Hypermobility of joints. Joint diseases in children: treatment, symptoms, causes Hyperactivity of the knee joints in a child
Most often, children are initially more flexible than adults, but in some cases, joints and ligaments can easily and without discomfort bend and expand beyond their anatomical capabilities. This condition is called hypermobile joint syndrome.
Causes of joint mobility
Hypermobile joints are common in healthy and normal children; this increased flexibility goes away with age. Doctors in this case talk about “benign hypermobility syndrome.”
In addition to the age factor, experts consider heredity to be another cause of joint hypermobility syndrome. This manifests itself as a change in the structure of collagen, a connective tissue protein, which allows the ligaments to stretch beyond normal limits.
But there are rare cases when joint hypermobility appears as a result of diseases (cleidocranial dysostosis, Down syndrome, Ehlers-Danlos syndrome, Marfan syndrome, Morquio syndrome). Only a specialist can give a definite answer in this case.
How to detect joint hypermobility in a child?
The simplest method is to assess flexibility using the Beighton system, which will be carried out by a specialist in the clinic:
- passive extension of the little finger of the hand more than 90°;
- passive pressing of the thumb to the inside of the forearm;
- hyperextension of the elbow joint more than 10°;
- hyperextension in the knee joint more than 10°;
- forward tilt of the body with palms touching the floor with straight legs.
The results are assessed on a scale from 0 to 10, and to establish a diagnosis, the presence of only 3 signs out of 5 is sufficient. If necessary, the doctor will also conduct other tests.
How else does joint hypermobility syndrome manifest?
The joints of the lower extremities (knees and ankles) are most susceptible to hypermobility, and less commonly the joints of the arms. The child may complain of discomfort or joint pain after physical activity, especially during periods of rapid growth and development.
Joint hypermobility may also be indicated by:
- pronounced degree of flat feet;
- “rolled in” heels;
- X-shaped deformity of the legs;
- pronounced disturbance of posture and gait;
- in the case of intense sports, effusion in the knee joints and/or swelling of the soft tissues of one or both ankle joints.
Possible consequences of joint hypermobility
Because children with hypermobility syndrome have weakened ligaments, possible problems may include:
- arthritis, which may develop later;
- frequent joint dislocations;
- joint sprains and deformities;
- flat feet of varying severity.
Treatment
In the case when joint hypermobility syndrome is not a consequence of any disease that we have mentioned, then no specific treatment is required - many experts consider this simply a variant of a constitutional feature. However, in order to avoid possible negative consequences due to increased extensibility of the ligaments, it is best to comply with the following conditions:
Maintain optimal load conditions. Since joint hypermobility syndrome most often means not only ligamentous, but also muscle failure, the child needs to maintain muscle tone. Activities should be chosen according to the age, gender and physical condition of the child.
Avoid sports that place additional stress on your joints. It’s easy to chase the glory of Olympic champions in rhythmic and artistic gymnastics when the coach, when selecting for the section, promises such “gutta-percha” children a stellar career. Of course, the presence of such congenital features may be a gift, but most experts do not advise overusing training for additional stretching, which will further aggravate hypermobility. Possible consequences may be severe joint pain, arthrosis, arthritis, synovitis and other diseases of the musculoskeletal system.
Follow the orthopedic regimen. The use of orthopedic insoles and wearing orthopedic shoes will avoid the occurrence of flat feet and additional stress on the spine.
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A joint is an organic connection of two or more bones. The integrity and mobility of the skeleton of an adult and a child is achieved thanks to the joints. A person’s ability to move and perform various manipulations is also determined by the presence and functioning of joints. Bone joints can be fixed (skull bones), with limited mobility (spine) and completely mobile (shoulders, elbows, pelvis, knees). Joints bother people not only in old age. Many children have problems with joint diseases from the first years of their birth. So, let's learn about the causes of various joint diseases, their types and treatment.
Causes of joint disease in children
Joint diseases in children can occur for a number of reasons. They can be the result of the natural growth and development of the child’s body, which is accompanied by rigidity and a significant decrease in the child’s mobility threshold. Also, joint diseases can be caused by sprains and deformations, fractures and dislocations, such as Osgood-Spatter disease, the course of which can be complicated by sports activities. Minor injuries to muscles, tendons and ligaments, due to the preservation of elasticity and the ability to function, can be rehabilitated by ordinary rest and rest. More severe tissue damage requires long-term recovery and the possibility of surgical treatment.
