

is caused solely by irritation of the neuroreceptors of the joint capsule, which can be caused by such reasons as:

• joint damage of organic origin;
• development of the initial stage of arthrosis/arthritis;
• weakening of the immune system;
• severe allergic reaction;
• infectious lesion;
• tumor formations.

What causes arthralgia

Causes of joint pain syndrome:

1. Gonarthrosis or deforming osteoarthritis of the knee. It is characterized by dystrophic changes in the joint, cartilage and bone, as a result of which the functionality of the limb is significantly reduced. In its advanced form it causes severe pain and leads to disability.
2. Reactive arthritis or Reiter's disease is an inflammatory disease that affects the joints. It worsens after infections of the nasopharynx, intestines or genitourinary system.
3. Potentially dangerous medications. These medications are taken under the strict supervision of a doctor. After completing the course, the side effects disappear.
4. Reactive arthralgia is a symptom of a general disease. Often the symptom is associated with a chronic infectious process that develops in a sluggish form. No special treatment is carried out, since the underlying disease needs to be eliminated.
5. Gouty affection of the knees. Usually affects small vessels of the legs, in rare cases it affects large joints. Gout is caused by metabolic disorders, accumulation of urate, and stagnation of uric acid in the body.

Arthralgia is associated with inflammation and diseases of the knee joints that have not yet manifested themselves. A thorough examination is necessary to make a correct diagnosis.

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.

Diagnosis of arthralgia

If you experience systematic pain localized in any area of ​​the musculoskeletal system, you should immediately seek medical help, the first stage of which is diagnosis.

Primary diagnosis is performed by a wide-spectrum specialist - a therapist, who determines the intensity of symptoms, collects the patient's medical history and refers to a specialized specialist.

The next stages of diagnostic examination are carried out by a rheumatologist. A set of certain knowledge, experience, as well as the availability of specialized equipment and the availability of various types of diagnostic methods allows you to accurately make a diagnosis, prescribe the correct treatment and monitor the effectiveness of the treatment method.

To differentiate the etiology of the disease, a number of objective studies are required, which include laboratory diagnostics (blood tests, biochemical tests). In addition, the following methods are used as clarifying methods:

• CT/MRI;
• research using ultrasound therapy.

Treatment of arthralgia

The entire process of treating arthralgia comes down to eliminating the disease that provokes the development of arthralgia syndrome. The treatment plan depends entirely on the existing concomitant diseases.

In the treatment of arthralgia, various methods can be used, in particular, medicinal and non-medicinal. Let's look at each of them in more detail.

Treatment of arthralgia is carried out using different methods

Treatment of arthralgia with medication

The treatment process is closely related to the severity of the symptoms of the disease.

So, in a situation where mild but sharp pain occurs, specialists choose treatment with medications and the use of various forms of drugs, a special place among which is occupied by analgesics.

Pronounced and at the same time long-lasting pain requires more serious measures and is eliminated exclusively by the injection method, using painkillers.

By studying the degree of effectiveness of the medications used, we can identify several groups of medications with the greatest therapeutic effectiveness. Among them:

• NSAIDs

  – non-steroidal anti-inflammatory drugs in tablets or rectal suppositories;

• applications and compresses

  ;

• ointments with local anesthetic or warming effect

  .

In addition, chondroprotectors are an excellent assistant in the regeneration of damaged tissues, among which the drug “Artracam”

.

Non-drug treatment for arthralgia

Physiotherapeutic procedures are considered one of the most popular non-drug treatment methods.

. Despite the fact that the use of methods of this kind is not justified in all cases, under the careful supervision of the attending physician, measures can be beneficial with an integrated approach to the treatment of diverse diseases.

Physiotherapeutic measures are prescribed taking into account the medical history of each individual patient and are regulated by an established treatment plan. It is important to note that physiotherapy is contraindicated in autoimmune pathologies, but in a situation where dystrophic processes are observed (especially caused by dystrophic processes), treatment should be started as soon as possible.

Among the most effective methods of physiotherapeutic treatment

highlight:

• electrophoresis;
• exposure to a magnetic field;
• UHF therapy;
• laser exposure;
• balneological treatment;
• paraffin therapy;
• use of therapeutic mud.

Surgical intervention

Joint pain may be an indication for various types of surgery. The basis for surgical intervention may be previous injuries or the presence of chronic diseases.

Operations can be carried out using two methods:

• open;
• using endoscopic equipment.
• Taking into account the existing symptoms, as well as the causes of pain, the following operations can be performed:
• arthroplasty, plastic surgery of the ligaments of the joint;
• removal of pathological formations;
• joint endoprosthetics.

The International Statistical Classification of Diseases and Problems, 10th revision (ICD-10), currently in use, is a normative document that ensures the formation of unified statistical control over the activities of medical institutions, assessment of the epidemiological situation in the country, and allows for the unity and comparability of incoming medical data [1] . ICD-10 is one of the important methodological tools for processing statistical data, which is extremely necessary for automating basic planning, regulatory and management work [2]. Unfortunately, this classification contains errors, both in the structural design of clinical sections and in the coding of a number of diseases. Some of the diagnoses that exist in it sound somewhat absurd; there is a confusion of placement of individual polyetiological diseases and syndromes in sections, which are often located in chapters that have a very indirect relationship to this nosology. In addition, many nosological forms, syndromes and symptoms that are currently common are not included in the accepted classification, which undoubtedly significantly limits the practical application of ICD-10.

