Healthy joints are a luxury, the value of which is difficult to appreciate for someone who has never experienced pain when walking or have no difficulty in raising an arm or leg, turning around or sitting down. Meanwhile, millions of people around the world each year seek help from orthopedic surgeons with similar complaints.
Epidemiology of joint diseases
About 30% of people sooner or later face joint pathology: even if in their youth they managed to avoid injuries or serious diseases, by old age the skeleton’s “shelf life” comes to an end. In addition to elderly people, those at risk are those who inherited weak joints of the bones, as well as athletes, workers suffering from obesity, diabetes and other chronic diseases.
Joint diseases such as juvenile rheumatoid arthritis occur predominantly in minors. Others, such as gout, are considered “aristocratic ailments”: they develop due to excess meat, red wine and chocolate in the diet. It is known that inflammation of the joints associated with fluctuations in the hormonal background is usually detected in the fairer sex. In men, traumatic injuries of the joints most often occur. In a word, joint diseases can threaten a person regardless of social status, habits, age and gender.
The main groups of joint diseases by the nature of the lesion
Joint diseases are classified by the nature of the pathological process.
Inflammatory and infectious diseases of the joints
In this case, the cause of the disease is an inflammatory reaction in response to an infectious, autoimmune or allergic process. The disease makes itself felt with pain and swelling in the joint. Symptoms can reach maximum severity in a few hours and then recede indefinitely. But behind a period of imaginary well-being, there is a hidden development of the pathological process.
Some arthritis is manifested primarily not by pain, but by morning stiffness, fever, a rash on the skin over the joint, or manifestations of a primary disease complicated by damage to the musculoskeletal system (for example, disorders of the genitourinary system – in Reiter’s disease and gonorrheal arthritis).
The stages of the inflammatory pathology of the joint can be distinguished through X-ray examination. So, at the beginning of the disease, no significant abnormalities are found in the images, with the second degree of arthritis, signs of destruction of bone and cartilage tissue appear. At the third degree, the doctor will see the deformation of the joint – by this moment the patient feels pronounced restrictions on mobility. Finally, the fourth degree of arthritis is accompanied by total changes in the joint: only surgeons can help the patient.
This group of pathologies, along with rheumatoid arthritis (in which the body’s immune system destroys the joints), includes infectious-allergic arthritis, ankylosing spondylitis, Goff’s disease, gout, psoriatic arthritis, etc.
The main prevention of arthritis is the prevention of infections by vaccination and other measures of protection against diseases that can be complicated by bacterial infection of the joint (gonorrhea, scarlet fever, tonsillitis, etc.)
These diseases tend to affect the elderly: they are associated with wear and tear of the joint, which leads to the destruction of the cartilage responsible for shock absorption during work. Another factor in the development of degenerative diseases is osteoporosis, in which bone density decreases.
Degenerative diseases manifest themselves gradually: the first sign will be short-term pain after an exhausting day on your feet. Over time, the pain in the joint will cease to subside after rest, and the movement in the joint will become limited. Sometimes swelling occurs in the affected area, and the joint aches when the weather changes and at night.
The severity of arthrosis is determined by examination and radiography. At the beginning of the process, only a slight reduction in the height of the gap between the bones due to the thinning of the cartilage tissue is noticeable in the images. In the second degree, the doctor will record a decrease in the joint cavity by a third of the norm and the appearance of bone outgrowths or areas of dead cartilage. Finally, the 3rd stage of arthrosis is characterized by deep, irreversible deformities of the joint, up to ankylosis – bone fusion.
The most common cause of disability among all joint diseases is osteoarthritis deformans , mainly affecting the hip and knee joints. Also, the source of the problem may be intervertebral osteochondrosis – a typical disease of office workers.
Experts point out that yoga, a set of exercises that strengthens ligaments and muscles through static loads, can be an excellent prevention of age-related changes in the joints. Scientists recently found that daily 12-minute yoga classes for 10 years increase the density of the bones of the hip and spine, which eliminates osteoporosis and arthrosis, preventing fractures in old age.
Congenital joint pathologies
Congenital joint diseases attract attention from the very first days of a baby’s life: the possible consequences of a malformation for the child’s health depend on therapeutic measures. So, in infants, congenital dislocation of the hip is often detected, which is often combined with dysplasia of the hip joint. Left unattended, this ailment will lead to gait and posture problems. However, timely intervention of an orthopedist will allow to correct congenital hip dislocation conservatively, without surgery.
Another common congenital joint pathology is Marfan’s syndrome , which includes a complex of disorders in the development of internal organs. Patients with Marfan syndrome have extremely mobile joints, poor posture, and a keeled chest. These are tall, thin, sickly people who, as a rule, end up in emergency rooms with dislocations and fractures. Subject to the recommendations of a doctor, they can live a long time without experiencing severe health problems.
Diseases of the periarticular tissues
Diseases from this group do not affect the joint itself, but if untreated, they can worsen its work. This includes inflammation of the tendons ( tendinitis ), bursae (bursitis), ligaments ( ligamentitis ), fascia (fibrositis). Sometimes the source of the pathological process is inflammation in the joint itself, but much more often the cause of the development of such ailments is physical exertion and ” chilling ” of the neck or limbs.