Infectious diseases, excess weight, hip dislocations, injuries, muscle imbalances, diseases of the musculoskeletal system can cause joint diseases in children: lordosis, rheumatoid arthritis, elbow and hip joints.
Lordosis in children
Lordosis is a curvature of the sagittal plane of the spine, which is convex forward. The disease can be congenital or acquired.
Congenital lordosis in children is extremely rare. The disease can be physiological and pathological. Physiological lordosis is detected in almost all children and adolescents in the cervical and lumbar spine. The disease develops in the first months of a child’s life and, due to unfavorable external factors, can take on a pathological form.
The spine in children and adults should not be and is not perfectly straight. Its physiological curves act as a shock absorber, taking on the load that a person experiences during physical activity and movement, without any discomfort. An unnatural increase in the curvature of the spinal column is a consequence of painful sensations in the back, neck or lumbar region of the child. Very often, parents do not pay attention to such complaints from children.
Pathological lordosis, in turn, is divided into primary and secondary.
Pathological primary lordosis is a consequence of inflammation and tumors of the spine, spondylolisthesis. Secondary lordosis is a consequence of trauma to the musculoskeletal system, abnormal or congenital dislocation of the hip.
Pathological lordosis is manifested by severe back pain, increased fatigue of the child, and educational lag. It is the pain syndrome in the back that sharply limits the movements of a sick child. The functioning of internal organs and metabolism is disrupted. The child sleeps poorly, becomes nervous and easily excitable. He struggles to maintain balance, tensing his muscles, which causes pain. When this form of lordosis actively develops, the child’s figure begins to change dramatically: the chest becomes flat, the shoulders move forward with the head, and the stomach begins to bulge.
When treating lordosis of all types, the diseases that provoked the curvature of the spine are initially eliminated. Primary lordosis is successfully eliminated through surgery, massage and physiotherapy, as well as therapeutic exercises.
Physical education and sports are effective preventive measures that prevent the occurrence of pathological lordosis.
Scoliosis in children
Today, about 80% of schoolchildren have scoliosis of varying severity. The disease develops intensively during skeletal growth, which is why it is called childhood. Fortunately, modern treatment methods can completely cure curvatures before the final formation of the spine. After reaching the age of twenty, it is impossible to correct the posture of a person with such a disease.
Scoliosis is a deformity, a lateral curvature of the spine, which has three types and four degrees of disease.
The following forms of curvature are distinguished:
- C-shape, representing one arc of curvature;
- S-shaped, having two arcs of curvature;
- The Z-shape is the most complex curvature, having three arcs.
Treatment methods for scoliosis and duration also depend on the degree of the disease, which is called radiological:
1st degree: curvature angle from one to ten degrees;
2nd degree: curvature angle from eleven to twenty-five degrees;
3rd degree: from twenty-six to fifty degrees;
4th degree: more than fifty degrees.
Scoliosis in children occurs due to incorrect posture when walking and sitting, when the back muscles relax and their tone is absent; sedentary lifestyle, as well as congenital asymmetry of the legs and pelvis. Both the first and second causes of scoliosis can be eliminated by the parents themselves together with the child.
Recognizing this disease at its first stage is also not difficult: ask your baby to turn his back to you and take a natural, relaxed position. Signs of spinal curvature, if any, will be noticeable.
- The left shoulder blade will appear asymmetrical in relation to the right.
- One shoulder is lower than the other.
- Leaning forward will demonstrate a noticeable curvature of the body's frame.
- When the child presses his hand to his side, there will be a considerable distance from the limb to the waist.
If you find such signs in a child, immediately go to see a doctor. A timely correct diagnosis and qualified treatment will eliminate many unwanted problems with your child’s health.
Regular exercises and special massage, physiotherapeutic procedures and special orthopedic corsets will help the child get rid of spinal curvature forever. Remember that after the age of eighteen, scoliosis is very difficult to treat, and surgery may most likely be required.
