Joint pain can range from mild to very severe. The intensity and character of joint pain depend on its cause. Besides pain, a common symptom of a diseased joint is mild swelling and redness, and limited joint mobility. In order to start with the treatment to eliminate the pain, it is first necessary to diagnose or determine the cause of the pain.

THE PURPOSE AND THE TYPES OF JOINTS

Joint is a connection between two bones allowing a different range of movements. Some joints, such as the shoulder, allow greater mobility, internal and external rotation and moving forward, back and aside. Other joints such as the elbow and toes of the arms and legs can only bend (flexion) and stretch (extension). Other joints provide stability and reduce the chance of damaging the structures due to long-term use.
The joint is made up of connective tissue that includes articular surface, joint capsule and other important components for the function of the joint are the ligaments, tendons, and muscles, as they all allow stability and movement of the human skeleton. The joints allow for the optimal distribution of mechanical stress and reduce friction during movement.

There are three different types of joints:

1. Synovial joints (diarthrosis) allow the joint to move freely. They have a synovial membrane that secretes synovial fluid.

2. Cartilaginous joints (amphiarthroses) separate adjacent bones with articular cartilage or cartilaginous disc and are joined together by solid ligaments, allowing very small movements (eg, the intervertebral disc between two vertebrae).

3. Fibrous joints (synarthrodial) – skull bones are an example where thin binding tissue divides the bones that have no movement.

MOST COMMON CAUSES OF JOINT PAIN

OSTEOARTHRITIS

Also known as osteoarthrosis or arthrosis, this is a chronic degenerative joint disease and after cardiovascular disease the second most common cause of physical disability. It is mainly caused by joint cartilage decay. Although osteoarthritis mainly affects the elderly, it can also occur at a younger age. Risk factors for developing osteoarthritis are overweight (enhances mechanical stress on articular cartilage), activities (too many repetitive movements due to a particular sport), genetics, hormones and injuries. Symptoms include thickening or deformation of the joint and limited movement and pain. Due to the severity of the disease, it is essential to act preventively before the onset of the disease and the treatment involves self- education, physical therapies, medication and surgery.

PSORIATIC ARTHRITIS

is a chronic condition, which means it never goes away, but it can be controlled using medication and changing the lifestyle. It is a form of arthritis that affects people with psoriasis, and the diagnosis is not always easy to make as it’s often considered as rheumatoid arthritis. Symptoms are pain and stiffness due to inflammation that occurs in the morning or after a break, but the symptoms can last all day. The joints can be swollen and warm to the touch.
It can usually occur on the Achilles tendon grip and plantar fascia of the foot, and 35% of patients with psoriatic arthritis may have thickening of the fingers, so- called “Sausage toes or dactylitis”. One of the common symptoms is recurrent inflammation of the anterior eye. It is usually treated with non-steroidal antirheumatic drugs, and in worse cases, biological drugs are also used.

RHEUMATOID ARTHRITIS

is a chronic inflammatory disease of the connective tissue (the immune system attacks the cartilage tissue), most commonly affecting the small joints of the hands, wrists, shoulders, knees and ankles. It usually affects the small joints on the arms and wrist on both sides of the body. The causes of rheumatoid arthritis are unknown but as it is an autoimmune disease, the family factor and infections (viral and bacterial) are taken as the trigger.
It affects more often women and older people. A characteristic symptom of rheumatoid arthritis is morning stiffness, which lasts at least half an hour. Swelling and joint pain last at least six weeks before it is diagnosed. 20% of patients may notice hard bumps or lumps, the size of a pie, and over time, rheumatoid arthritis can affect the internal organs. It is treated, that is, kept under control using medicines and changing the lifestyle.

LUPUS

is an autoimmune disease causing the joint pain with 90% of patients. In addition to the joints, the disease can affect the skin, kidneys, lungs, nervous system and is characterized by active and withdrawal stages. Lupus affects mainly women of reproductive age, caused by gene factors and external factors. Symptoms can vary from mild to severe with fatal outcome.
Symptoms include general weakness and fever. Early symptoms of the disease affect all joints resulting in swelling, limited mobility, and even clinical symptoms of arthritis can occur. Symptoms not only affect skin and internal organ but can lead to depression. The physician must make the decision about the therapy carefully, and besides medication it is necessary to change the lifestyle that includes light physical activity, proper nutrition, preventing the infections, and avoiding sun exposure.

GOUT

is joint inflammation (one type of arthritis) caused when uric acid starts forming the crystals in the joints (in connective tissue, cartilage, tendons). Symptoms are sudden attacks of severe pain, redness and swelling of the joints. The disease usually begins with severe pain, redness and swelling of the thumb. The pain is so strong that even the weight of the bedsheet can be painful.
Redness and pain can spread to the ankle and lower leg causing limited movement. It most commonly affects men between the ages of 40 and 50 and women in menopause. The cause is the genetic factor and the excessive consumption of protein-rich foods. It is treated with anti-inflammatory drugs, and the most important thing is to change the eating habits and achieve optimal weight.

LYME DISEASE

joint pain is one of the many possible symptoms of Lyme disease. The initial symptom is specific redness (erythema migrans), which usually appears after incubation a week or two after the tick bite. From the initial erythema, Borrelia, a genus of bacteria, can expand to other tissues by lymphatic or bloodstream, thus affecting the skin, muscles, nervous system and heart.
The disease usually affects only one or two joints, and the symptoms become less frequent and less severe as time goes by. If you think you have Lyme disease, it is important to get early diagnosis and treatment, as well as ongoing medical care. When spending time in nature, it is necessary to protect yourself with repellents and suitable clothing (long pants and sleeves), and in the case of redness, consult a doctor immediately.

HYPOTHUROIDISM

comes as a result of the underactive thyroid gland. This is more common in women (especially those over 50) and the risk is higher if there is a family history of the disease, if the person smokes or has Hashimoto’s thyroiditis. In some patients, joint pain and numbness, carpal tunnel syndrome, or swelling in certain joints may occur.
Best therapy to treat hypothyroidism is using thyroid replacement hormones. Painkillers can be helpful as well as a lifestyle change that involves more exercise and a healthy diet and avoiding gluten.

FIBROMYALGIA

is a disorder that causes chronic pain in muscle and connective fibrous tissue, and affects about 3% of the population. Women are more likely to develop this disorder and in 1992. it was recognized as a true illness by WHO. Common symptoms are fatigue, muscle pain and joint pain.
Pain episodes can come and go, and triggers can be physical or emotional stress. Women between the ages of 40 and 75 and overweight are at a higher risk. People with rheumatoid arthritis or lupus also have a higher risk of developing the condition. For now, there is no cure for fibromyalgia, but the problems it causes can be alleviated. Therapy involves certain medications, exercises, psychological help, and an adjusted diet.