What are the symptoms of Complex Regional Pain Syndrome. How is CRPS diagnosed. What causes Complex Regional Pain Syndrome. What are the treatment options for CRPS. Can Complex Regional Pain Syndrome be prevented. How does CRPS affect quality of life. What is the prognosis for people with CRPS.

Understanding Complex Regional Pain Syndrome (CRPS)

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that typically affects a single limb, usually following an injury or trauma. It is characterized by severe, persistent pain that is disproportionate to the initial injury. CRPS can be a debilitating condition that significantly impacts a person’s quality of life and daily functioning.

There are two types of CRPS:

• Type 1 (Reflex Sympathetic Dystrophy): Occurs after an illness or injury that did not directly damage nerves in the affected limb. This type accounts for about 90% of CRPS cases.
• Type 2 (Causalgia): Occurs following a distinct nerve injury but presents similar symptoms to Type 1.

Recognizing the Symptoms of CRPS

CRPS manifests through a variety of symptoms that can vary in intensity and duration among individuals. The primary symptoms include:

• Continuous burning or throbbing pain in the affected limb
• Heightened sensitivity to touch or cold
• Swelling in the painful area
• Changes in skin temperature, alternating between sweaty and cold
• Skin color changes, ranging from white and blotchy to red or blue
• Alterations in skin texture, becoming tender, thin, or shiny
• Changes in hair and nail growth
• Joint stiffness, swelling, and potential damage
• Muscle spasms, tremors, weakness, and atrophy
• Decreased mobility in the affected body part

How do symptoms of CRPS progress over time? Typically, pain, swelling, redness, temperature changes, and hypersensitivity occur first. As the condition advances, the affected limb may become cold and pale, with skin and nail changes, as well as muscle spasms and tightening. In some cases, CRPS can spread to other parts of the body, such as the opposite limb.

Causes and Risk Factors for CRPS

The exact cause of CRPS remains unclear, but it is believed to result from an injury to or abnormality of the peripheral and central nervous systems. CRPS often develops following a trauma or injury, such as:

• Fractures or crushing injuries
• Sprains or strains
• Surgeries
• Heart attacks
• Infections

Why do some people develop CRPS after an injury while others don’t? Researchers believe it may be due to a dysfunctional interaction between the central and peripheral nervous systems, coupled with inappropriate inflammatory responses. However, the precise mechanisms are not fully understood.

Diagnosing Complex Regional Pain Syndrome

Diagnosing CRPS can be challenging, as there is no single definitive test for the condition. Healthcare providers typically rely on a combination of clinical observations, patient history, and diagnostic tests to make a diagnosis. The diagnosis process may include:

1. Physical examination to assess pain, sensitivity, and changes in appearance of the affected limb
2. Detailed medical history to understand the onset and progression of symptoms
3. Imaging tests such as X-rays, MRI, or bone scans to detect changes in bone and tissue
4. Sympathetic nervous system tests to evaluate nerve function
5. Thermography to measure temperature differences between affected and unaffected limbs

Why is early diagnosis crucial for CRPS treatment? Early detection and intervention can significantly improve outcomes and potentially lead to remission in some cases.

Treatment Approaches for CRPS

Treatment for CRPS is most effective when started early and typically involves a multidisciplinary approach. The goal is to reduce pain, improve function, and prevent the condition from worsening. Common treatment strategies include:

Medications

• Pain relievers (over-the-counter and prescription)
• Antidepressants and anticonvulsants to manage pain
• Corticosteroids to reduce inflammation
• Bone-loss medications in cases of osteoporosis

Physical Therapy

Physical therapy plays a crucial role in CRPS treatment. It aims to improve mobility, reduce pain, and prevent muscle atrophy. Techniques may include:

• Gentle, weight-bearing exercises
• Range-of-motion exercises
• Mirror therapy to trick the brain into perceiving movement without pain
• Desensitization techniques to reduce skin sensitivity

Psychological Support

Living with chronic pain can take a toll on mental health. Psychological interventions such as cognitive-behavioral therapy can help patients cope with the emotional aspects of CRPS and develop pain management strategies.

Interventional Procedures

In some cases, more invasive treatments may be necessary:

• Sympathetic nerve blocks
• Spinal cord stimulation
• Intrathecal drug pumps

How effective are these treatments for CRPS? The effectiveness of treatments can vary widely among individuals. A personalized treatment plan, developed in consultation with a pain specialist, often yields the best results.

Preventing CRPS: Is It Possible?

While it’s not always possible to prevent CRPS, certain measures may reduce the risk of developing the condition:

• Taking high doses of vitamin C after a wrist fracture has been shown to lower the risk of CRPS in some studies.
• Early mobilization after a stroke may reduce the risk of developing CRPS.
• Proper management of acute injuries and swift treatment of infections may help prevent CRPS.

Why is vitamin C potentially effective in preventing CRPS? Vitamin C is a powerful antioxidant that may help reduce inflammation and oxidative stress, which are thought to play a role in the development of CRPS.

Living with CRPS: Coping Strategies and Quality of Life

CRPS can significantly impact a person’s quality of life, affecting physical abilities, emotional well-being, and social interactions. Developing effective coping strategies is crucial for managing the condition long-term. Some helpful approaches include:

• Joining support groups to connect with others experiencing similar challenges
• Practicing stress-reduction techniques such as mindfulness meditation or deep breathing exercises
• Maintaining a healthy lifestyle with proper nutrition and regular, gentle exercise as tolerated
• Exploring alternative therapies like acupuncture or biofeedback, under medical supervision
• Setting realistic goals and pacing activities to avoid overexertion

How can family and friends support someone with CRPS? Education about the condition, emotional support, and practical assistance with daily tasks can make a significant difference in the life of someone managing CRPS.

Research and Future Directions in CRPS Treatment

Ongoing research into CRPS aims to improve our understanding of the condition and develop more effective treatments. Some promising areas of investigation include:

• Genetic studies to identify potential risk factors for CRPS
• Neuroimaging research to better understand brain changes associated with the condition
• Exploration of new pharmacological treatments targeting specific pathways involved in CRPS
• Development of advanced neuromodulation techniques for pain management
• Investigation of immunomodulatory therapies to address the inflammatory component of CRPS

What potential breakthroughs in CRPS treatment are on the horizon? While it’s difficult to predict specific breakthroughs, the growing body of research offers hope for more targeted and effective treatments in the future.

In conclusion, Complex Regional Pain Syndrome is a challenging condition that requires a comprehensive, multidisciplinary approach to diagnosis and treatment. Early intervention, personalized treatment plans, and ongoing support are key factors in managing CRPS effectively. As research continues to advance our understanding of this complex condition, there is hope for improved outcomes and quality of life for those affected by CRPS.

Complex regional pain syndrome – Symptoms and causes

Overview

Complex regional pain syndrome (CRPS) is a form of chronic pain that usually affects an arm or a leg. CRPS typically develops after an injury, a surgery, a stroke or a heart attack. The pain is out of proportion to the severity of the initial injury.

CRPS is uncommon, and its cause isn’t clearly understood. Treatment is most effective when started early. In such cases, improvement and even remission are possible.

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Symptoms

Signs and symptoms of CRPS include:

• Continuous burning or throbbing pain, usually in your arm, leg, hand or foot
• Sensitivity to touch or cold
• Swelling of the painful area
• Changes in skin temperature — alternating between sweaty and cold
• Changes in skin color, ranging from white and blotchy to red or blue
• Changes in skin texture, which may become tender, thin or shiny in the affected area
• Changes in hair and nail growth
• Joint stiffness, swelling and damage
• Muscle spasms, tremors, weakness and loss (atrophy)
• Decreased ability to move the affected body part

Symptoms may change over time and vary from person to person. Pain, swelling, redness, noticeable changes in temperature and hypersensitivity (particularly to cold and touch) usually occur first.

Over time, the affected limb can become cold and pale. It may undergo skin and nail changes as well as muscle spasms and tightening. Once these changes occur, the condition is often irreversible.

CRPS occasionally may spread from its source to elsewhere in your body, such as the opposite limb.

In some people, signs and symptoms of CRPS go away on their own. In others, signs and symptoms may persist for months to years. Treatment is likely to be most effective when started early in the course of the illness.

When to see a doctor

If you experience constant, severe pain that affects a limb and makes touching or moving that limb seem intolerable, see your doctor to determine the cause. It’s important to treat CRPS early.

Causes

The cause of CRPS isn’t completely understood. It’s thought to be caused by an injury to or an abnormality of the peripheral and central nervous systems. CRPS typically occurs as a result of a trauma or an injury.

CRPS occurs in two types, with similar signs and symptoms, but different causes:

• Type 1. Also known as reflex sympathetic dystrophy (RSD), this type occurs after an illness or injury that didn’t directly damage the nerves in your affected limb. About 90% of people with CRPS have type 1.
• Type 2. Once referred to as causalgia, this type has symptoms similar to those of type 1. But type 2 CRPS occurs after a distinct nerve injury.

Many cases of CRPS occur after a forceful trauma to an arm or a leg. This can include a crushing injury or a fracture.

Other major and minor traumas — such as surgery, heart attacks, infections and even sprained ankles — also can lead to CRPS.

It’s not well understood why these injuries can trigger CRPS. Not everyone who has such an injury will go on to develop CRPS. It might be due to a dysfunctional interaction between your central and peripheral nervous systems and inappropriate inflammatory responses.