You can avoid scoliosis by using prevention: skiing and swimming, ballroom dancing; the right choice of furniture on which your child sleeps and sits, strict control over the child’s posture.
Rheumatoid arthritis in children
Rheumatoid arthritis in children and adolescents is a joint disease that is characterized by a chronic progressive course. A very common disease, and the frequency of diseases among girls is two to three times higher than the frequency of diseases among boys. The cause of the development of this disease has not been reliably established, and when diagnosing it, special attention is paid to disorders of the autoimmune process, characterized by the production of lymphocytes and autoantibodies.
Children with rheumatoid arthritis experience joint pain and stiffness, as well as morning stiffness. The lesion is invariant: the disease spreads to the wrist, knee, elbow and ankle joints. A medical examination reveals their deformation in the form of swelling, and later the formation of limited mobility of the limbs. The disease may be accompanied by enlarged lymph nodes, the formation of subcutaneous nodules that are not painful to the touch, located near the elbows. Initial and serious damage to the peripheral nervous system and internal organs: heart, lungs and kidneys, as well as increased body temperature, cannot be excluded.
If you suspect such a disease, you should immediately consult a doctor for diagnosis and prescribe further therapy.
An experienced doctor should treat rheumatoid arthritis in children. Treatment must be comprehensive and comprehensive.
Elbow joint diseases in children
A common source of elbow joint disease in young children is dislocation. The cause of subluxation of the main radioulnar joint is the careless handling of children by adults who pull the hand of a small child without feeling their strength, thereby harming his health. The peak incidence occurs at two or three years of age and extends to eight years. In girls, the left arm is more often affected by dislocations. Injury can occur even when pulling a child out of the bath with only one hand, and is accompanied by a barely audible click. An x-ray taken will show displacement of the radial head. Any movement of the child's elbow causes pain. Treatment does not involve surgery; the head of the radius can be easily returned to its place. Then it is necessary to check whether the child has repeated dislocations. After eight years, when the annular ligament becomes strong, subluxations no longer occur.
Diseases of the hip joints in children
If your child experiences pain in the knees, then the hip joint needs to be checked. Disease of the hip joint - arthritis - has another name - coxitis. Its occurrence is provoked by purulent tuberculosis infection and reactive arthritis.
Treatment of hip arthritis in a child begins with identifying the cause of the disease. Early stages of identifying a disease make it possible to cure it quickly and efficiently. For children with this diagnosis, in addition to inpatient examination and treatment, sanatorium-resort treatment is also indicated.
Hip dysplasia in a child is a congenital anomaly of all its elements and structures. If dysplasia in a newborn child is not treated, the consequences will be extremely severe: curvature of the spine and the occurrence of early osteochondrosis, disruption of the position of the pelvis, subluxation of the opposite joint and the development of a severe degenerative disease, dysplastic coxarthrosis, which portends early childhood disability.
If a child’s pathology is diagnosed in the first months of birth, then treatment is completed very successfully. If hip dysplasia is discovered after six months of age, treatment can be lengthy. Surgery cannot be ruled out.
One of the main rules for treating dysplasia in newborns is to use a functional treatment method that can completely restore the anatomical shape of the hip joint and maintain its mobility.
For parents, there is nothing more important than the health of their own children. Your attention to them, timely medical examinations and preventive measures aimed at maintaining health will help you avoid serious joint diseases in children. Take care of your children and give them more parental attention!
Especially for nashidetki.net - Diana Rudenko
Joint pain in children of any age can occur due to many different reasons. It may be the result of the child's natural growth and development and may be accompanied by rigidity and decreased mobility. Joint pain can result from sprains, strains, fractures, dislocations, or conditions such as Osgood-Schlatter disease, which are made more severe by exercise. Mildly injured (twisted or sprained) muscles, tendons and ligaments generally remain elastic and functional and usually only need rest to heal. Since in more severe injuries the tissue may be partially or completely torn, surgical treatment may be required for complete recovery.
Joint pain can also be caused by arthritis (inflammation of the cartilage, tendons and ligaments), muscle inflammation (myositis), bacterial infection of the bones (acute arthritis; osteomyelitis) and sometimes tumors (bone cancer). With proper treatment, joint pain due to most causes heals and disappears without complications (joint dislocations).