Symptoms of diseases of the periarticular tissues have peculiarities: unlike the pathology of the joints, pain in the ligaments, tendons and joint capsules is felt only with active movements and is absent when the limb is exposed to the office of a doctor or masseur. With arthritis, patients complain of “diffuse” pain, and with damage to the periarticular tissues, they can indicate a specific point where the pain is maximum. X-ray and MRI allow you to finally make sure of the nature of the disease and prescribe treatment.
Types of joint diseases at the site of localization
Many joint diseases have their own “favorite” localization, thanks to which the doctor can make a preliminary diagnosis even before receiving the results of medical imaging.
- Diseases of the shoulder joint often occur in people who earn a living by physical labor, or in those who are regulars in gyms. The most obvious causes of shoulder pain are periarthritis of the scapula and osteochondrosis of the cervical spine. In some cases, osteoarthritis or arthritis of the shoulder joint is found.
- Diseases of the elbow joint are also common concerns for athletes ( epicondylitis ). Sometimes discomfort and restriction of mobility in this area are caused by osteochondritis dissecting , deforming osteoarthritis and inflammation of the muscles of the arm.
- The joints of the hand (fingers) become inflamed in rheumatoid arthritis. It can manifest itself as a “tight glove syndrome”: in the morning it is difficult to stretch the hands, restoring their mobility. A feature of this disease is the simultaneous defeat of both hands. There are frequent cases of arthrosis and tendon lesions in the practice of orthopedists, which occur in musicians and representatives of professions associated with fine motor skills (engravers, jewelers, etc.), as well as those who daily and for a long time work with the keyboard.
- Ubiquitous disease of the hip joint is coxarthrosis , typical for elderly people. Also, elderly patients often face osteoporosis – a softening of the structure of the femur, fraught with a pathological fracture of its neck. Bursitis and tendinitis of the hip joint is diagnosed in athletes – runners and football players.
- Knee joint diseases are observed in people of all ages. In children, infectious and rheumatoid arthritis is more often diagnosed, in mature sports people – lesions of the ligamentous apparatus and meniscus trauma, and after 50 years, gonarthrosis , a degenerative lesion of the knee joint, comes first .
- Ankle pain can result from arthritis or subluxation. Such pathologies are typical for athletes, dancers and women who wear high-heeled shoes every day . Ankle arthrosis (as well as coxarthrosis and gonarthrosis ) affects many obese people.
Types of joint diseases according to traditional Chinese medicine
An alternative view of the nature of joint diseases is given by traditional Chinese medicine (TCM). According to her, rheumatism, rheumatoid arthritis and osteoarthritis are manifestations of “B syndrome” – an obstacle that affects bones and joints. “Syndrome B” arises from the influence of pathogenic factors. They enter the body, settle in muscles, tendons and joints, and then block the normal flow of vital energy Qi and blood through the energy channels (meridians). All of this causes pain, stiffness, inflammation, and deformation of bones and joints.
What pathogens cause B syndrome?
- The wind is calling “wandering B”. Acute joint pain begins and ends quickly, but can travel throughout the body, limiting the range of comfortable movement. The patient’s pulse becomes floating, and the tongue becomes covered with a thin white coating.
- The cold is causing the “painful B”. Severe joint pain leads to stiffness of movement. The pain is especially pronounced when the ambient temperature drops. At the same time, the pulse becomes tense. Painful B may also develop a white coating on the tongue. With the onset of heat, a person’s condition improves.
- Dampness causes “fixed B”. The pain is accompanied by a feeling of heaviness, numbness, or edema in the affected area. Pulse – floating, tongue – with a greasy coating.
- The heat causes the “heat B”. The heat reduces the flow of blood and vital energy Chi through the joints, thereby impairing their function. This causes inflammation and swelling in the joint. The tongue becomes covered with a reddish-yellow coating, and the pulse becomes fast.
- Combinations of pathogens:
- Wind, cold and dampness. Delaying wind, cold and dampness in the meridians makes it difficult for Qi and blood to flow out. Excess cold is manifested by stagnation of vital energy and blood. With this combination, severe pain and swelling of the joint occurs, a tense pulse is observed, as well as a pale tongue with a white coating.
- Wind, dampness and heat. Pathogens block the movement of qi and blood, affecting muscles and skin. The joints become red and swollen. In addition, pain often develops, which can be accompanied by heaviness and fever. The tongue becomes covered with a reddish-yellow coating, and the pulse becomes fast.
- Deficiency of blood in the liver and kidneys, phlegm. Qi and blood deficiencies cause long-term joint pain, which is accompanied by swelling, inflammation, knee pain and deformity. Pain syndrome restricts movement. Internal accumulation of phlegm and stagnation manifests itself as subcutaneous nodules. In this case, the person has a state of exhaustion, lethargy, dizziness and blurred vision. The pulse becomes uneven, the tongue darkens and becomes covered with a thin coating.
Treatment of joint diseases in Chinese medicine is aimed at dissipating wind, cold, heat, as well as converting dampness and restoring the flow of Qi and blood. This is helped by acupuncture, moxibustion (warming up with wormwood cigars) and acupressure.
Remember it’s important to be alert to any symptoms – pain, stiffness, swelling, rash, or crunching sound when moving. The overwhelming majority of joint diseases can be successfully treated at the initial stages, however, in an advanced state of the disease, they can disrupt life and professional plans, requiring expensive surgical intervention and complex rehabilitation measures.