Complications

If CRPS isn’t diagnosed and treated early, the disease may progress to more-disabling signs and symptoms. These may include:

• Tissue wasting (atrophy). Your skin, bones and muscles may begin to deteriorate and weaken if you avoid or have trouble moving an arm or a leg because of pain or stiffness.
• Muscle tightening (contracture). You also may experience tightening of your muscles. This may lead to a condition in which your hand and fingers or your foot and toes contract into a fixed position.

Prevention

These steps might help you reduce the risk of developing CRPS:

• Taking vitamin C after a wrist fracture. Studies have shown that people who take a high dose of vitamin C after a wrist fracture may have a lower risk of CRPS compared with those who didn’t take vitamin C.
• Early mobilization after a stroke. Some research suggests that people who get out of bed and walk around soon after a stroke (early mobilization) reduce their risk of developing CRPS.

Feb. 18, 2020

Rickets – Symptoms and causes

Overview

Rickets is the softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency. Rare inherited problems also can cause rickets.

Vitamin D helps your child’s body absorb calcium and phosphorus from food. Not enough vitamin D makes it difficult to maintain proper calcium and phosphorus levels in bones, which can cause rickets.

Adding vitamin D or calcium to the diet generally corrects the bone problems associated with rickets. When rickets is due to another underlying medical problem, your child may need additional medications or other treatment. Some skeletal deformities caused by rickets may require corrective surgery.

Rare inherited disorders related to low levels of phosphorus, the other mineral component in bone, may require other medications.

Symptoms

Signs and symptoms of rickets can include:

• Delayed growth
• Delayed motor skills
• Pain in the spine, pelvis and legs
• Muscle weakness

Because rickets softens the areas of growing tissue at the ends of a child’s bones (growth plates), it can cause skeletal deformities such as:

• Bowed legs or knock knees
• Thickened wrists and ankles
• Breastbone projection

When to see a doctor

Talk to your doctor if your child develops bone pain, muscle weakness or obvious skeletal deformities.

Causes

Your child’s body needs vitamin D to absorb calcium and phosphorus from food. Rickets can occur if your child’s body doesn’t get enough vitamin D or if his or her body has problems using vitamin D properly. Occasionally, not getting enough calcium or lack of calcium and vitamin D can cause rickets.

Lack of vitamin D

Children who don’t get enough vitamin D from these two sources can develop a deficiency:

• Sunlight. Your child’s skin produces vitamin D when it’s exposed to sunlight. But children in developed countries tend to spend less time outdoors. They’re also more likely to use sunscreen, which blocks the sun’s rays that trigger the skin’s production of vitamin D.
• Food. Fish oil, egg yolks and fatty fish such as salmon and mackerel contain vitamin D. Vitamin D has also been added to some foods and beverages, such as milk, cereal and some fruit juices.

Problems with absorption

Some children are born with or develop medical conditions that affect the way their bodies absorb vitamin D. Some examples include:

• Celiac disease
• Inflammatory bowel disease
• Cystic fibrosis
• Kidney problems

Risk factors

Factors that can increase a child’s risk of rickets include:

• Dark skin. Dark skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight.
• Mother’s vitamin D deficiency during pregnancy. A baby born to a mother with severe vitamin D deficiency can be born with signs of rickets or develop them within a few months after birth.
• Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets.
• Premature birth. Babies born before their due dates tend have lower levels of vitamin D because they had less time to receive the vitamin from their mothers in the womb.
• Medications. Certain types of anti-seizure medications and antiretroviral medications, used to treat HIV infections, appear to interfere with the body’s ability to use vitamin D.
• Exclusive breast-feeding. Breast milk doesn’t contain enough vitamin D to prevent rickets. Babies who are exclusively breast-fed should receive vitamin D drops.

Complications

Left untreated, rickets can lead to:

• Failure to grow
• An abnormally curved spine
• Bone deformities
• Dental defects
• Seizures

Prevention

Exposure to sunlight provides the best source of vitamin D. During most seasons, 10 to 15 minutes of exposure to the sun near midday is enough. However, if you’re dark-skinned, if it’s winter or if you live in northern latitudes, you might not be able to get enough vitamin D from sun exposure.

In addition, because of skin cancer concerns, infants and young children, especially, are warned to avoid direct sun or to always wear sunscreen and protective clothing.

To prevent rickets, make sure your child eats foods that contain vitamin D naturally — fatty fish such as salmon and tuna, fish oil and egg yolks — or that have been fortified with vitamin D, such as:

• Infant formula
• Cereal
• Bread
• Milk, but not foods made from milk, such as some yogurts and cheese
• Orange juice

Check labels to determine the vitamin D content of fortified foods.

If you’re pregnant, ask your doctor about taking vitamin D supplements.

Guidelines recommend that all infants should receive 400 IU a day of vitamin D. Because human milk contains only a small amount of vitamin D, infants who are exclusively breast-fed should receive supplemental vitamin D daily. Some bottle-fed infants may also need vitamin D supplements if they aren’t receiving enough from their formula.

Feb. 25, 2021

What Causes Joint Pain and Why Women Get It More Than Men…

In the competition for worst joint pain, men and women start off tied – all genders come equipped with an equal complement of 360 joints in their respective skeletons. After that, the game is rigged against the female gender.

The most common cause of joint pain for both men and women is arthritis (the medical prefix “arth” means bone, and the suffix “-itis” means inflammation. )

What are the types of arthritis?

Arthritis comes in a multitude of different varieties, but the two most common by far are osteoarthritis (OA) and rheumatoid arthritis (RA). The primary symptom of each condition is pain in a joint, but the causes of the two conditions are different.

What is osteoarthritis?

Osteoarthritis is generally a product of wear and tear over time.

Osteoarthritis is not an equal opportunity disorder. It picks on women. The gender disparity between men and women in the incidence of OA becomes statistically noticeable around age 40. The risk of osteoarthritis becomes significantly greater after women enter menopause. And, by the time a woman is 65, she is twice as likely to experience OA as a man. From another statistical perspective, 27 million Americans have osteoarthritis; 60% of them are women.

What is rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune disease, wherein the body’s own immune system has switched sides and is traitorously attacking its host.

Rheumatoid arthritis is an even worse gender bully than OA. Out of every four sufferers of RA, three are women.

What are other causes of joint pain?

Some causes of joint pain include bursitis, fibromyalgia, psoriasis, septic arthritis, psoriatic arthritis, reactive arthritis, tendinitis, arthralgia, systemic lupus erythematosus, hepatitis, and Lyme disease.

More common causes of joint pain include:

• Back pain
• Knee pain
• Joint dislocation
• Big toe pain
• Sprains
• Muscle pain
• Pseudogout
• Buildup of uric acid

Treatment options for chronic pain often include self-care

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and acetaminophen can provide pain relief in the affected joint. This is especially helpful for morning stiffness getting out of bed.

For severe joint pain and joint inflammation, pain medications and corticosteroids may be prescribed.  Physical therapy and exercises to prevent overuse of the affected joints can also be helpful.

So, what causes the gender differences regarding joint pain?

There are a plethora of theories that purport to explain why women are at higher risk for joint pain. Some of these include:

1. Estrogen and menopause

Estrogen is an inflammation fighter, so it protects the slick cartilage that lines the joints against the “-itis” (inflammation) component of arthritis pain.

When women hit menopause, their estrogen levels plummet. So, it’s no coincidence that the onset of menopause coincides with an increased arthritis risk. And women experience a reduction of estrogen levels monthly, with each and every period, so the damage isn’t all postponed until the onset of menopause.

The “estrogen is good” theory is buttressed by the results of a study conducted in London. Among more than 1,000 postmenopausal study participants, the cohort that used hormone replacement therapy experienced significantly less osteoarthritis in both their knees and their hands.

2. Testosterone protects men from joint pain

Another hormonal sex difference is that men have a lot more testosterone coursing through their systems than women do. Testosterone may very well be responsible for most of the world’s problems, but it has at least one positive consequence: it builds a strong musculoskeletal system.

So men’s joints are more likely to be sheathed in protective muscle, which reduces the incidence of joint ailments.

3. What is relaxin and how does it affect women?

A third hormonal distinction involves relaxin, a hormone that is released in small quantities concurrently with each ovulation. (When pregnancy occurs, relaxin is released in much greater quantities.)

Relaxin is still somewhat mysterious, but it seems designed to prepare a woman’s body for pregnancy. One of relaxin’s effects is to loosen the ligaments and tendons that keep joints strapped tightly together. This facilitates fetal delivery by allowing expansion of the joints in the pelvic area.

But relaxin operates systemically, so it destabilizes joints throughout a woman’s body. Joint laxity can lead to bones straying from their natural boundaries. This can lead to cartilage damage and, eventually, osteoarthritis.

Sex differences are also biomechanical

All people may have the same 360 joints, but there are still structural differences. For example, a woman’s hips are proportionally wider than a man’s. This facilitates childbearing.

But it also means that women tend to be slightly knock-kneed, while men’s legs tend to be more of a straight line from hip to ankle. That inward bend at the knee, be it ever so slight, exerts significant torsional forces on a woman’s knee joint. So women’s knee ligaments tend to rupture more readily than men.

What is kneecap misalignment?

Women are more likely than men to develop a condition called patellofemoral misalignment. Essentially, the kneecap doesn’t fit quite right with the femur (thigh bone). This misalignment leads to recurrent friction between the kneecap and the femur.