Joint- This is the movable part of the limb where two bones meet. Bones are held in place by ligaments (strong bands of tissue) and moved by muscles and tendons (the latter attach the muscle to the bone). Pain in any of these parts is considered joint pain.
Arthritis is an inflammation of one or more joints or their constituent tendons and ligaments (connective tissue). Inflammation is indicated by symptoms: swelling of the joint, limited movement, fever, pain and redness. More than 100 pathological conditions, such as infections and blood disorders, contribute to the development of arthritis.
If one joint is affected, they speak of monoarthritis, two or three joints - oligoarthritis, more than three - polyarthritis. Joint pain due to bacterial infection is not associated with physical activity: it occurs even when a person is physically at rest and noticeably intensifies with movement. In this case, there is swelling and redness of the skin around the joint, a feeling of stiffness - especially in the morning, there is a change in the shape and outline of the joint caused by inflammation of the articular tissues, disruption of the osteochondral surfaces of the joint and the accumulation of inflammatory fluid in its cavity. General symptoms such as feeling tired, fever, headache, weakness, and irritability also occur.
Causes of joint pain in children:
1. Septic inflammation of the joint (arthritis): can be caused by streptococci, staphylococci, influenza viruses and other common infections. Large joints are usually affected. The disease suddenly begins with fever, then swelling of the joint, pain when moving, and pain when touched. If the knee joint is affected, the child begins to limp.
2. Rheumatism: the disease is preceded by an acute infection of the upper respiratory tract. The classic form of rheumatism begins with fever and joint pain. Large joints are usually affected: knee, ankle, elbow, wrist. The pain is fleeting and moves from one joint to another. Redness and swelling may appear around the affected joint, but no irreversible changes occur. If the disease lasts for a long time, rheumatic nodules may appear around the joint. They look like dense, lentil-sized formations. They usually occur in places subject to pressure: elbows, wrists, forearms, knees. On the skin of a child with rheumatism, there are peculiar rashes: pale reddish, curved or ring-shaped spots, narrow stripes. As the disease progresses, severe heart damage develops.
3. Chronic arthritis lasts at least 6 weeks. The most common form of chronic arthritis in children is juvenile rheumatoid arthritis, but in addition there are about 50 rarer forms, including those associated with systemic lupus erythematosus (an inflammatory disease of the joints, skin and internal organs) and juvenile ankylosing spondylitis (inflammatory arthritis of the spine).
Although the peak incidence occurs between 2 and 5 years of age, juvenile rheumatoid arthritis can begin at any age, from the first months of life to 16 years. JRA develops in girls almost 2.5 times more often than in boys.
Although any joint can be affected, including the toes, hands, jaw, and Achilles tendons, the most commonly affected joints at the onset of the disease are the knees, ankles, and elbows. Depending on the specific form of JRA that has developed, other organs may be involved, including the eyes, skin, and heart. While untreated JRA becomes more and more damaging to the body, state-of-the-art medical care, including comprehensive, close medical supervision using medications, physical therapy, and sometimes surgery, can ensure a relatively normal life for most patients. children. However, even with the best treatment, not all symptoms can be controlled, and unexpected exacerbations of the disease should always be expected.
There are 3 subgroups of juvenile rheumatoid arthritis, which can be identified by characteristic signs and symptoms. This is a systemic form (involving the whole organism in the process); polyarthritis form (involving 5 or more joints in the process) and pauciarthritis form (involving less than five joints in the process).
– JRA was originally widely known as Still's disease, named after the doctor who first clearly described it in 1896. The term Still's disease is currently used to refer to a systemic form of JRA that affects about 20% of all children with arthritis. The systemic form of JRA, which is the most difficult to diagnose, can often begin with fever or rash and enlargement of the liver, spleen and lymph nodes. Despite the presence of pain in the muscles and heart, many months may pass before inflammation of the joint appears.
– The polyarthritis form accounts for 35% of children suffering from arthritis. This form often affects the small joints of the hands and feet, as well as the ankle, knee and hip joints. Usually there is symmetrical damage to the joints. So, if a certain joint on the left side of the body is affected, then the corresponding joint on the right side of the body is also affected.
