Joint pain (arthralgia)

Arthralgia - joint pain

joint pain(arthralgia) can occur in a single joint or in several joints simultaneously (polyarthralgia). Arthralgias are seen in rheumatic, endocrine, infectious, tumor, neurological, autoimmune diseases, injuries, overweight. Discovering the causes of joint pain has an important differential diagnostic significance; performed by means of X-rays, ultrasound, laboratory, invasive methods (arthrocentesis, arthroscopy). Treatment of arthralgia is reduced to treating the condition that caused it. Symptomatic measures (analgesics, local heat, ointments), immobilization, physiotherapy, surgical interventions are applied.


Arthralgias differ in location and depth, number of joints involved, nature and intensity of the pain syndrome, its daily rhythm, duration of existence, connection with a certain type of movement. In the presence of pain in a single joint, they speak of monoarthralgia, with simultaneous or sequential pain syndrome in several joints - about oligoarthralgia, with involvement of 5 or more joints - about polyarthralgia syndrome.

According to the nature of the arthralgia syndrome, sharp and uncomfortable pains are distinguished; by intensity - from weak and moderate to intense; according to the type of flow - transient and constant. More often, arthralgia occurs in large joints - hip, knee, shoulder and elbow, less often in medium and small - wrist, ankle, interphalangeal.

The occurrence of joint pain is promoted by irritation of the neuroreceptors of the synovial membranes of the joint capsules with inflammatory mediators, products of immune reactions, salt crystals, toxins, osteophytes. In rheumatology, it is customary to distinguish the following types of joint pain:

  • caused by toxic syndrome in acute infections;
  • primary episode or intermittent (intermittent) arthralgia in acute or recurrent arthritis;
  • long-term monoarthralgia of large joints;
  • oligo or polyarthralgia syndrome accompanying synovial membrane involvement or progressive degenerative-dystrophic changes in cartilage;
  • post-inflammatory or post-traumatic residual arthralgia in joints;
  • pseudarthralgia.

Why do joints hurt?

common infectious diseases

Arthralgia syndrome often accompanies the course of acute infections. Joint pain can be observed both in the prodromal period of the disease and in the initial clinical stage, occurring with fever and intoxication. The infectious form of arthralgia is characterized by "pain" in the joints of the lower and upper extremities, the polyarticular nature of the pain, and its association with myalgia. Mobility in the joint is completely preserved. Typically, infectious arthralgia resolves within a few days as the toxic syndrome caused by the underlying disease weakens.

infectious arthritis

Possible options for the development of post-infectious reactive arthralgia after acute intestinal or urogenital infections; parainfectious arthralgia syndrome caused by tuberculosis, infective endocarditis, secondary syphilis. Often, the cause of joint pain is foci of existing chronic infection - pyelonephritis, cholangitis, adnexitis, paratonsillar abscess or parasitic invasion.

Residual arthralgia after joint inflammation is chronic or transient. Joint pain and stiffness may persist for weeks or months; in the future, the well-being and functions of the members are fully restored. In the chronic form of arthralgia, its exacerbations are associated with overload, weather lability and hypothermia.

Knee joint pain can be a symptom of rheumatic diseases

rheumatic diseases

Joint pain of the poly or ologarthralgia type is the main symptom of inflammatory rheumatic diseases. Rheumatic arthralgia is characterized by a syndrome of constant, intense and migratory pain, involvement of large joints, mainly of the lower extremities, limitation of movement in the joints.

The onset of rheumatoid arthritis, as well as systemic rheumatic diseases, is manifested by the polyarticular syndrome, which affects small symmetrical joints of the feet and hands, motor stiffness in the morning.

In microcrystalline gouty arthritis, arthralgia manifests as recurrent paroxysmal pain in an isolated joint, which, appearing suddenly, rapidly peaks in intensity and does not go away for several days.

degenerative joint injuries

Gradual increase in joint pain over a long time may indicate osteoarthritis deformans and other degenerative-dystrophic injuries. In this case, knee or hip joint involvement is typical; type of dull, aching, exercise-related pain that disappears at rest. Arthralgia can be weather dependent, accompanied by a "crushing" of the joints during movement, weakening when using local distraction therapy.

joint injuries

Contusions, joint dislocations, damage to the ligament apparatus, intra-articular fractures are accompanied by intense pain. The affected joint becomes swollen, deformed, hot to the touch. The supporting function of the lower limb is impaired, movement in the joint becomes difficult, and pathological mobility sometimes occurs. Lesions may be accompanied by hemorrhage in the joint cavity, which leads to its stiffness.