The problem is often exacerbated within the hyperextended knees of women who frequently wear high heels.

Evolutionary biology and women’s joint pain

Nature is efficient. It causes humans to evolve in ways that are beneficial for the survival of the species.

At least, that’s one plausible explanation for the indisputable fact that, when compared to men’s knees, the bony surfaces of women’s knee joints do not fit together as well, nor do they move as synchronously. Also, women’s knees contain less cartilage than men’s knees, even when bone size and body mass are taken into account. And we’ve already discussed testosterone and stronger male muscles.

All this male strength is readily explicable by the existence of an efficient force of Nature. After all, many, many millennia ago, men actually did need to have bodies that were more capable of heavy-duty performance. Men had to have industrial-strength joints, so they could chase down the mastodons, slay them, and drag the carcasses back to the cave, where the woman, who understood how much art would appreciate, was teaching the kids how to draw on the walls (an educational activity that doesn’t require extraordinarily strong knees).

At least that’s the story as told by evolutionary biologists.

Obesity is more prevalent among women

It’s not a fun fact, but it is a fact. Women carry more excess weight than men. A 2015 study reports that 38% of American women qualify as obese, while 34% of men in the United States are obese. And obesity is “the most important risk factor by far for osteoarthritis.” Every additional pound of bodyweight above the knee is equivalent to four pounds of stress on the knee.

Let’s blame your painful joints on Grandma

Researchers have found specific genetic links between ancestral women and their descendants, for both hand and knee osteoarthritis.

Having a family history of arthritis, especially rheumatoid arthritis, ups the risk for both men and women. But the increased risk is proportionately greater for the female descendent of an arthritic woman.

Last thoughts, and some good advice to help deal with joint pain

Most causes of arthritis are beyond your control. We don’t know how to stop growing older or being female. You can’t prevent your ancestors from giving you a proclivity toward arthritis. But women of all age groups can take a few simple steps that will reduce their susceptibility to both OA and RA:

1. Maintain a healthy weight. Excess weight overloads both your hips and knees so talk to your doctor about weight loss.
2. Control your blood sugar. High levels of blood sugar can harden the cartilage that supports your joints.
3. Even limited amounts of regular exercise will strengthen the muscles and connective tissue that protect your joints. Stick to low-impact activities, such as cycling, walking, or swimming.
4. Stretching will improve your range of motion and make injury less likely.
5. If you smoke, don’t.
6. Eat fish that are high in Omega-3s, such as salmon, trout, and mackerel. Omega-3s reduce inflammation.
7. Get routine preventative healthcare. Your doctor can suggest methods that may reduce the risk of arthritis, or at least slow its progress.

About Dr. Aliabadi

As one of the nation’s leading OB/GYN’s, Dr. Thaïs Aliabadi offers the very best in obstetrics and gynecology, including telehealth appointments. Together with her warm professional team, Dr. Aliabadi supports women through all phases of life. She creates a special one-on-one relationship between patient and doctor.

We invite you to establish care with Dr. Aliabadi. Please click here to make an appointment or call us at (844) 863-6700.

We take our patients’ safety very seriously. Our facility’s Covid-19 patient safety procedures exceed all CDC and World Health Organization recommendations. Masks are required in our office at all times during the coronavirus pandemic.

The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center are conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.

Dr. Aliabadi and her medical practice associates work hard to empower their patients and website visitors with the most up-to-date information about pregnancy and gynecological care.

Our goal is to pass on truly useful information to our readers. We hope you enjoy our work and find it of value. Please let us know!

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Why Do My Joints Hurt? Causes of Joint Pain & Pain Relief Options

Joints form the connections between bones. They provide support and help you move. Any damage to the joints from disease or injury can interfere with your movement and cause a lot of pain.

Cause of Joint Pain

Joint pain is extremely common, especially as you age. In one national survey, about one-third of adults reported having joint pain within the past 30 days.  Knee pain was the most common complaint, followed by shoulder and hip pain. But joint pain can affect any part of your body, from your ankles and feet to your shoulders and hands.

A wide range of conditions can lead to painful joints:

• Osteoarthritis, a “wear and tear” disease, is the most common type of arthritis.
• Rheumatoid arthritis is an autoimmune disorder that happens when your body attacks its own tissues.
• Bursitis is when sacs of fluid that help cushion your joints get inflamed.
• Gout is a form of arthritis that most often affects your big toe joint.
• Strains, sprains, and other injuries.

Often, the pain can come with swelling and inflammation, stiffness, and loss of range of motion.

Treatments for Joint Pain

Joint pain can range from mildly irritating to debilitating. It may go away after a few weeks (acute), or last for several weeks or months (chronic). Even short-term pain and swelling in the joints can affect your quality of life. Whatever the cause of joint pain, you can usually manage it with medication, physical therapy, or alternative treatments.

Your doctor will first try to diagnose and treat the condition that is causing your joint pain. The goal is to reduce pain and inflammation and preserve joint function. Treatment options include:

Medications

For moderate-to-severe joint pain with swelling, an over-the-counter or prescription nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, celecoxib, ibuprofen, or naproxen can provide relief. NSAIDs can have side effects, potentially increasing your risk for gastrointestinal bleeding.

If you have mild pain without any swelling, acetaminophen can be effective. Be careful when taking this medicine though, especially if you drink alcohol, because high doses may cause liver damage. Because of the risks, you should take any of these pain medications with caution.

If your pain is so severe that NSAIDs aren’t effective enough, your doctor may prescribe a stronger opioid medication. Because opioid drugs can cause drowsiness, you should only use them under a doctor’s care. They also can cause constipation, which you can relieve by taking laxatives.

Other drugs that may help relieve pain include:

• Muscle relaxants to treat muscle spasms (may be used together with NSAIDs to increase the effect)
• Some antidepressants and antiepileptic drugs (which both interfere with pain signals)

Topical Agents

Capsaicin — a substance found in chili peppers — may relieve joint pain from arthritis and other conditions. Capsaicin blocks substance P, which helps transmit pain signals, and it triggers the release of chemicals in the body called endorphins, which block pain. Side effects of capsaicin cream include burning or stinging in the area where it is applied. Another topical option is an arthritis cream containing the ingredient, methyl salicylate.

Injections

For people who don’t find joint pain relief from oral or topical medications, the doctor may try injections.

• Steroids. Mostly commonly, they might inject a steroid medication (which may be combined with a local anesthetic) directly into the joint every 3 to 4 months. Steroid injections are most commonly used in patients with arthritis or tendinitis. If steroid injections mask an injury, you could overuse the joint and damage it even further. The procedures are effective, but in many situations the effect may be temporary.
• Platelet-rich plasma therapy. Platelet-rich plasma (PRP) is made from your own blood, which is then injected into your painful joint. Your joint contains a large number of platelets and proteins that have anti-inflammatory and immune-modulating effects.
• Prolotherapy. It involves a series of injections of an irritant (often a sugar solution) into joints, ligaments, and tendons. The theory is that the injections stimulate local healing of injured tissues. A treatment program may involve 15-20 shots given monthly for 3-4 months.  

Other injection options include:

• Removing fluid from the joint (and is often done in connection with a steroid injection)
• Injections of hyaluronan, a synthetic version of the natural joint fluid. This is used to treat osteoarthritis.

Physical Therapy

You can work with a physical therapist to strengthen the muscles around the joint, stabilize the joint, and improve your range of motion. The therapist will use techniques such as ultrasound, heat or cold therapy, electrical nerve stimulation, and manipulation.

If you are overweight, losing weight can relieve some of the pressure on your painful joints. Exercise is one effective way to lose weight (along with diet), but be careful to stick with low-impact exercises that won’t further irritate the joint. Swimming and bicycling are among the best exercises because both allow you to exercise your joints without putting impact on them. Because water is buoyant, swimming also relieves some of the pressure on your joints.

Home Care

You can relieve short-term joint pain with a few simple techniques at home. One method is known by the acronym PRICE:

• Protect the joint with a brace or wrap.
• Rest the joint, avoiding any activities that cause you pain.
• Ice the joint for about 15 minutes, several times each day.
• Compress the joint using an elastic wrap.
• Elevate the joint above the level of your heart.

Applying ice to your painful joints can relieve the pain and inflammation. For muscle spasms around joints, try using a heating pad or wrap several times a day. Your doctor may recommend that you tape or splint the joint to minimize movement or reduce pain, but avoid keeping the joint still for too long because it can eventually become stiff and lose function.

Alternative Treatments

Some research shows that glucosamine and chondroitin supplements can help with joint pain and improve function. Both of these substances are components of normal cartilage, which helps cushion the bones and protect joints. Glucosamine and chondroitin supplements are available in capsule, tablet, powder, or liquid form. Although these supplements don’t work for everyone, they are safe to try because they don’t have any significant side effects.

When to Call Your Doctor

No matter what treatment you’re following, get medical help right away if the pain gets intense, your joint suddenly becomes inflamed or deformed, or you can no longer use the joint at all.

7 out of 10 women suffer joint pain from the age of 35

18 Jul 7 out of 10 women suffer joint pain from the age of 35

• 68% of the population over 35 suffer joint pain. This figure rises to 73% in the case of women
• They are data from a study by Vanir, a brand specializing in food supplements belonging to the American laboratory Opko Health, in collaboration with the Osteoarthritis Foundation International (OAFI)

68% of Spanish women between the ages of 35 and 65 have had joint pain in the last year. By sex, women suffer the most (73%), a number that exceeds by 10 points the number of men who report having had this problem. Although half of the population suffers mild pain, 40% reveal that for this reason they cannot develop some physical activity or exercise normally.

