Joint diseases – causes, symptoms & therapy

Joint diseases

Joint diseases are among the most common diseases of the musculoskeletal system. In particular, degenerative forms, ie damage to the joints caused by wear and tear, account for a large proportion. The medical generic term arthropathy generally refers to diseases of the joints without further specification.

What are joint diseases?

Joint diseases are a common ailment, because almost half of the people in the second half of their lives are affected by joint diseases. Joints, as movable connecting pieces between two bones, are a basic requirement for any form of movement. The most common joint diseases include degenerative changes (e.g. arthrosis) and inflammatory forms (e.g. arthritis).

Due to the constant work on the joints during every movement, but also due to the carrying of the body weight and any extraordinary stress, certain signs of wear naturally occur with increasing age . If these exceed the average degree of joint change to be expected, this is referred to as joint disease.

The lower extremities are very often affected, i.e. the hip and knee joints. But the joints of the shoulders, elbows and even the fingers can also be pathologically altered (sometimes at a young age) and cause symptoms. Arthropathies are generally divided into inflammatory forms, known as arthritis, and non-inflammatory joint diseases, known as arthrosis. Depending on the location, cause, severity and progression, further differentiation is then made.

causes

The causes of joint diseases are just as diverse as the different forms and courses of arthropathies. While severe and permanent overloading of the joints, e.g. during constant and intensive sports activities, can be the trigger for a number of joint diseases, severe overweight also poses a real problem for joints in the long term knees, hips, etc., often leads to severe joint pain in obese people and significantly increases the risk of permanent damage to the joint structures. Here, too, the constant overload plays a causal role.In this context, in addition to individual risk factors such as severe obesity and excessive sport, work-related or heavy physical stress can also overstrain the joint and accelerate the wear and tear processes; This can happen through carrying and lifting very heavy loads, but also through one-sided, repetitive movements or static muscle work .

As a result, articular cartilage can increasingly lose its elasticity and can no longer withstand the mechanical stress effects to a sufficient extent. This can even lead to the synovial membrane being irritated by the splintering of small pieces of cartilage and the joint no longer being adequately lubricated by the splinters present in the synovial fluid. The result is acute inflammation and possibly joint effusion , which is accompanied by severe pain. In the further course, the joint reacts with the formation of new supporting osteophytes, which can lead to surface hardening as well as permanent movement restrictions and inflammatory reactions.

Possible causes of arthropathies can also lie in malpositions caused by growth or accidents, which affect the respective joint. This can be the case, for example, with hip dysplasia, knock knees or bowlegs or hallux vagus. Inadequate supply (e.g. due to an unbalanced diet ) of the joint cartilage with joint nutrients, such as glucosamine, is suspected to be a possible cause of a reduction in the function and performance of the joints and possible damage to the cartilage due to the various stresses.

When to the doctor?

Joint diseases are characterized by the typical fatigue, start-up and stress pain. If you experience these symptoms, you should consult your family doctor or an orthopaedist. In general, all unusual symptoms – pain, but also crunching noises during joint movements, thickening, swelling, malpositions or joint effusions – should be clarified. This is especially true when the symptoms do not seem to subside or are even increasing in intensity.

Overweight and older people are at increased risk of joint disease. The same applies to people who already suffer from a disease of the bones or joints. Anyone who counts themselves among these risk groups should ideally have any noticeable symptoms clarified immediately. Early therapy significantly improves the chance of recovery and reduces the risk of complications. A clarification is also useful in the case of chronic diseases, so that medication can be used to counter pain and other side effects. If the symptoms significantly affect the quality of life, a quick diagnosis is all the more important. Otherwise, the respective joint disease can sometimes also develop psychological suffering, which in turn is associated with complications.

symptoms and course

Joint diseases manifest themselves in the early stages through a specific combination of pain symptoms: The so-called “early triad” is characterized by the typical fatigue, start-up and stress pain. In the further course of arthropathies, permanent pain as well as night and muscle pain occur.

This symptomatology is referred to as the so-called “late triad”. In addition to these different forms of pain, advanced joint diseases usually lead to restricted movement of the affected joints, but also to the well-known crunching noises during joint movements (crepitations). As well as to instability, bony thickening and swelling, misalignment, joint effusions, but also to a detectable muscle breakdown ( muscular atrophy ) or local redness and hyperthermia.

In the later course of the disease, a changed, rough or fibrous surface can be observed in X-rays , and under certain circumstances also a narrowing of the joint space, a compaction of the surrounding bone substance (so-called subchondrial sclerotherapy), but also rubble cysts (missing bone substance) and osteophytes can appear. Particularly in the case of inflammatory joint diseases, such as chronic polyarthritis, very specific inflammatory values ​​can be detected in the blood count . In advanced stages of joint disease, severe joint deformities and deformities can also occur, as well as deposits of calcium pyrophosphate in the cartilage, known as chondrocalcinosis.

Common shapes and types

Common joint diseases:

  • hip dysplasia

Joint diseases include the most diverse forms of arthrosis, arthritis and other diseases such as rheumatic diseases, psoriatic arthritis or rheumatic fever. In the most common form, arthrosis, there is premature wear and tear of the articular cartilage. This wear and tear of the cartilage layer later leads to the bone ends rubbing painfully against each other and muscles, joint capsules and ligaments can also be affected.

Joint wear is extremely painful and cannot be cured per se. In principle, arthrosis can occur in all joints, but the joints that are most frequently affected are those that are most stressed by everyday life, work and extraordinary loads. These include diseases of the knee joints (so-called gonarthrosis ), the hip joints (so-called coxarthrosis ), the spine (so-called spondylarthrosis), but also the wrists and ankles.