The variety of different forms of diseases complicates the structure of the classification, so the latest revision has become much larger in volume and was accompanied by extensive guidelines, unfortunately, often without taking into account clinical practice. As a result, some of the clinical diagnoses ended up within the limits of unrefined conditions or conditions that were not sufficiently differentiated, and not in the headings or subheadings of the corresponding sections of the classification.

A number of difficulties arise with regard to the topographic classifications and terms used in ICD-10, many of which are imprecise, contradictory and do not correspond to clinical practice. Unfortunately, it should be noted that ICD-10 cannot currently be recommended as a model for terminology and recording of clinical diagnoses in medical records and other medical records.

To solve the problem of uniform standardization of medical diagnoses and statistical records, back in the late 70s of the last century, the idea arose of creating a “family” of classifications of diseases and health problems based on the ICD, adapted to a specific specialty, taking into account modern achievements of medical science.

Classification options for dentists, oncologists, dermatologists, rheumatologists and orthopedists, pediatricians, psychiatrists, and general practitioners have been published and recommended by WHO. Unfortunately, in the field of andrology there is still no unified classification [2].

Currently, the Research Institute of Urology is developing printed and electronic versions of a similar classification for urology and andrology, which is based on three-digit and four-digit ICD-10 codes. The coding system for urological and andrological diseases is presented in the form of a tree, where each subnode refines the information of the previous node. When forming a subnode, a number from zero to nine is added to the main code through a dot. The proposed system also provides for taking into account the localization of the pathological process, its stage and/or phase [3-5].

The creation of a printed and electronic version of a new unified clinical and statistical classification of andrological diseases will allow:

• facilitate data collection and improve the analysis of statistical material on andrology by increasing the reliability of statistical information and reducing the number of errors due to inconsistency of clinical diagnoses with ICD-10 diagnoses;
• provide a detailed assessment of the complexity of clinical cases and final treatment results when providing specialized (including high-tech) medical care;
• standardize the formulation of andrological diagnoses in medical documents and computer information systems of health authorities of the Russian Federation;
• improve the economic and statistical analysis of the provision of medical care in the field of andrology in the interests of healthcare of the Russian Federation, individual medical institutions and compulsory health insurance (CHI);
• optimize costs for diagnosis and treatment of andrological diseases.

It should be taken into account that andrological diseases, as a rule, are multi-etiological and many of them do not fit only into the framework of the block “Diseases of the male genital organs”. The modern concept of andrology is, of course, based on interdisciplinary interaction and is at the intersection of related medical disciplines (urology, endocrinology, psychiatry, genetics, neurology, therapy, etc.). Therefore, andrological diseases are heterogeneous in nature and are widely represented in different sections of ICD-10 (Table 1).

Table 1. General classification of andrological diseases according to ICD-10 and proposals for its correction

This summary table shows those symptoms, syndromes and nosological forms according to ICD10 that a practicing specialist in the field of andrology encounters in real practice. At the same time, in our opinion, some of them no longer correspond to the modern understanding of pathophysiological processes and require terminological and classification clarification (right column).

Naturally, the above classification needs to be supplemented and refined, and fundamental amendments be made taking into account interdisciplinary interaction. With our publication, we would like to provoke a discussion among specialists in the field of andrology, the main goal of which would be to create a single, integral classification of andrological diseases. This is undoubtedly valuable and convenient for medical practitioners, health authorities, scientific research, and insurance companies. We will be grateful for your comments and remarks, which can be sent to the email address

Key words: ICD-10, andrological diseases, clinical and statistical classification.

Keywords : ICD-10, andrology diseases, clinical and statistical classification.

Literature

1. International classification of diseases and related health problems. WHO, 1992
2. Order of the Ministry of Health of the Russian Federation dated May 27, 1997 No. 170 (as amended on January 12, 1998) “On the transition of health authorities and institutions of the Russian Federation to the international statistical classification of diseases and health-related problems of the X revision.”
3. Sivkov A.V., Kakorina E.P., Keshishev N.G. Unified clinical and statistical classification of urological diagnoses // Materials of the XI Congress of Urologists of Russia. M. 2007. pp. 598-599.
4. Unified clinical and statistical classification of urolithiasis / Apolikhin O.I., Dzeranov N.K., Sivkov A.V., Kakorina E.P., Keshishev N.G. // Urology. 2008. No. 6. P. 3-6.
5. On the creation of a unified clinical and statistical classification of oncological urological diseases using the example of kidney tumors / Apolikhin O.I., Sivkov A.V., Chernyshev Yu.V., Kakorina E.P., Keshishev N.G., Zhernov A.A. // Experimental and clinical urology. 2010. No. 1. pp. 23-28.