This is reflected in a study on joint health developed by Vanir, a brand specializing in food supplements belonging to the American laboratory Opko Health, in collaboration with the International Osteoarthritis Foundation (OAFI). It follows that in 21% of the population joint pain directly affects their quality of life. A situation that goes further with age: 10% of the Spanish over 50 years defines the pain as severe, which means that they have serious difficulties to carry out their daily life because of the intense pain in some joint.

Actually, 12% of women between the ages of 50 and 65 say that this ailment has led them to seek help or hire services for domestic tasks. In addition, about 30% of the population has seen their working lives affected and declining their work performance by joint pain. Specifically, 17% state that they have applied for leave or work leave because of this: 23% were men and 13% women.

“We live longer and, in this sense, the main key is to maintain a high quality of life over the years. We assume that we can move without problems, but as soon as we begin to have some difficulty, such as joint pain or stiffness, we begin to lose quality of life, “says Elsa Genové, CEO of Vanir.

The knee joints are the most resentful (52%) as this report shows. These are followed by those of the spine (mentioned by 4 out of 10 Spaniards) and those of the hands (25%). In the case of the latter, the figure rises to 37% in the case of women over 50, a figure that exceeds 13 points for men in the same age group.

Specifically, this type of pain is closely related to ailments such as osteoarthritis, a disease that, as warned from OAFI, affects more than 242 million people worldwide. “The symptoms of osteoarthritis are usually progressive and dilated over time. In a first stage, the pain associated with the movement and the effort to which the joint is submitted appears, although in this first phase the pain ceases with rest. In a second stage, the worsening of the osteoarthritis makes the pain appear after rest and exercise, so the discomfort is more continuous and practically constant, “says Josep Vergés, president of the Foundation.

About Vanir

Vanir is the brand specializing in food supplements belonging to the US laboratory Opko Health, a multinational biopharmaceutical and diagnostic company that bases its activity on the discovery, development and commercialization of novel products and technologies. The aim of Vanir is to market high-end products in self-care aimed at improving the health and well-being of people, especially focused on joint and muscular health. Its range of products consists of Vanit Fit (muscle toning and strength), Vanir Flex (prevention of joint wear and mobility improvement) and Vanir Go! (concentration). In addition, Vanir is a pioneer brand in its sector in the direct sale to the consumer through the online channel and all its products are manufactured in Spain complying with standards of maximum quality.

Joint Pain: Symptoms, Causes, and Treatment

Overview

What is joint pain?

Joint discomfort is common and usually felt in the hands, feet, hips, knees, or spine. Pain may be constant or it can come and go. Sometimes the joint can feel stiff, achy, or sore. Some patients complain of a burning, throbbing, or “grating” sensation. In addition, the joint may feel stiff in the morning but loosen up and feel better with movement and activity. However, too much activity could make the pain worse.

Joint pain may affect the function of the joint, and can limit a person’s ability to do basic tasks. Severe joint pain can affect the quality of life. Treatment should focus not only on pain but also on the affected activities and functions.

Who is more likely to experience joint pain?

Joint pain tends to affects those who:

• Have had previous injuries to a joint
• Repeatedly use and/or overuse a muscle
• Have arthritis or other chronic medical conditions
• Suffer from depression, anxiety, and/or stress
• Are overweight
• Suffer from poor health

Age is also a factor in stiff and painful joints. After years of use, and wear and tear on joints, problems may arise in middle-aged or older adults.

Possible Causes

What causes joint pain?

The most common causes of chronic pain in joints are:

• Osteoarthritis, a common type of arthritis, happens over time when the cartilage, the protective cushion in between the bones, wears away. The joints become painful and stiff. Osteoarthritis develops slowly and usually occurs during middle age.
• Rheumatoid arthritis is a chronic disease that causes swelling and pain in the joints. Often the joints become deformed (usually occurring in the fingers and wrists).
• Gout is a painful condition where crystals from the body collect in the joint, causing severe pain and swelling. This usually occurs in the big toe.
• Bursitis is caused by overuse. It is usually found in the hip, knee, elbow, or shoulder.
• Viral infections, rash, or fever may make joint movement painful.
• Injuries, such as broken bones or sprains
• Tendinitis is an inflammation of the tendons, or the flexible bands that connect bone and muscle. It is typically seen in the elbow, heel, or shoulder and is usually caused by overuse.

Care and Treatment

How is joint pain treated?

Although there may not be a cure for the pain, it can be managed to bring the patient relief. Sometimes the pain may go away by taking over-the-counter medication, or by performing simple daily exercises. Other times, the pain may be signaling problems that can only be corrected with prescription medication or surgery.

• Simple at-home treatments, such as applying a heating pad or ice on the affected area, may be recommended for short periods, several times a day. Soaking in a warm bathtub may also offer relief.
• Exercise can help get back strength and function. Walking, swimming, or other low-impact aerobic exercise is best. Those who participate in strenuous workouts or sports activities may need to scale it back or begin a low-impact workout routine. Gentle stretching exercises will also help. Check with the doctor before beginning or continuing any exercise program.
• Weight loss may also be suggested, if needed, to lessen strain on joints.
• Acetaminophen, (Tylenol®) or anti-inflammatory drugs (ibuprofen), may help ease the pain. Both of these medicines are available over the counter, but stronger doses may need a doctor’s prescription. If you have a history of stomach ulcers, kidney disease, or liver disease, check with your physician to see if this is a good option for you.
• Topical treatments, such as ointments or gels that can be rubbed into the skin over the affected joint area, may also help ease pain. Some of these may be found over the counter, or the doctor may write a prescription.
• Dietary supplements, like glucosamine, may help relieve pain. Ask the doctor before taking any over-the-counter supplements.

If those medications or treatments do not ease the pain, the doctor may prescribe:

• Supportive aids, such as a brace, cane, or orthotic device in the shoe, can help support the joint to allow ease of movement. The doctor, physical or occupational therapist, or social worker will be able to assist with the right option(s) available.
• Physical or Occupational Therapy, along with a balanced fitness program, may gradually help ease pain and improve flexibility.
• Antidepressants may be prescribed to help improve sleep for a patient suffering from joint pain.
• Steroids, often given by injection into the joint, provide short-term relief of pain and swelling.
• Painkilling drugs that help ease pain.

Please note that medicine, even those available over the counter, affects people differently. What helps one person may not work for another. Be sure to follow the doctor’s directions carefully when taking any medicine, and tell him or her if you have any side effects.

What can be done to relieve joint pain?

Surgery may be an option if the joint pain is long lasting and does not lessen with drugs or physical therapy and exercise. Please be sure to discuss this with the doctor to make sure that an operation makes sense.

There are many different surgical options available, including:

Arthroscopy: A procedure where a surgeon makes two or three small incisions in the flesh over the joint and gets into the joint using an arthroscope, or a thin, flexible, fiberoptic instrument, to repair cartilage or remove bone chips in or near the joint.

Joint replacement: If other treatments do not help, surgery may be needed to replace the joint once the cartilage that cushions and protects the ends of the bones gradually wears away. This can be done for hip, knee and shoulder joints.

A surgeon removes parts of the patient’s bone and implants an artificial joint made from metal or plastic. This procedure has had excellent results and the majority of patients feel long-lasting pain relief after this type of surgery.

When to Call the Doctor

What symptoms of joint pain are causes for concern?

Symptoms of joint pain range from mild to disabling. Without cartilage, bones rub directly against each other as the joint moves. Symptoms can include:

• Swelling
• Stiff or enlarged joint
• Numbness
• Noisy joints, or clicking, grinding, or snapping sounds when moving the joint
• Painful movement
• Difficulty bending or straightening the joint
• Loss of motion
• A red and hot and swollen joint (This should be evaluated quickly by a doctor)

When should I see a doctor?

If pain is interfering with normal daily life activities, it is time to talk to a doctor about the problem. It is important to diagnose the cause of the pain quickly and begin treatment to relieve pain and maintain healthy, functioning joints.

You should see a doctor if:

• Pain is accompanied by a fever
• There is unexplained weight loss (10 pounds or more)
• Pain is preventing you from walking normally

During the appointment, the doctor will ask many questions to figure out what may be the cause of the pain. The patient should be ready to answer questions about previous injuries to the joint, when the joint pain began, a family history of joint pain, and the type of pain experienced.

An examination of the affected joint will follow to see if there is pain or limited motion. The doctor will also look for signs of injury to the surrounding muscles, tendons, and ligaments.

If necessary, the doctor may also order X-rays or blood tests. X-rays can show if there is joint deterioration, fluid in the joint, bone spurs, or other issues that may be contributing to the pain. Blood tests will help confirm a diagnosis or rule out other diseases that may be causing the pain.

Joint Pain: Many Joints – Bone, Joint, and Muscle Disorders

Doctors ask about pain severity, onset (sudden or gradual), how symptoms vary over time, and what increases or decreases pain (for example, rest or movement or time of day when the symptoms worsen or abate). They ask about joint stiffness and swelling, previously diagnosed joint disorders, and risk of exposure to sexually transmitted diseases and Lyme disease.