– Approximately 45% of children suffering from JRA are affected by the pauciarthritis form. The onset of the disease is often gradual: the knee or ankle first swells, and parents only notice this when the child begins to limp. Joint pain is rare, especially in young children. Uveitis (persistent inflammation of the middle choroid, iris, and surrounding tissues with a network of tiny blood vessels in the middle of the eye) may also develop, which can threaten vision if left untreated. Children with uveitis usually need regular follow-up with an ophthalmologist (eye doctor) to monitor whether the eye has become inflamed. This inflammation is often asymptomatic and is not accompanied by redness or other obvious signs.
In many cases of JRA, after several months or years of active disease, spontaneous development of long-term remission (absence of active manifestations of the disease) is observed. In some cases, symptoms reappear from time to time, and only sometimes the child suffers from long-term continuous JRA.
Arthritis is characterized by the sequential appearance of pain, stiffness, warmth, redness, swelling and, finally, a slight decrease in the functional activity of one or more joints. Restricted movement of the affected joint may be caused by muscle spasms or fluid buildup around the joint. In the case of systemic JRA, general malaise, including fever, rash, lethargy and loss of appetite, precedes joint involvement by up to 6 months. If JRA progresses uncontrollably, weakening and destruction of the joint may occur with severe limitation of freedom and ease of movement. When such destruction of the ankle and foot occurs, the child often develops a waddling, flat-footed gait. Lameness and a dragging gait occur when the knees and hips become inflamed and swollen. Joint damage may be accompanied by a variety of other symptoms. Often there is a low and constant temperature or, conversely, a high one, reaching a peak of more than 38.8 ° C once or twice a day. Pale red or pink, usually non-itchy, the rash becomes brighter during a fever. The size of the lymph nodes, liver and spleen increases. Sometimes there is a decrease in appetite and weight.
4. Serum sickness: is an allergic reaction to the administration of medicinal serums or drugs (for example, penicillin, aspirin, etc.). It usually occurs 6-12 days after the child comes into contact with the provoking factor. Manifested by joint pain (arthritis), fever, muscle pain, skin rash (urticaria), itching, swelling of the face and neck.
5. Joint injuries: as a rule, pain is observed in one joint. It swells, becomes deformed, and becomes red or bluish. Movement in the affected joint is limited and painful. Sharp pain occurs when there is mechanical stress on the joint. Young children from 1 to 4 years old often experience traumatic subluxation of the elbow joint, for example, in a fall when they are “dragged” by the arm by an adult. In this case, the annular ligament is torn at the site of its attachment to the radius bone of the forearm and is pinched between the head of the humerus and the radius. As a result, the child refuses to move his arm and keeps it motionless, slightly bent at the elbow and turned inward at the forearm around its axis.
6. Tuberculous arthritis: most often affects the hip joint. Externally, the disease first manifests itself as mild lameness and pain when walking, which radiates to the knee or mid-thigh. Over time, hip movement is limited in all directions, and swelling is noticed around the joint. The affected hip becomes flexed, pressed against the other leg, and slightly turned inward. If the spine is affected, the child complains of pain in the part of the body that is innervated from the diseased area of the spinal cord. He can hardly lift objects lying on the floor, walks very carefully, on tiptoes, and holds his torso straight. Likes to lie on his stomach.
Arthritis of the cervical spine causes torticollis, and the child is forced to support his head with his hands. If the disease process involves the thoracic spine, a hump develops.
Orthopedist-traumatologist
Rheumatologist
Phthisiatrician
The symptom chart is for educational purposes only. Do not self-medicate; For all questions regarding the definition of the disease and methods of its treatment, consult your doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal.
- Symptoms of arthritis in children
- Causes of arthritis in children
- Types of arthritis in children
- Treatment of arthritis in children
- A couple of tips for parents
It is sad to realize that such a terrible disease as arthritis does not bypass even the smallest inhabitants of our planet. But harsh statistics say that every thousand child under the age of 3 falls victim to this disease. The peak incidence is considered to be between one and three years of age, but this is purely individual. What are the symptoms and treatment methods for arthritis in children, you will learn from our material below.