oncological diseases

Oligo and long-lasting persistent polyarthralgia, accompanied by the formation of "Hippocratic fingers" (deformities of the nails and distal phalanges such as "watch glass" and "drumsticks"), indicate a paraneoplastic lesion of the synovial membranes. In these patients, oncologic pathology of internal organs, especially lung cancer, should be suspected.

endocrine diseases

Common causes of joint pain are endocrine disorders - primary hyperparathyroidism, ovariogenic dysfunctions, hypothyroidism, obesity. The joint syndrome of endocrine genesis proceeds in the form of oligoarthralgia associated with ossalgia, myalgia, pain in the pelvic bones and spine.

other reasons

Other possible causes of arthralgia include:

  • intoxication with heavy metals (thallium, beryllium);
  • frequent overload or microtrauma of the joints;
  • long-term drug therapy;
  • post-allergic reactions;
  • flat foot;
  • Deformation of the members in an X or O shape;
  • pseudarthralgia, simulated by primary ossalgia, neuralgia, myalgia, vascular pathology, psychosomatic disorders.


As joint pain is only a subjective symptom, clinical, anamnestic and physical examination characteristics come to the fore in determining the causes of its occurrence. It is necessary to consult a rheumatologist, orthopedist. To differentiate the etiology of arthralgia, several objective studies are performed:

  • X-ray of the joints.It is a routine method that allows you to examine all joints in various diseases. Most often, radiography is performed in one or 2 projections, it is also possible to study in a special style, perform contrast arthrography. A more detailed picture of the state of the osteochondral and soft tissues of the joints is available with CT and MR images.
  • Joint ultrasound.It allows to detect effusion in the joint cavity, bone erosion, changes in the synovial membrane, measure the width of joint spaces. The availability of ultrasound makes it indispensable for the diagnosis of rheumatic joint pathologies.
  • invasive methods.According to the indications, a joint puncture, a biopsy of the synovial membrane is performed. In debatable cases, diagnostic arthroscopy is performed, which allows examining the joint cavity from the inside, in order to carry out diagnostic and therapeutic measures.
  • Laboratory tests.Helps identify the presence of an inflammatory process,rheumatic diseases. In peripheral blood, ESR, C-reactive protein level, uric acid, specific immunopathology markers (rheumatoid factor, antinuclear antibodies, ACCP) are determined. An important diagnostic method is the microbiological and cytological examination of the synovial fluid.
  • Additional diagnostic methods:thermography, podography.
Joint plasmolifting - the introduction of the patient's plasma into the joint cavity with arthralgia


Help before diagnosis

For any joint pain, it is necessary to remain calm and not strain the limb. The metabolic causes of arthralgia dictate the need for a balanced diet, normalization of weight. With recent injuries, it is necessary to apply cold to the joint, immobilize the injured limb with a splint or fixation dressing. You can take pain relievers or NSAIDs.

The neglect of competent examination and treatment of arthralgia is fraught with the development of irreversible functional disorders of the joints - stiffness, ankylosis, contracture. As joint pain can serve as a marker for a variety of conditions, it is necessary to see a doctor if joint syndrome occurs and persists for more than 2 days.

Conservative therapy

In the treatment of joint pain, the main role is given to the treatment of the main pathology. Drug treatment of arthralgia aims to stop intra-articular inflammatory processes and pain. Systemic therapy includes the use of non-steroidal anti-inflammatory drugs.

With moderate arthralgia or the presence of contraindications to oral drug administration, local external therapy is performed with warming, anti-inflammatory and analgesic ointments. Applications with dimethylsulfoxide are applied to the joint area. Joint gymnastics, physiotherapy procedures (drug electrophoresis, magnetotherapy, phonophoresis, UHF therapy) are recommended.

If necessary, periarticular blocks, intra-articular injections of glucocorticoids, chondroprotectors, synovial fluid prostheses are performed. Promising modern methods of therapy for chronic joint pathologies are ozone therapy, joint plasmolifting, and orthocin therapy.


Various types of surgical interventions are justified by joint pain caused by injuries, as well as by chronic diseases that lead to loss of joint function. They can be performed by open (arthrotomy) or endoscopic (arthroscopy) methods. Depending on the causative disease, the following is carried out:

  • arthroplasty;
  • arthrodesis;
  • plastic binding;
  • joint cavity rehabilitation;
  • removal of pathological formations (cysts, intra-articular bodies);
  • synovectomy;
  • joint arthroplasty.