Starting with damage to the joint cartilage, degenerative arthropathy can also lead to deformation and changes in the adjacent bones. So-called secondary arthrosis is caused by congenital or acquired malpositions or after injuries and inflammation of the joint . In the inflammatory forms of joint diseases, either one joint can be affected (so-called monoarthritis), or several joints can be affected (so-called polyarthritis). These arthritis always begin in the synovial membrane and are characterized by redness , swelling , loss of movement and pain.

In infectious arthritis, bacteria are considered to be the trigger; it is often accompanied by a purulent joint effusion and can lead to severe joint damage. In the case of rheumatic fever, which mainly occurs in children after a streptococcal infection , acute inflammation of various joints and the associated pain, increased temperature and swelling can also lead to inflammation of the inner lining of the heart .

Chronic polyarthritis or rheumatoid arthritis is the most common form of non-infectious joint inflammation. Here, immunological processes are suspected as possible triggers (so-called autoimmune disease ). The course of the disease in chronic polyarthritis usually begins at the metatarsophalangeal joints and subsequently spreads to numerous other joints. Severe cases can lead to severe joint deformation and destruction. In many cases, the disease occurs in childhood and adolescence.

Other forms of arthropathy are psoriatic arthritis (a pathological joint involvement in psoriasis) and Bechterew’s disease , which primarily affects the joints of the spine. Gout is also one of the inflammatory polyarthropathies. Another common joint disease is hallux vagus, a joint disease in the area of ​​the big toe that is particularly common among older people.

complications

As a rule, joint diseases can lead to a great many different ailments and compilations. For this reason, a general prediction of the complications is usually not possible. Due to joint diseases, those affected are in most cases significantly restricted in their movement and thus also in their everyday life. It is not uncommon for this to lead to coordination disorders and severe restrictions in movement. Those affected may then also be dependent on walking aids or the help of other people or carers. In general, joint diseases always lead to a reduction in the quality of life.

Not infrequently, these are also associated with pain or swelling and also have a negative effect on the psyche of those affected. This can lead to depression or other psychological problems. As a rule, the pain can always be limited with the help of painkillers. Especially at night, pain can lead to insomnia and thus to irritability of those affected. Further treatment consists of various therapies and possibly surgical interventions. In some cases, prostheses are also necessary to allow the patient mobility. Special complications usually do not arise.

treatment and therapy

The therapy of joint diseases depends on the exact form of the arthropathy and the stage of the disease. Osteoarthritis is treated conservatively in the first step, ie in the form of heat therapy , medication and physiotherapy. In the further course or in the case of severely advanced arthrosis, often only surgical treatment can lead to an improvement for the patient. Here, for example, the inflamed synovial membrane is surgically removed or artificial joints (joint prostheses) are used.

Drug therapy for inflammatory joint diseases includes non-steroidal anti-inflammatory drugs and, in severe cases, opioids, which are primarily aimed at effectively reducing pain. In addition, chondroprotective agents are also used in some cases: the hyaluronic acid contained has an anti-inflammatory effect and reduces the effect of enzymes that promote the breakdown of cartilage in the joints.

In the case of joint effusions, these are punctured or treated with preparations containing cortisone in chronic courses. These are injected directly into the affected joint and are intended to reduce the inflammatory processes. In the case of severe forms of rheumatic disease, modern “biologicals” (tumour necrosis factor alpha inhibitors such as etanercept or infliximab) and immunosuppressants (e.g. methotrexate) are used in addition to basic rheumatic drugs.

In the case of joint diseases, orthopedic and ergotherapeutic measures also play an important role. The further progression of joint overloading or incorrect loading should be slowed down by learning joint-gentle movements and activities, as well as by significantly relieving the affected joints. This can be done, for example, with corrective or cushioning insoles, forearm supports and other aids.

Targeted physiotherapy exercises are also intended to counteract muscle breakdown, alleviate pain symptoms and generally support and facilitate movement processes. The therapeutic measures focus on maintaining and building muscle and improving the diseased and degeneratively affected joints. Electrotherapy can also be used for chronic pain and often helps to relax and noticeably improve the pain symptoms.

Surgical procedures are also becoming increasingly important, which repair minor defects in the cartilage (so-called cartilage bone transplants) or rinse the joint and smooth the diseased cartilage as part of a joint reflection ( arthroscopy ). However, signs of wear and tear on joints in particular cannot be reversed or completely healed. That is why the success of therapy for arthrosis, but also for arthropathies in general, depends crucially on the time of diagnosis.

prevention

Relief and protection of the joints are recommended as preventive measures. In concrete terms, this means reducing existing excess weight and, in the case of joint problems that are already beginning, possibly also contribute to joint relief with orthopedic aids (e.g. hand sticks, shoe inserts or buffer heels). In addition, athletes should make sure that their sport is as easy on the joints as possible.This also includes high-quality equipment, especially footwear. General strengthening muscle training carried out under professional guidance can prevent diseases of the musculoskeletal system and joints if they are not subjected to incorrect and unfavorable stress. In general, a healthy diet and an adequate intake of calcium and vitamin D are of great importance for healthy bone and cartilage tissue.

Since joint diseases, especially the forms of arthrosis caused by wear and tear, are not reversible or curable, good prevention and early intervention in the case of existing symptoms are crucial for the further course. Mindful exercise and stress in everyday life as well as appropriate, regular and, above all, joint-gentle exercise and sport can certainly significantly reduce the risk of joint diseases.
Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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