Symptoms of arthritis in children
If the child is very small and is not yet able to clearly express his complaints, then it can be quite difficult to determine whether he has arthritis.
Parents should be attentive to their child's behavior. You should be wary of the following signs:
Unreasonable whims of the child with possible refusal to eat;
Lameness while walking or playing (the baby tries to walk less and does not allow touching the sore spot);
Complaints of pain without any objective reason (there was no fall or injury);
Swelling and redness in the joint area;
Difficulty raising an arm or leg;
Changes in the child's gait.
If at least one of the above symptoms is detected, you should immediately seek advice from a medical specialist.
The general symptoms of arthritis in children also include the following series of signs:
Increased body temperature;
The appearance of itchy spots and rashes on the skin around the sore joint;
Enlargement of regional lymph nodes located near the source of inflammation.
Causes of arthritis in children
Proper treatment of arthritis in children is possible only after establishing the true cause of its occurrence.
Causes of childhood arthritis include:
Infectious diseases;
Hereditary predisposition;
Decreased immunity;
Violation of metabolic processes in the body;
Traumatic injuries;
Diseases of the nervous system;
Exposure to low temperatures.
Diagnosing arthritis in children is often difficult. For example, a child suffered from an infectious disease, to which the parents did not attach much importance, and the complication was inflammation of the joints.
Types of arthritis in children
Among all the types of childhood arthritis, the following main forms can be distinguished:
Reactive form of arthritis. This is an aseptic inflammatory disease that mainly affects the joints of the lower extremities. The cause is a previous bacterial infection. Reactive forms of arthritis include urogenital and postenterocolitic arthritis. For example, the urogenital form occurs due to an existing infectious process in the organs of the genitourinary system;
An infectious form of arthritis. The occurrence of this form of the disease is facilitated by bacterial, viral and fungal infections. The location of pathogens is the joint cavity itself, into which they enter through the blood or lymph flow. The risk of infectious arthritis increases after joint trauma. Infectious arthritis is most common in children under three years of age;
Juvenile form of rheumatoid arthritis. The etiology of this disease is still not fully understood. It is believed that the determining factor is burdened heredity. Children under 16 years of age are at risk for developing juvenile arthritis. Juvenile arthritis primarily affects large joints, causing them to become enlarged and deformed. The danger of the disease lies in its rapid and steady progression, and in severe cases, even damage to internal organs is possible. The juvenile form of rheumatoid arthritis can occur with inflammation of only the joint apparatus, or may involve the lungs or heart in the process;
Ankylosing spondylitis. Most often, this disease debuts at an early age and manifests itself as a chronic inflammatory process in the peripheral joints and spinal column;
Rheumatic form of arthritis. It is a pathognomonic manifestation of childhood rheumatism. Children under 16 years of age are at risk for morbidity. For diseases such as chorea minor, ring erythema and rheumatism, the unifying feature is their infectious origin. Most often, the cause of their occurrence is streptococcal infection (tonsillitis, sore throat, pharyngitis).
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Treatment of arthritis in children
Treatment of arthritis in children can last a long time, and the approach to it must be comprehensive. Along with drug therapy, special therapeutic massage and physiotherapy are used. If the disease is in the acute phase, outpatient treatment will be ineffective. The child must be in a hospital, where he can be given a special splint to immobilize the diseased joint.
Surgery for arthritis in childhood is indicated only in the presence of severe joint deformation, which can be corrected with prosthetics.
Drug therapy consists of two successive stages:
The use of non-steroidal anti-inflammatory drugs to relieve painful symptoms of the disease;
Taking medications that suppress the immune system, if we are talking about rheumatoid arthritis (immunosuppressants);
Carrying out detoxification therapy;
Strengthening the drainage function of the body.
The use of the first group of drugs helps relieve severe pain, reduce the inflammatory reaction and improve joint mobility.
