Dr. Gil Gonzalez is a reputed doctor specialized in Rheumatology, expert in the treatment of arthritis, osteoarthritis, fibromyalgia, among other pathologies. In addition, she is also a specialist in Clinical Analysis and has a master’s degree in Dietetics and Nutrition. During his long career, he has been a general practitioner in several centers in Seville, including the Ministry of Health and Social Services of Andalusia, as well as a specialist in Rheumatology and Clinical Analysis in the provinces of Seville and Cadiz.
What is joint pain?
Joint pain is the main symptom of rheumatic diseases and is the most frequent cause of consultation. Normally this pain originates in the joints, but it can also originate in all the musculoskeletal structures close to the joints, such as tendons, muscles, serous sacs, ligaments and bones.
Sometimes the pain is accompanied by other discomforts, such as pinching, heaviness, tightness or fatigue localized in one area of the body (shoulder, neck, lumbar region, legs) with difficulty in performing activities of daily living. On other occasions, the localization is more imprecise and the pain is perceived in more extensive areas of the body, although it is almost always more intense around the joints and in the areas of muscle insertion.
Why do joints hurt?
The body is endowed with sensitive receptors for pain, which can be stimulated by chemical substances and mechanical factors. In rheumatic processes, inflammatory phenomena occur that lead to the release of substances with great capacity to stimulate these receptors. Likewise, physical stimuli, such as excessive and prolonged stretching of the muscles, ligaments, joint capsule and nerves, or by blows and trauma, can also activate these receptors. Once the receptor is activated, it transforms the painful stimulus into an electric current that is transmitted through the fibers of the sensitive nerves, and the message of the painful sensation reaches the cerebral cortex and in that location it becomes conscious, that is, it is when the painful sensation is noticed.
What causes or generates pain in the joints?
When a joint becomes inflamed we speak of arthritis, and pain is usually the predominant discomfort, but it can also be accompanied by other symptoms such as limited mobility, swelling of the joint, increased heat, redness. The pain usually has a rhythm that is called “inflammatory”, characterized by pain not only with movement of the joint, but also hurts at rest, and often intensifies at night. This type of pain is seen in rheumatoid arthritis, spondyloarthropathies, psoriatic arthropathy and infectious arthritis among others.
There is another type of joint pain that is not accompanied by the inflammatory signs described, and then we speak of arthralgias. This pain usually has a rhythm that we call “mechanical”, characterized by pain that usually intensifies when the affected joint is mobilized and improves or disappears when it remains at rest. This type of pain is observed in patients with osteoarthritis, as the most frequent pathology.
Are there risk factors that favor the appearance of joint pain?
Rheumatic diseases are caused by the interaction of many factors related to the individual, such as race, sex, genetics, diet, and environmental factors, such as infections or toxins such as
environmental factors, such as infections or toxic substances like tobacco or alcohol.
Any of the musculoskeletal structures can be injured and become diseased. Common causes include:
- Infections.
- The deposit of crystals.
- Physical exertion in sports, at work or at home, which can cause acute damage, such as fracture, tendinitis or torn ligaments.
- The wear and tear of the structures themselves as a result of repeated use, which can trigger cartilage degeneration or osteoarthritis.
- Autoimmune inflammatory diseases, which cause inflammation of the joints and surrounding structures, such as rheumatoid arthritis, psoriatic arthritis, lupus, spondylitis, among others.
When should I see a specialist?
When you have a musculoskeletal disease you should go to a rheumatologist, who is the doctor specialized in diseases of the musculoskeletal system and can more accurately diagnose the cause of pain among the multiple diseases. Pain management requires a complete medical history, with careful questioning and examination. In many cases it is necessary to perform complementary tests such as analytical tests, X-rays or other imaging techniques.
After making the diagnosis of the disease, the rheumatologist will establish a treatment plan, which may include various drugs, physical therapy and patient education. Sometimes referral to other specialists is also necessary for assessment and complementary treatments, such as rehabilitation, traumatologist, among the most frequent.
How is joint pain treated?
The treatment of joint pain and rheumatic diseases in general should aim at curing the disease. But sometimes, this is not possible, and the main objective is that the disease does not cause pain, controlling symptoms, preserving functional capacity, avoiding sequelae and maintaining an adequate quality of life for the patient. The therapeutic treatments available to achieve this do not only include medication; it is also often necessary to use rehabilitation or physical therapy, psychological support and, sometimes, surgery.
Non-pharmacological measures are also important, which require the patient’s involvement with his disease, applying a series of hygienic-dietary measures that can help him to improve his pathology. Thus, in general, it is recommended to avoid a sedentary lifestyle and to perform regular aerobic physical exercise adapted to the personal physical conditions of each patient. The aim is to improve motor coordination and prevent falls, to improve joint mobility and muscle balance, to stimulate the formation of new bone and to promote the patient’s psychological well-being, and to avoid excess weight, which is a factor in many rheumatic diseases, especially osteoarthritis and arthritis. This causes mechanical overload of the joints, especially at the level of the spine, hips, knees, ankles and feet, which leads to a greater increase in pain.
Finally it should be noted that it has been observed that patients with arthritis and smokers are more prone to suffer more episodes of joint inflammation, so it is advisable to avoid smoking.