Doctors then do a complete physical examination. They check all joints (including those of the spine) for swelling, redness, warmth, tenderness, and noises that are made when the joints are moved (called crepitus). The joints are moved through their full range of motion, first by the person without assistance (called active range of motion) and then by the doctor (called passive range of motion). This examination helps determine which structure is causing the pain and if inflammation is present. They also check the eyes, mouth, nose, and genital area for sores or other signs of inflammation. The skin is examined for rashes. Lymph nodes are felt and the lungs and heart examined. Doctors usually test function of the nervous system so that they can detect disorders of the muscles or nerves.

Some findings give helpful clues as to the cause. For example, if the tenderness is around the joint but not over the joint, bursitis or tendinitis is likely the cause. If tenderness is present all over, fibromyalgia is possible. If the spine is tender as well as the joints, possible causes include osteoarthritis, reactive arthritis, ankylosing spondylitis, and psoriatic arthritis. Findings in the hand can help doctors differentiate between rheumatoid arthritis and osteoarthritis, two particularly common types of arthritis. For example, rheumatoid arthritis is more likely to involve the large knuckle joints (those that join the fingers with the hand) and wrist. Osteoarthritis is more likely to involve the finger joint near the fingernail. The wrist is unlikely to be affected in osteoarthritis, except at the base of the thumb.

90,000 Why joints hurt – causes, treatment and prevention

Views: 280 904

Date of last update: 26.08.2021

Average Read Time: 9 minutes

Contents:

Diseases that cause joint pain
Treatment of joint pain
Drug methods
Motrin® preparation for joint pain
Educational video “Pain in joints”

More than half of people over 40 years of age regularly experience joint pain.The reasons are caused by mechanical trauma, prolonged hypothermia, age-related changes in bone tissues, excessive physical exertion, viral / infectious diseases, genetic predisposition, bad habits, etc. Also, the appearance of pain in joints is facilitated by work in wet conditions, in the cold, etc.

Diseases causing joint pain

Joint pain that occurs without an objective cause is called “arthralgia”.It can appear due to rheumatic, infectious, autoimmune, neurological diseases and a number of other reasons. Many pathologies can manifest themselves as pain:

• reactive arthritis is an inflammatory disease with joint damage that develops after the transfer of certain infections (genitourinary, gastrointestinal tract). It occurs most often in people 20-40 years old. It is manifested by acute pain when bending, reddening of the skin over the affected joint, swelling of tissues, increased body temperature.Reactive arthritis, which includes the following symptoms: arthritis, conjunctivitis, urethritis or cervicitis, colitis, and characteristic skin lesions, is called Reiter’s syndrome;
• rheumatoid arthritis – refers to an autoimmune disease that affects the knee and elbow joints, feet and hands. Differs in constant soreness in the affected area. The joints are deformed, swollen, rheumatoid nodules appear on the skin. The patient often has a decrease in weight, damage to the eyes, skin, spleen;
• psoriatic arthritis – is considered a genetically determined pathology.The disease most often spreads to the feet and fingers, and the right and left joints are affected asymmetrically. Characterized by the presence of plaques, a purple-cyanotic hue in the affected areas;
• Osteoarthritis – belongs to the most common diseases of non-inflammatory origin. Affects the hip, knee, wrist joints. The main manifestations are: aching pain, crunching and stiffness, which becomes more noticeable with exertion. Tissues swell over the affected area, an increase in body temperature is noted;
• Gout is an inherited disease.At the heart of its occurrence lies a metabolic disorder, leading to the deposition of salts. Most often, pathological changes are observed in the ankle joints, on the elbows and on the big toes. The skin over the sore joints becomes hot, reddens, swells and flakes. Gout in most cases is accompanied by damage to the kidneys and heart;
• ankylosing spondylitis (or ankylosing spondylitis ankylosing spondylitis ) – refers to inflammatory diseases and is characterized by gradual damage to the joints of various parts of the spine.With this pathology, over time, scar tissue forms in the joints with salts deposited on it, which significantly limits mobility. A person has a fever, posture suffers greatly, pain in the sacrum and lower back is more pronounced at night. The dorsal muscles become stiff at rest, and chest soreness is noted, especially when inhaling deeply. The reasons are not completely clear. More common in men 20-40 years old. In the absence of treatment, the mobility of the spine is significantly impaired, up to its complete immobility;
• post-traumatic arthritis – can affect any joints: shoulder, ankle, hip, knee, etc.It is a consequence of dislocations, fractures and sprains, tendon damage, severe bruises. In the absence of timely treatment, it becomes chronic. Signs of post-traumatic arthritis: pain syndrome, crunching in joints, aching bones, swelling in the area of ​​injury, stiffness of movements;
• Osteoarthritis – occurs mainly in people over 50, as it is caused by constant stress on the joints. The disease manifests itself in pain, redness of the skin and edema.

Separately, it should be said about drug arthralgia, which refers to temporary painful conditions. It, like the pathologies described above, manifests itself in severe pain in the joints, but its cause is the intake of certain medications: antibiotics, tranquilizers and some other groups. This complication is especially often observed with a high dosage of drugs.

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Joint pain treatment

Joint pain can be caused by mechanical trauma, prolonged hypothermia, age-related changes in bone tissues, excessive physical exertion, viral / infectious diseases, genetic predisposition, bad habits, etc.Only a doctor is able to make an accurate diagnosis by conducting the necessary research. It is impossible to independently determine how to treat joint pain in each specific case, since the causes of the appearance of different diseases are different. It is necessary to seek help from specialists at the first signs of the disease, this will help to carry out treatment on time and avoid severe irreversible deformations.

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Medication

These methods include the use of ointments, tablets, solutions for injections, plasters, suppositories.Let us consider in more detail the medical treatment methods that doctors today recommend to their patients.

Non-steroidal anti-inflammatory drugs. NSAIDs do not contain hormones. Their main purpose is to eliminate pain, to reduce the inflammatory response. They do not affect the speed of the pathological process and do not control it, but they well remove such concomitant symptoms as acute pain and local fever. NSAIDs are usually taken as tablets or applied as creams or ointments to the affected area.In severe conditions, the best route of administration is by injection directly into the affected joint.

Indications for the use of NSAIDs: arthritis of all types, arthrosis, Reiter’s syndrome, osteoarthritis, pain after surgery on the joints. These drugs help to quickly relieve the troubled area when taken in the right dosages. Long-term use of NSAIDs in correct dosages is possible after consulting a doctor.

Glucocorticoids. These medicines have analgesic, anti-inflammatory, anti-allergic and immunoregulatory effects.For joint pain, they are used in two ways:

• systemically – by intramuscular or intravenous injection;
• locally – by intra-articular injection.

Indications for use include rheumatoid arthritis, gout, osteoarthritis, synovitis and other conditions accompanied by severe pain. Glucocorticoids are considered a second line of treatment after NSAIDs if they are not effective enough after two weeks. The use of glucocorticosteroids is possible only in accordance with the doctor’s recommendation according to the scheme indicated by him

Peptic ulcer disease, diabetes mellitus, heart failure, arterial hypertension, epilepsy are considered relative contraindications for the use of glucocorticoids.But even with the listed contraindications, it is possible to use glucocorticosteroids strictly under the supervision of a physician if the potential benefit of treatment outweighs the risk of developing adverse events.

Chondroprotectors. These drugs are classified as drugs with unproven efficacy and safety. Their composition includes biologically active additives, which theoretically should slow down the course of the disease, but in practice, the desired results have not yet been obtained.

Physiotherapy treatments

The doctors’ arsenal of methods also includes stimulation with electric current, cold and heat therapy, and ultrasound.Their effectiveness largely depends on the cause and stage of the disease. In some cases, physical therapy can restore mobility to damaged joints and reduce soreness.

Surgical treatments

In case of significant destruction of the joints, surgery may be required to restore the anatomy of the organ. Most often, patients undergo hemiarthroplasty (partial bone grafting) or complete replacement of the joint by prosthetics. Correctly performed surgical intervention relieves pain, restores joint function and restores the patient’s ability to work.Usually, surgical methods of treatment are resorted to in the last stages of the disease.

Physiotherapy exercises

Exercise therapy is often prescribed by doctors after joint surgeries and as an integral part of the complex for the treatment of joint pain. Physiotherapy exercises under the supervision of a specialist helps to solve several problems at once:

• Maintain joint mobility at the proper level;
• gradually increase muscle strength and strengthen ligaments;
• develop body flexibility and control weight;
• Increase the endurance of the cardiovascular system.

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Motrin® preparation for joint pain

Motrin® is a drug belonging to the NSAID group and helps relieve pain in the joints. Its action is also directed against inflammation, so it can help to get rid of edema. The tool is approved for use in adults and children over 15 years old. Before using Motrin®, you should read the instructions for the preparation and consult your doctor.

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The information in this article is for reference only and does not replace the professional advice of a physician. Consult a qualified professional for diagnosis and treatment.

Educational Video “Joint Pain”

90,000 causes and treatment. What to do if joints hurt

Pain Causes Classification Diagnostics Treatment Preparations

Causes of severe joint pain.What to do if joints hurt.

Joint pain

Joint pain (or as it is called in another way – arthralgia) is an important symptom in the diagnosis of many diseases. It was she who first said that serious changes began at the junction of the bones. Joint pain is not always accompanied by swelling, curvature, severe soreness when feeling or redness. The patient also does not complain of significant restrictions in the mobility of large joints. It also happens that even an X-ray examination does not allow us to see signs of inflammation.But this does not make joint pain an innocent symptom: it can signal severe organic lesions and even pathologies that are not related to the state of the joint itself.