The following drugs are used for the symptomatic treatment of arthritis in children::
Acetylsalicylic acid. It is a mandatory attribute of conservative drug therapy for arthritis. The advantages of this drug include its effectiveness, but it is strictly contraindicated in case of existing blood clotting disorders;
Diclofenac. Currently, experts have come to the conclusion that the use of diclofenac by children may cause erosive changes in the upper parts of the digestive tract. In addition, it is strictly contraindicated for children under 6 years of age;
Naproxen is another anti-inflammatory drug. It is indicated for the treatment of rheumatoid and juvenile arthritis in children. Its only drawback is the age restrictions. Naproxen is only indicated for children over 10 years of age.
Detoxification therapy is aimed at activating local and general immunity, harmonizing metabolic processes and normalizing blood circulation in the joint apparatus.
Stimulation of the drainage function is the key to complete removal of toxins from the source of the disease and stimulation of nutrition of the joint area.
The specifics of treatment of reactive arthritis in children are the following sequential actions:
Relief of severe pain;
Neutralization of the infectious focus.
Elimination of the consequences of the disease.
The non-steroidal anti-inflammatory drugs (NSAIDs) described above are used to relieve pain. If a child is experiencing excruciating pain that cannot be relieved by NSAIDs, one has to resort to intra-articular injections using hormonal anti-inflammatory drugs from the glucocorticoid group (methylprednisolone). Before prescribing corticosteroids, you must be sure that there are no pathogenic microorganisms in the intra-articular fluid.
To eliminate the infectious focus, in the practice of treating childhood arthritis, doctors widely use drugs from the macrolide group. Thanks to their gentle effects, it is possible to avoid serious side effects. The drugs of choice are clarithromycin, roxithromycin and josamycin.
If we talk about the intestinal etiology of the reactive form of arthritis, then, by and large, the fight against intestinal infection will be useless due to its absence at the time of diagnosis. The thing is that when arthritis develops, there is no longer any source of infection in the intestines. Only before potential immunosuppressive therapy should antibiotic therapy with aminoglycosides be administered.
If the disease has become chronic, there is a need for pathogenetic treatment. The main components of such therapy are immunomodulatory drugs that ensure stable functioning of the immune system. These drugs include taquitin, lycopid and polyoxidonium.
For rheumatoid arthritis no treatment will bring the expected result if immunosuppressants are not used. Only these remedies can stop the process of destruction of the child’s affected joints. Commonly used drugs include cyclosporine, mercaptopurine and leflunomide.
Treatment of juvenile arthritis carried out using anti-inflammatory drugs in combination with a special diet. Your child's daily diet should include foods rich in calcium. In order for the treatment to take place with maximum benefit, the regime of physical activity and rest should be properly organized.
Unconventional methods of treatment
Non-traditional methods of treating arthritis in children can serve as an excellent addition to conservative therapy.
One of the universal and very effective remedies is white, blue and pink clay. It has a pronounced anti-edematous and anti-inflammatory effect. The clay is suitable for external use in the treatment of arthritis in children over 3 years of age. It must be used in the form of a compress, which is applied to the sore joint, covered with cellophane and wrapped in woolen cloth.
To treat children over 6 years of age, you can use a decoction of thistle herb in the form of compresses and lotions. It is a good adjuvant in the treatment of rheumatoid arthritis. To prepare the decoction, you need to take 1 tablespoon of thistle herb and pour a glass of boiling water. You need to cook the broth for half an hour, then cool and strain. A small piece of gauze is moistened in the resulting decoction and applied to the sore joint; the compress should be covered with polyethylene and woolen cloth on top.
For older children, going to the bathhouse may be a good auxiliary treatment. Brief exposure to heat on your joints will help relieve pain. However, a bath is unacceptable during the acute period of the disease.
It is important to remember that this kind of procedure can be resorted to only after prior consultation with your doctor.
Prognosis for recovery
Unfortunately, arthritis is a disease that accompanies a person throughout his life. Provided the correct treatment is prescribed in a timely manner, the child will be able to lead a full life without remembering his illness. Of course, physical activity will have to be limited to the level of daily exercise, but professional sports for these children are strictly prohibited.
To prevent frequent relapses of arthritis from leading to disability, the child should immediately seek help from a medical specialist immediately after the first signs of the disease appear.
