If the pain is judged as coming from the joint in question then certain decisions have to be made as to the causes of this. Inflammatory arthritis is the first category to be considered, with inflammatory changes affecting the the synovial membranes and the entheses, the junctions between the bones and the ligaments and tendons. Non-inflammatory arthritis involves changes in the structure and function of the joint, occurring as damage to the menisci or the articular cartilage lining the joint or secondary to changes in the joint which can be from a variety of causes.
The third possibility is joint pain or arthralgia in the absence of significant pathology, such as fibromyalgia or with sub clinical changes that have yet to declare themselves. Different types of joint disorders can occur in the same joint with inflammatory disorders typically destabilising a joint and leading to structural abnormality. Pain is a significant symptom of these joint disorders and in inflammatory conditions the pain is present whether the joint is moving or still, with it typically being worse as the movement is started. With arthritic changes that are not secondary to inflammation pain occurs typically with movement and improves with resting.
If the vertebral column or the large joints suffer from significant degenerative changes they may give pain when resting and at night, disturbing sleep. It is less easy to localise accurately the pain from larger joints as compared to smaller ones, with the hip being an example of how pain can be referred to several areas including the fronts of thighs, the groin, the side of the hip and the buttock. Patients perceive difficulty moving a joint, especially when just getting going, as stiffness and this symptom is usually better once the joint has got going and worse again after a rest period. Normal joint stiffness lasts 10-15 minutes but inflammatory stiffness may be for an hour or longer.
There are several changes which can occur in a joint to make it swell. If the joint is affected by non-inflammatory arthritis then bony growths form at the margins of the joints and the end of the fingers or the knees become knobbly joints. Or an effusion, a collection of fluid within a joint capsule, can form secondary to inflammatory disease and can be drawn off by injecting the joint. It is common for an affected joint to show a degree of loss of movement either because the soft tissues have tightened up, the joint is damaged anatomically or by restriction from pain and inflammation.
Getting dressed, looking after oneself and mobility such as walking and stairs are some of the activities of daily living which can be affected by arthritic disease. Loss of bulk and power in the muscles can explain at least some of functional loss and if pain and weakness occur in a joint then a muscular or neurological pathology is unlikely. Having problems with stable gait, getting up from a chair or the floor and holding things can all be interfered with by the weakness. Feeling unwell and suffering fatigue occurs in systemic arthritic conditions as the whole body is affected. Arthritic symptoms can come on slowly or fast, with rapid onset due to infection, crystal arthritis and traumatic events.
The develop of joint symptoms over weeks to months is more common and is the case in osteoarthritis and rheumatoid arthritis, the two most common conditions. If symptoms are present less than six weeks they are acute, from 6 to 12 weeks they are sub-acute and over 12 weeks they are termed chronic, although this is not a rigid classification. Joint involvement varies with different patterns, such as episodes of joint pain with pain-free times in between as in gout, to the persistence of joint problems as further joints are involved. Arthritis is also classified by the number of joints affected with polyarthritis affecting five or more, oligoarthritis two to four and monoarthritis one joint only.
Joint involvement can either by symmetrical or non-symmetrical in pattern. If the same joints are affected on each side of the body this is symmetrical involvement and commonly shown in rheumatoid arthritis and systemic lupus erythematosus (SLE). If different joints are affected or only one on one side of the body this is asymmetrical joint involvement and shown in reactive arthritis and psoriatic arthritis. Joints are affected in differing patterns with different types of conditions. The end joints of the fingers are affected in osteoarthritis, gout or psoriatic arthritis but not in rheumatoid arthritis. - 14130
The third possibility is joint pain or arthralgia in the absence of significant pathology, such as fibromyalgia or with sub clinical changes that have yet to declare themselves. Different types of joint disorders can occur in the same joint with inflammatory disorders typically destabilising a joint and leading to structural abnormality. Pain is a significant symptom of these joint disorders and in inflammatory conditions the pain is present whether the joint is moving or still, with it typically being worse as the movement is started. With arthritic changes that are not secondary to inflammation pain occurs typically with movement and improves with resting.
If the vertebral column or the large joints suffer from significant degenerative changes they may give pain when resting and at night, disturbing sleep. It is less easy to localise accurately the pain from larger joints as compared to smaller ones, with the hip being an example of how pain can be referred to several areas including the fronts of thighs, the groin, the side of the hip and the buttock. Patients perceive difficulty moving a joint, especially when just getting going, as stiffness and this symptom is usually better once the joint has got going and worse again after a rest period. Normal joint stiffness lasts 10-15 minutes but inflammatory stiffness may be for an hour or longer.
There are several changes which can occur in a joint to make it swell. If the joint is affected by non-inflammatory arthritis then bony growths form at the margins of the joints and the end of the fingers or the knees become knobbly joints. Or an effusion, a collection of fluid within a joint capsule, can form secondary to inflammatory disease and can be drawn off by injecting the joint. It is common for an affected joint to show a degree of loss of movement either because the soft tissues have tightened up, the joint is damaged anatomically or by restriction from pain and inflammation.
Getting dressed, looking after oneself and mobility such as walking and stairs are some of the activities of daily living which can be affected by arthritic disease. Loss of bulk and power in the muscles can explain at least some of functional loss and if pain and weakness occur in a joint then a muscular or neurological pathology is unlikely. Having problems with stable gait, getting up from a chair or the floor and holding things can all be interfered with by the weakness. Feeling unwell and suffering fatigue occurs in systemic arthritic conditions as the whole body is affected. Arthritic symptoms can come on slowly or fast, with rapid onset due to infection, crystal arthritis and traumatic events.
The develop of joint symptoms over weeks to months is more common and is the case in osteoarthritis and rheumatoid arthritis, the two most common conditions. If symptoms are present less than six weeks they are acute, from 6 to 12 weeks they are sub-acute and over 12 weeks they are termed chronic, although this is not a rigid classification. Joint involvement varies with different patterns, such as episodes of joint pain with pain-free times in between as in gout, to the persistence of joint problems as further joints are involved. Arthritis is also classified by the number of joints affected with polyarthritis affecting five or more, oligoarthritis two to four and monoarthritis one joint only.
Joint involvement can either by symmetrical or non-symmetrical in pattern. If the same joints are affected on each side of the body this is symmetrical involvement and commonly shown in rheumatoid arthritis and systemic lupus erythematosus (SLE). If different joints are affected or only one on one side of the body this is asymmetrical joint involvement and shown in reactive arthritis and psoriatic arthritis. Joints are affected in differing patterns with different types of conditions. The end joints of the fingers are affected in osteoarthritis, gout or psoriatic arthritis but not in rheumatoid arthritis. - 14130
About the Author:
Jonathan Blood Smyth is the Superintendent of Physiotherapists at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for physiotherapist in Blackpool visit his website.
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