As statistics show, sharp pains in the joints of the arms and legs begin to bother every second person over the age of 40-50 years. In persons who have crossed the 70-year mark, diseases of the musculoskeletal system are even more common – in 90% of cases.

Causes of joint pain

Age-related changes

Among the possible causes of pain – age-related changes in the joints: the cartilage tissue becomes thinner and loses its elasticity, which causes painful sensations and stiffness of movements.Also, less and less synovial fluid is produced, which fills the “capsule” around the junction of the bones and lubricates the joint. As a result, the articular surfaces can begin to touch, and the joint can wear out. Without proper protection and support of cartilage, osteoarthritis and other diseases that accompany acute pain can develop. The process of age-related changes in the joint is aggravated by improper diet, weak muscle tone, the presence of past injuries, a sedentary lifestyle, or, conversely, excessive physical exertion.It is noteworthy that the discomfort in the joints due to the age factor often increases in the fall and spring.

Physical activity

Increased physical activity can be considered as an independent reason, in which even young people may experience aching or sharp joint pain. Intensive training at the limit of possibilities and hard physical labor in one way or another have a negative impact on the musculoskeletal system. Even in the absence of injury, excessive exercise can cause blood flow disturbances in the synovium surrounding the joint.Because of this, the cartilage tissue ceases to receive “nutrition” and becomes thinner without the possibility of normal regeneration. This problem is often faced by professional athletes and people of certain professions – builders, miners, mechanics, etc.

Diseases

Various diseases can also “hit” the joints. So, joint pains often confirm the presence of rheumatic processes, in which the connective tissues of the body are affected. In this case, the pain syndrome is pronounced in the morning hours and tends to decrease in the evening.A person feels the strongest discomfort in the small joints of the hands and feet. In the morning, the patient often suffers from the fact that he cannot immediately get up and walk quickly – his body is stiff.

In some patients, joints ache after suffering an inflammatory disease of the musculoskeletal system. In this case, you just need to wait until the discomfort goes away on its own.

If paroxysmal pain, arose unexpectedly, intensified during the day and persists for several days, while only one joint on the big toe aches, one can suspect gouty arthritis, in which uric acid crystals accumulate in the articular structures.

If the pain grows very slowly, the inflammatory process has affected the pelvic area, knees, the symptoms intensify during physical work and weaken at night, then the presumptive diagnosis is osteoarthritis deformans.

Infectious diseases are also among the causes of joint pain, for example, after bowel diseases, a person may experience discomfort in which all joints of the body ache. Mobility in them remains, but the unpleasant symptom lasts for several days.

If there are foci of chronic infections in the human body, joints can also ache.

The list of less common causes of joint pain is very long and includes:

• weather dependence;
• heavy metal poisoning;
• long-term use of certain medications;
• post-allergic reactions;
• psychosomatic disorders.

Classification of joint pain

There are several classifications of joint pain.According to the criterion of localization, there are:

• monoarthralgia – in this case, only one joint is affected;
• oligoarthralgia – different joints hurt at the same time, but no more than four;
• polyarthralgia – discomfort is felt in more than 4 joints of the body.

By the nature of the lesion, the pathology can be non-inflammatory and inflammatory. In separate groups, post-inflammatory arthralgias and pseudoarthralgias are distinguished.

Joint pain occurs under different circumstances.A person feels starting pains at the very beginning of the movement – when trying to change the position of the limbs, stand up or walk at a different speed. Night pains disturb during the period of night rest, when a person is at rest. This discomfort is often the cause of sleep disorders and greatly impairs the quality of life. Reflected pain can be seen in areas where there are actually no painful deviations from the normal state. There are also mechanical pains that occur during or after certain exercises or activities.

In addition, joint pains vary in nature. They are:

• blunt and sharp;
• permanent and transitory;
• weak, moderate and intense.

This classification is largely subjective and depends on the individual characteristics of the human body.

Diagnosis of joint pain

To understand why the joints of the legs and arms hurt, you need to see a doctor. The doctor prescribes a number of diagnostic procedures for the patient.To begin with, laboratory tests are taken:

• Complete blood count. It makes it possible to detect deviations, taking into account the nature of the joint damage and the degree of its severity.
• Biochemical blood test. In case of joint inflammation, they look at the levels of C-reactive protein, fibrinogen, total protein, seromucoid, diphenylamine reaction, as well as some other indicators that confirm a rheumatic diagnosis.

In addition, the following examinations can be assigned:

• Radiography.It is mandatory for painful joints, since without pictures the doctor cannot carry out differential diagnostics and assess the degree of damage to the skeletal system;
• Computed tomography. Used to study the location of injured or inflamed bone areas;
• Ultrasound examination is an affordable diagnostic method that describes in detail the joint and adjacent tissues;
• Densitometry. An additional type of diagnosis showing how well the bone density is preserved.Used to diagnose osteoporosis;
• Arthroscopy. During the procedure, a specialist visually examines the structure of the joint, its structure, takes a tissue sample from the desired area;
• Radionuclide (radioisotope) scanning. Effective in the early stages of joint diseases;
• Arthrography. The doctor injects special contrast agents inside the joint (contrast may not be used). A change in the initial picture makes it possible for him to judge the presence of affected sections in hard-to-reach parts of the joint.

If the doctor deems it necessary, a biopsy is performed – a diagnostic sampling of cells from the affected area.

Joint pain treatment

Treatment of arthralgia will be effective only if doctors find out the cause of the symptom, establish the development of which disease it signals. To relieve inflammation, the patient may be prescribed:

• chondoprotectors – slow down the progression of osteoarthritis, help prevent the destruction of cartilage, reduce inflammation; an example of a well-known drug from this group is the drug Teraflex®, which contains glucosamine and chondroitin sulfate, the components activate regenerative processes in the cartilage, due to which the pain gradually disappears, the patient’s condition improves;
• non-steroidal anti-inflammatory drugs – eliminate pain, prevent the spread of inflammatory reactions, normalize body temperature;
• muscle relaxants – designed to minimize skeletal muscle stiffness;
• antibacterial drugs – used for arthritis of an infectious nature;
• vitamin and mineral complexes – vitamins D, A, E, C, group B are necessary for the normal functioning of the joints and their speedy recovery.Calcium, magnesium and selenium are also important;
• hormonal drugs – steroids – are used for severe and severe inflammation, in the absence of the effectiveness of treatment with non-steroidal drugs.

In parallel with taking tablets, intramuscular and intravenous administration of drugs, the patient can be prescribed warming, analgesic and anti-inflammatory ointments and creams.

If the aching pain is unbearable, it is possible to perform a nerve blockade.During the procedure, powerful medications are used that help to forget about pain symptoms for a while.

Additional methods of therapy for joint pain include:

• physiotherapy exercises;
• massage;
• manual therapy;
• mechanotherapy;
• traction of joints using special equipment;
• diet.

From physiotherapy procedures, the patient is shown:

• shock wave therapy;
• laser therapy;
• phonophoresis;
• myostimulation;
• magnetic therapy and others.

“Teraflex” for joint pain

The Teraflex product line was created specifically to address joint health problems.

Teraflex drugs belong to the group of chondroprotectors, that is, drugs that prevent the destruction of the cartilage tissue of the joints, which can be associated with both age-related changes and increased physical activity, as well as a number of other reasons. Chondroprotectors contribute to the restoration of joints, relieve inflammation and pain, and prevent the further development of the disease.The Teraflex products not only relieve symptoms, but act directly on the cause of pain and joint stiffness.

90,000 why do joints hurt, what to do and how can you get rid of pain?

According to statistics, complaints of joint pain – arthralgia – refer to approximately 50% of people over 40 years old, and after 70 years, the symptom manifests itself in 90% of cases [1]. And these are only official figures, while many patients prefer to self-medicate and avoid visiting doctors.But if the patient has already tried all the methods of European medicine without visible progress, the opportunity to get rid of joint pain still remains. We will tell you about this possibility.

Why do joints hurt?

Joint pain occurs due to irritation of the nerve endings coming from the synovial joint capsule. The peculiarity of the structure of the articular tissue is such that, due to the large number of these endings and good blood supply, the joint is able to quickly respond with a painful reaction to direct and indirect stimuli.Toxins, products of autoimmune processes, salt crystals and other inflammatory components can act as irritants.

A favorable background for the appearance of arthralgia is many factors, such as age, which naturally contributes to degenerative-dystrophic changes in the joints, irritation of the synovial membrane by bone growths (osteophytes), congenital defects and pathologies, which resulted in the malformation of the joints, for example, hip dysplasia , as well as genetics, excess weight, excessive exercise or, conversely, a sedentary lifestyle.A separate role in the occurrence of pain is played by joint injury, stretching of the tendon-ligamentous apparatus. Joint pain can be caused by vascular disorders as a result of changes in weather conditions or prolonged muscle spasm.

Sometimes arthralgia is a reflection of pathological processes occurring in other internal organs – with angina pectoris, tumors in the lungs and myocardial infarction, pain in the shoulder joint can be observed, and with pathology of the pelvic organs, pain in the sacrum often occurs.Arthralgia accompanies acute viral diseases – everyone knows “bone aches” with influenza, and also accompanies some blood diseases.

The cause of joint pain can be neurological diseases of the spine, as well as diffuse diseases of the connective tissue caused by systemic diseases of an autoimmune nature – lupus erythematosus, rheumatoid arthritis.

