Arthralgia

Arthralgia (from Greek arthro-, joint + -algos, pain) literally means joint pain.[1][2] Specifically, arthralgia is a symptom of injury, infection, illness (in particular arthritis), or an allergic reaction to medication.[3]

Arthralgia
SpecialtyRheumatology

According to MeSH, the term "arthralgia" should only be used when the condition is non-inflammatory, and the term "arthritis" should be used when the condition is inflammatory.[4]

Causes

The causes of arthralgia are varied and range, from a joints perspective, from degenerative and destructive processes such as osteoarthritis and sports injuries to inflammation of tissues surrounding the joints, such as bursitis.[5] These might be triggered by other things, such as infections or vaccinations.[6]

CauseMono- or
polyarticular		Speed of onset
Rheumatoid arthritisPolyarticular [7]Weeks–months[8]
Systemic lupus erythematosusPolyarticular[7]Months[9]
Viral arthritisPolyarticular[7]
Ehlers-Danlos Syndrome[10]
Reactive arthritisPolyarticular[7]
Rheumatic feverPolyarticular[7]
Lyme diseasePolyarticular[7]
Gonococcal arthritisPolyarticular[7]
Drug-induced arthritisPolyarticular[7]
Ligamentous laxityPolyarticular[7]
OsteoarthritisMonoarticular[7]
Gout attackMonoarticular[7]Hours[11]
PseudogoutMonoarticular[7]
Behcet's DiseaseMonoarticular[7]
Physical traumaMonoarticular[7]Immediate
Septic arthritisMonoarticular[7]Hours[11]
HemarthrosisMonoarticular[7]
5HT2-antagonists[12]
Henoch-Schonlein purpura[13]

Diagnosis

Diagnosis involves interviewing the patient and performing physical exams. When attempting to establish the cause of the arthralgia, the emphasis is on the interview.[2] The patient is asked questions intended to narrow the number of potential causes. Given the varied nature of these possible causes, some questions may seem irrelevant. For example, the patient may be asked about dry mouth, light sensitivity, rashes or a history of seizures.[2][14] Answering yes or no to any of these questions limits the number of possible causes and guides the physician toward the appropriate exams and lab tests.

Treatment

Arthralgia is managed by treating the underlying cause. Joint replacement surgery for severely damaged joints. Immunosuppressants for immune system dysfunction. Antibiotics when an infection is the cause. Discontinue medication when an allergic reaction is the cause. Stretching exercises, NSAIDs, paracetamol.

Treatment depends on a specific underlying cause. The underlying cause will be treated first and foremost. The treatments may include joint replacement surgery for severely damaged joints, immunosuppressants for immune system dysfunction, antibiotics when an infection is the cause, and discontinuing medication when an allergic reaction is the cause. When treating the primary cause, pain management may still play a role in treatment.[15] The extent of its role varies depending on the specific cause of the arthralgia. Pain management may include stretching exercises, over the counter pain medications, prescription pain medication, or other treatments deemed appropriate for the symptoms. Capsaicin, a substance found in chili peppers, may relieve joint pain from arthritis and other conditions. Capsaicin blocks the actions of substance P, which helps transmit pain signals, and capsaicin triggers the release of pain-blocking chemicals in the body known as endorphins. 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 (Bengay).

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See also

References
  1. "Arthralgia Definition". MedicineNet.com. Archived from the original on 11 October 2007. Retrieved 2007-09-20.
  2. Joe G. Hardin. "Arthralgia". Clinical Methods - The History, Physical, and Laboratory Examinations. Retrieved 2007-09-20.
  3. James R Philp. "Allergic Drug Reactions - Systemic Allergic Drug Reactions". Clinical Methods - The History, Physical, and Laboratory Examinations. Retrieved 2007-09-20.
  4. "MeSH". Retrieved 2007-12-23.
  5. Joe G. Hardin. "Table 161.1. Some Common Regional Rheumatic Syndromes". Clinical Methods - The History, Physical, and Laboratory Examinations. Retrieved 2007-09-20.
  6. Loris McVittie. "Information from CDC and FDA on the Safety of Gardasil Vaccine". supplement to your biologics license application (BLA) for Human Papillomavirus Quadrivalent (Types 6, 11, 16 and 18) Vaccine, Recombinant (GARDASIL), to include arthralgia, myalgia, asthenia, fatigue, and malaise in the Adverse Reactions section of the package insert. Retrieved 2008-07-21.
  7. Table 6-8 in: Elizabeth D Agabegi; Agabegi, Steven S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 978-0-7817-7153-5.
  8. Diagnosis lag time of median 4 weeks, and median diagnosis lag time of 18 weeks, taken from: Chan, K. W.; Felson, D. T.; Yood, R. A.; Walker, A. M. (1994). "The lag time between onset of symptoms and diagnosis of rheumatoid arthritis". Arthritis and Rheumatism. 37 (6): 814–820. doi:10.1002/art.1780370606. PMID 8003053.
  9. Doria, A.; Zen, M.; Canova, M.; Bettio, S.; Bassi, N.; Nalotto, L.; Rampudda, M.; Ghirardello, A.; Iaccarino, L. (2010). "SLE diagnosis and treatment: When early is early". Autoimmunity Reviews. 10 (1): 55–60. doi:10.1016/j.autrev.2010.08.014. PMID 20813207.
  10. "Ehlers-Danlos syndrome - Symptoms and causes". Retrieved 10 February 2018.
  11. Page 740 (upper right of page) in: Schaider, Jeffrey; Wolfson, Allan B.; Hendey, Gregory W.; Ling, Louis; Rosen, Carlo L. (2009). Harwood-Nuss' Clinical Practice of Emergency Medicine (Clinical Practice of Emergency Medicine (Harwood-Nuss)). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 978-0-7817-8943-1.
  12. Anneke Passier, Eugène van Puijenbroek (2005). "Mirtazapine-induced arthralgia". Br J Clin Pharmacol. PMID 16236049.CS1 maint: uses authors parameter (link)
  13. "Henoch-Schonlein purpura (video)". Khan Academy. Retrieved 2020-06-06.
  14. "Table 159mptomatic Extraarticular Features of the Connective Tissue Diseases and the Spondyloarthropathies". Clinical Methods - The History, Physical, and Laboratory Examinations. Retrieved 2007-09-20.
  15. "Pain Management". Arthritis Action UK. Arthritis Action. Archived from the original on 13 February 2016. Retrieved 16 October 2015.
Classification
External resources
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