Given the variety of possible causes, if you experience pain in the joints, you should immediately consult a doctor in order to carry out a comprehensive diagnosis and start treatment on time.

Tips
Certain medications, such as penicillin antibiotics, tranquilizers, contraceptives, can also cause arthralgia. This type of pain is characterized by symmetrical damage to the small joints of the hands. After stopping the drug, pain disappears .

Types of joint pain

Modern medicine divides joint pain according to several characteristics, depending on the time of their manifestation, the nature of the damage, the extent of progression and localization.Different types of joint pain are characteristic of different diseases.

According to the time of manifestation of pains are divided into four types:

1. Night, or congestive, pain . Unpleasant sensations intensify at night when the body is resting. This is due to the fact that, due to the lack of movement, stagnation of synovial fluid occurs in the joint, its blood supply slows down. In addition, the muscles that maintain the normal position of the deformed head of the bones in the joint become relaxed, and the pain increases.
2. Mechanical pain . They are caused by physical exertion during the day or pressure on the joint. Such pains usually worsen in the evening, after a night’s rest, they disappear.
3. Starting pains. This type of pain is experienced by most people, but usually they are simply overlooked. Starting pain in the joints occurs at the beginning of any movement, when the joint was at rest until that time. When the joint warms up, the pain subsides or disappears completely.
4. Reflected pain . Occur in diseases of internal organs or after childbirth in women.

By the nature of joint damage , two types of pain are distinguished: inflammatory and non-inflammatory. The former is caused by a reaction to an infection, an allergic or autoimmune process. Usually, such pains are accompanied by joint swelling, redness of the skin and an increase in body temperature. The absence of these signs, even in the presence of severe pain in the joint, indicates its non-inflammatory nature.

According to the extent of progression , joint pain is divided into mono-oligo- and polyarticular type. Monoarticular pain affects only one joint, oligoarticular pain affects from two to four, and polyarticular pain is that pain that affects more than 5 joints.

Localization – general and localized pain. Generalized pain, also called diffuse pain, affects several different joints at the same time and can change location. Localized pain occurs in a specific joint without changing its location.

Various diseases are characterized by combinations of different types of pain. For example, in rheumatic diseases, such as ankylosing spondylitis, arthralgia occurs more often at night, in several joints at once, of the oligo- or polyarticular type, while the pain can “migrate”, recur.

With degenerative-dystrophic diseases of the joints, that is, with deforming osteoarthritis (DOA), the pain is mechanical, sometimes starting pains appear in the first half of the night.

Pain caused by infections is polyarticular in nature, and pain can affect one joint or the other.

Notes
Approximately 14% of patients with leukemia and 25% of patients with lymphoma have severe joint pain [2].

Diagnostics

It is possible to establish the true cause of joint pain only in the process of a full examination. First of all, you need to contact a therapist, who, if necessary, will refer you to a cardiologist, rheumatologist, traumatologist, orthopedic surgeon, etc.Diagnostics consists of several stages:

• study of history data to identify links with trauma, infection, nutritional errors, hormonal disruptions, etc.
• visual examination, during which the external condition of the joint, the skin is examined, and the body temperature is measured;
• determination of the severity of pain and their nature;
• blood test – general and biochemical – for the presence of an inflammatory process and other pathologies;
• X-ray of the joints, with the help of which the change in the relief of the joint surface, the presence of subluxations, osteoporosis, changes in the height of the joint space, marginal bone growths or defects, etc.etc .;
• densitometry – determination of bone and cartilage tissue density using ultrasound, MRI and CT;
• endoscopy, or arthroscopy, of the articular cavity;
• Diagnostic puncture of the joint or collection of synovial fluid for further laboratory examination.

In addition, the doctor may prescribe immunological studies, tests for the determination of antistreptolysin, a blood test for the HLA system. Treatment is prescribed solely based on test results.

Treatment for joint pain

Regardless of what disease caused arthralgia, doctors must prescribe drug treatment , first of all – non-steroidal anti-inflammatory drugs (NSAIDs) , if coagulation disorders do not interfere with their intake blood, acute gastrointestinal diseases (for example, an ulcer).NSAIDs relieve edema, hyperemia, lower the temperature and the intensity of the development of the inflammatory process. Such drugs include Ibuprofen, Diclofenac, Meloxicam, Aspirin, etc. In addition to NSAIDs, vasodilators (Actovegin, Euphyllin, Lipoic acid) can be prescribed to accelerate blood flow in the focus pathology and stimulation of the recovery process. Muscle relaxants (“Tizanidine”, “Tolperisone”, “Baclofen”) are prescribed for a short time and only if there is an overstrain of the muscles surrounding the joint caused by its stiffness or compression of nerve fibers.

Steroid hormones are another possible component of the drug method. With severe pain syndrome and an active inflammatory process, especially in cases where other drugs are ineffective, the doctor may prescribe “Hydrocortisone”, “Celeston” or “Diprospan” in the form of injections into the joint area.

An important group of drugs in the treatment of arthralgia – chondroprotectors , usually containing chondroitin sulfate and glucosamine, which is part of the synovial fluid of the joint.They are involved in the production of new bone and cartilage tissue, contribute to the disappearance of the symptoms of arthrosis and other diseases.

In addition to injections and tablets, the doctor can also recommend medicinal creams and ointments with active ingredients. However, it should be remembered that no more than one tenth of the medication penetrates the sore joint through the skin, so by definition it is impossible to replace pills and injections with ointments.

Surgical methods treatment of arthralgia is a serious intervention in the work of the body and is prescribed in extreme cases.These methods include a joint puncture, during which the doctor uses a special needle to remove the inflammatory fluid or inject medications into the joint cavity.

• Arthroscopic debridement by endoscopy allows you to remove dead tissue from the joint cavity through small holes and rinse it with medicinal solutions.
• Periarticular osteotomy refers to traumatic operations. It is indicated for those patients who, for one reason or another, cannot undergo joint replacement.It consists in filing the bones and their subsequent splicing at a different angle to reduce the load on the joint.
• Endoprosthetics is a radical method in the treatment of large joints. During the operation, the patient is fitted with a special biocompatible joint prosthesis.

Physiotherapy . These include shock wave therapy based on the effect of cavitation, in which dynamic impulses stimulate blood circulation, enhance bone synthesis, and destroy salt deposits.

• Myostimulation simultaneously trains and relaxes the muscles that surround the joint, and helps to reduce pain, relieve stress, and burn fat.
• Phonophoresis – administration of topical drugs in combination with ultrasound therapy to increase the effect of their use.

The main rehabilitation methods treatment of joint pain include kinesitherapy (motion therapy), massage, mechanotherapy, traction therapy, reflexology, occupational therapy, psychotherapy [3] .

In addition, if the pain in the joints is reflected, that is, caused by diseases of the internal organs, then successful treatment of the underlying disease is necessary.

What to do when all else fails?

Unfortunately, there are often situations when many treatments have been tried, and the patient is still suffering from joint pain. This leads to a decrease in the quality of life, a person becomes unable to perform his usual functions, suffers not only physically, but also mentally, feeling practically disabled.In this case, turning to traditional Chinese medicine can help. Chinese doctors have a wealth of experience in treating such diseases, knowledge and skills have been accumulating over thousands of years, and today they are also combined with modern methods of therapy.

The main commandment of Chinese medicine is a purely individual approach. The patient will be prescribed more than just the drugs prescribed by the diagnosis. The doctor will take into account all the characteristics of the body, the course of the disease and many more different factors up to the place of residence.

Today, Chinese doctors successfully treat arthrosis, osteoarthritis, osteoporosis, gouty arthritis, osteoarthritis, polymyalgia rheumatica, spondyloarthrosis, dermatomyositis, polymyositis. Before starting treatment, the patient undergoes a comprehensive diagnosis – according to the pulse, the cornea of ​​the eye, skin condition, localization and degree of pain, etc.

After receiving an accurate picture of the development of the disease and other data about the patient, doctors begin therapy. A characteristic feature of the treatment of Chinese specialists is that, if necessary, the treatment tactics can be changed at any time – this is the main difference between Eastern medicine and Western medicine.

The treatment program can be very extensive. For arthrosis of the knee joint (gonarthrosis), for example, one of the main methods of treatment is acupuncture , which consists in placing metal needles on bioactive points of the human body. Acupuncture allows you to quickly reduce or completely stop pain. According to Chinese philosophy, acupuncture helps to move the “Qi” energy, which is responsible for human health.

Together with acupuncture, the technique of phytocompress is used, for which concentrated decoctions of medicinal herbs heated to a certain temperature are used.The tissue flaps soaked in them are also applied to biologically active points for a certain time, contributing to their stimulation. Phytotherapy assumes that the composition of drugs is selected individually and can include up to 40 types of medicinal herbs.

Possible appointment moxibustion – warming up active points with wormwood cigars. Its action is akin to that of acupuncture, while moxibustion also has a general strengthening and calming effect.

As for massage , in case of arthrosis, it is prescribed without fail.Tuina therapeutic massage is the second basic method for eliminating joint pathologies. Chinese medicine knows 7 ways to perform this massage, and the doctor chooses the technique for each specific case. Cupping massage, or vacuum therapy, affects the joint at several levels – it provides blood flow, increases nutrition of the joint, warming up stops the inflammatory process, and vacuum provides lymphatic drainage, removes salt from the joint, increasing its mobility. Massage is most effective in combination with acupuncture.

Along with massage, Chinese gymnastics taijiquan or qigong can be recommended, whose exercises are aimed specifically at improving the condition of the joints, increasing their mobility, strengthening and preventing arthralgia. Under the supervision of Chinese specialists, people with chronic joint diseases can do this gymnastics.

Of course, traveling to China for treatment can be quite costly. But today this is not necessary – in many large cities, clinics of traditional Chinese medicine have been opened, in which qualified specialists in the field of joint diseases work.

menopause joint pain

menopause joint pain

Wear of cartilage on the surface of bones leads to the development of deforming osteoarthritis or osteochondrosis of the spine. The joints undergo degenerative changes. The lesion site swells, becomes inflamed, reddens against the background of thinning, destruction of cartilage between the vertebrae. For deforming arthrosis, a characteristic feature is a crackling in the joints. The disease progresses rapidly (especially over the years) and is difficult to treat.Often, patients with such diagnoses have to agree to surgery to regain minimum mobility. The independent editorial staff got interested in the product and conducted their own investigation. The results of clinical trials, expert opinions, and real customer reviews were taken into account. Conclusions based on the collected information: Ortex is not a divorce, but a cardinal solution to all joint problems.

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Joint pain and menopause.Relief of symptoms and ways to prevent the development of arthritis during menopause. Olga Yakovleva, endocrinologist. Editor. Gerasimov. How to relieve joint pain during menopause. Stay active. Practice de-stress programs. Follow your diet. It is possible to relieve joint pain during menopause with medication. Hormone replacement therapy and the mechanism of action of estrogens on the joints. What to do if joint pain is severe? The mechanism of action of estrogens on the joints. Joint pain: the role of hormones.Menopause is a period of extinction of a woman’s reproductive function. At this time, there is a gradual decrease in the production of sex hormones, which during the entire previous life not only ensured the woman’s ability to reproduce, but also protected her body from many diseases. Hormonal changes are associated with metabolic disorders and a deterioration in general well-being. How to protect joints during menopause? It is impossible to restore a joint that has begun to collapse, experts say.But you can slow down and even stop the destruction process if you consult a doctor in time and follow his instructions. Pain in joints, bones, feet, spine in women of this age is a manifestation of climacteric syndrome. Menopause is a normal physiological phenomenon, during which the level of female sex hormones (estrogens) decreases. Estrogens, in turn, are involved in the qualitative absorption of calcium from food, followed by the penetration of the mineral into the bones. With a decrease in the production of female sex hormones, calcium is absorbed worse, which leads to a decrease in bone mineral density, resorption of bone tissue, which is the cause of pain.Causes of joint pain with menopause. It would seem, how can menopause and joints be connected? It turns out that the connection between these concepts is direct and close. Menopause is characterized by a decrease in the production of sex hormones: estrogens and progestins. These substances cease to be produced by the ovaries when the supply of follicles in them is depleted. Menopause and joints are interconnected things. As soon as a woman begins to undergo hormonal changes in her body, they are accompanied by pain in the joints. There are many reasons for this.Treatment is selected depending on the etiology of pain. Prevention plays an important role. Causes of aches and pains in the joints with menopause. Menopause, postmenopause and menopause are 3 conditions that follow each other from the age of 45. They are characterized by a total restructuring of the body. First of all, the production of sex hormones decreases. These substances are responsible not only for the condition and functioning of the reproductive system. Joint pain. Joint pain complaints are very typical for women who have entered the time of menopause.In childbearing age, metabolic processes in the connective tissue are regulated by sex hormones. Without estrogen protection, metabolism is disrupted. In addition, collagen synthesis is inhibited. Sometimes joint pain during menopause is of an inflammatory nature. This is also due to a decrease in estrogen production. For such cases, the term climacteric arthritis is used. The manifestations of osteoarthritis and climacteric arthritis are similar: joint pain, stiffness in the morning, limitation of mobility. The defeat is often symmetrical.Joint inflammation progresses, joint pain becomes constant, exhausting, stiffness in the morning increases and lasts at least an hour. New small and even large joints can be involved in the process. The defeat remains symmetrical. A woman’s body temperature may rise, but more often it is a slight (subfebrile) rise, signs of damage to other organs and systems appear. The risk of developing contractures (decreased joint mobility) and ankylosis (complete immobility of the joints) increases.Extra-articular symptoms (they are not always found, but require immediate medical attention) After menopause, climacteric syndrome is observed 1.5-2 times more often than in premenopause. Its typical symptoms are especially common in the first 2-3 years of postmenopause. Menopause syndrome, symptoms. With climacteric syndrome, a woman may experience a number of unpleasant sensations. Symptoms can be of different intensity and present in different combinations. They are divided into several groups.Neurovegetative symptoms Up to 30% of the population in developed countries suffers from chronic back pain (Aronoff G. M, 1992, Bonica J. J., 1990). hormonal: female sex, early menopause, late onset of menstruation, amenorrhea, infertility; lifestyle: dietary habits, smoking, low physical activity, caffeine abuse; the presence of concomitant diseases: endocrine, rheumatic, hematological, tumor, etc. The main factors of the etiopathogenesis of back pain in elderly women are: metastatic lesions of the skeleton; osteoporosis, manifesting bone deformities The causes of multiple pain in joints and muscles during menopause are associated with hormonal changes.The aforementioned female hormone estrogen has been proven to have anti-inflammatory and immunosuppressive effects on our body. Estrogen receptors are present in the nervous system and joints. Entering menopause means that the estrogen levels in the life cycle have dropped, so the pain increases. Fatigue, poor sleep quality, and mood changes that occur during menopause can also exacerbate these pains. How to safely overcome menopause?

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Pain symptoms resulting from joint problems can occur for various reasons.Most often, the process is aggravated by the progression of joint diseases, the presence of inflammation and tendon rupture. The drug “Ortex” contains active ingredients of natural origin, which are balanced in such a way as to act as quickly and efficiently as possible on the focus of pain and, thanks to the healing properties of plant extracts, restore joint health. According to doctors, joint pain is classified into mechanical, starting, night and reflected. Each of the typical types is accompanied by depressive conditions, leading to anxiety, increased feelings of anxiety, insomnia, a decrease in the quality of life and the progression of joint ailments.

90,000 Why do joints hurt at a young age?

Recently, more and more young people began to suffer from joint pain. Early arthritis and arthrosis no longer surprise anyone. Let’s figure out why this is happening. However, let’s add an explanation: modern medicine often calls arthritis and arthrosis in one word “osteoarthritis”.

The fact is that osteoarthritis can often occur with damage to the joints, with systematic physical overstrain, with hypothermia.Therefore, at risk among young people are such categories of people as:

– professional athletes;

– dancers;

– fans of extreme sports;

– all those whose lifestyle is associated with increased physical activity.

Excessive exercise can cause serious problems. Sports in which you have to run and jump a lot can negatively affect the health of the joints: athletics, acrobatics, basketball, volleyball, football, and so on.As well as activities requiring complex depreciation: alpine skiing, snowboarding, extreme sports.

Another negative consequence of fanatical sports is injury. Unfortunately, not a single injury, even a minor one, passes without a trace. Even if the bone is not damaged, ligament ruptures and cartilage damage can occur, and their restoration will require a long time and careful care.

Other causes of osteoarthritis at a young age include:

– hereditary predisposition;

– excess weight;

– concomitant diseases (for example, disorders of the thyroid gland).

Signs of osteoarthritis:

The main and main signs of the possible development of osteoarthritis are pain and crunching in the joint. At the same time, a crunch is not a click, but a sound, as if a person is walking in the snow in frost. Another sign is limited mobility, which can occur due to inflammation in the joint.

If, after exercising in the gym or even a long walk, there is pain in the knee or hip area, you should be on your guard.This is how joint diseases can begin to manifest. Therefore, at the first painful sensations, you should definitely seek the advice of a specialist.

Prevention of osteoarthritis at a young age:

1 – a balanced diet.

Food should be rich in calcium, vitamins, microelements. Ideally, exclude fried, salty, spicy foods. On the recommendation of a doctor, you can additionally take vitamins, minerals, fish oil.

2 – maintaining a normal body weight.

Excess weight increases the load on the joints and blood vessels and makes them more vulnerable to pathological processes.

3 – giving up bad habits.

Alcohol and tobacco only harm the joints. In addition, their detrimental effect on vital organs can aggravate the course of other diseases and lead to complications.

4 – moderate physical activity.

Joints love movement, so an active lifestyle is welcome. The stronger the muscle corset, the better the joints are fixed, which means they are less prone to injury in everyday life.

However, many sports activities not only strengthen the muscles, but also put additional stress on the joints. Therefore, firstly, in everything you need to know when to stop: unnecessary loads will not benefit the body. And, secondly, to choose a “safe” load for the joints.

Swimming can be a great alternative to other sports for those concerned with joint health. During swimming, all muscle groups work, but there is no serious stress on the joints. Therefore, regular activities in the pool are useful for everyone, regardless of age.

5 – conducting courses of physiotherapy.

Physiotherapy can also help to activate the body’s blood circulation, for example, preventive courses of therapy with a magnetic pulsed field using the ALMAG + apparatus.This course normalizes blood circulation and metabolic processes, improves drug absorption. It can also help relieve inflammation, swelling and pain and promote recovery.

It is also important to choose and wear the right, comfortable shoes to reduce stress on your joints. Women should remember that high heels are bad for joints and should not be worn for a long time.

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