Hypermobility syndrome is a condition of the joints in which the amplitude of their movements significantly exceeds normal, physiological indicators. Depending on the elasticity and stretchability of the capsule, tendon and ligament, the degree of mobility is determined. Doctors agree that hypermobility is transmitted along the hereditary line, due to the fact that the child receives collagen that differs from normal in structure, namely, it acts as the basis of connective tissue protein.
Given this feature, people have increased fiber stretchability. The syndrome provokes rapid wear and tear of the surface of the joint, as well as the surrounding tissues. Against this background, symptoms of hypermobility may occur, but these are only medical assumptions, and doctors still do not have an exact answer. Based on statistical data and research, scientists assure that if a person uses joint hypermobility too often, then the symptoms increase. It is also worth noting that the syndrome is classified as a benign condition, but it provokes the development of many dangerous pathologies. Let's take a closer look at what hypermobile joint syndrome is.
Studying the clinical picture of different patients with the presented syndrome, experts note that both children and adults have a pronounced feeling of discomfort in the joints, the symptoms manifest themselves especially strongly after physical activity, as well as during the period of growth of bone structures.
In most cases, discomfort is present in the legs, but can also be localized in the upper extremities. Joint pain most often affects the knee joint, but there have been cases where the patient complains of discomfort in the ankle. Those people who engage in professional sports activities also suffer from soft tissue swelling and joint effusion.
The results of histological studies confirm the absence of inflammatory processes, and the general clinical picture is very similar to the condition after injury. The composition of synovial fluid is characterized by a small amount of protein and other cells. The degree of damage, in most cases, remains within normal limits, which allows the patient to continue playing his favorite sport.
Kinds
As mentioned earlier, the majority of clinical cases of this pathology are classified as a congenital condition of the joints, but hypermobility syndrome is not an independent disease. Increased mobility of joint nodes occurs against the background of the pathological state of the surrounding connective tissue, which is the main component of ligaments and joints.
Another characteristic is the fact that in most cases, even when experienced specialists carefully carry out all the necessary studies, it is not possible to identify connective tissue pathologies. In this case, doctors diagnose a tissue development disorder. Symptoms regarding joints will be typical, but the prognosis is favorable, due to the low likelihood of complications.
Sometimes artificially created increased mobility of joints is diagnosed. A similar condition is diagnosed in professional athletes who engage in gymnastics or acrobatics. Ballerinas also try to develop a similar joint ability through increased training aimed at stretching the muscular-ligamentous apparatus. In this way, it is possible to increase the elasticity and improve the flexibility of the body.
But it is worth noting that even excessive and prolonged training of an ordinary, healthy person will not give the same results as with hypermobility. Therefore, an artificially created condition is considered by doctors as a pathology.
Criteria
There are certain parameters for assessing the degree of joint hypermobility:
- Passive flexion of the joint of the fifth finger in the area of the metacarpophalangeal joint in both directions;
- Passive flexion of the first finger towards the forearm when moving in the wrist joint;
- Hyperextension of the elbow and/or knee joint by more than 10 degrees;
- When leaning forward, resting your palms on the floor, but your knees are not bent.
For a doctor to diagnose hypermobility, the patient must have any three indicators. Speaking of assessment, they use a scale from 1 to 9, where the smallest number indicates a pathological ability to hyperextend. A reading of up to two is considered normal.
Also, for a more accurate assessment, they use a graduated scale, which evaluates movements in each joint from 2 to 7, but this technique is rarely practiced.
In children
Each child who has a feature in the form of joint hypermobility can express various complaints regarding the discomfort that arises in the musculoskeletal system. Most often they talk about pain in the area of pathological joints, which manifests itself after physical activity in which hypermobile joints are involved. Pain appears in one or more joints, and can be symmetrical or generalized.
In most cases, symptoms occur in the knee joint, but any joints can be affected, including the spinal column. The pain most often goes away on its own, but after overexertion it reappears. In rare cases, patients in the younger age group complain of muscle pain, spasms and other discomfort not related to the joints.
Speaking about the connection of pathology with diseases of the cardiac or vascular system, it is worth noting that hypermobility syndrome is detected in children who suffer from mitral heart valve disease. After all, it is in this case that the pathology affects the connective tissue. Gradually, while the child grows, the connective tissue matures and strengthens, and accordingly, the symptoms of the syndrome decrease.
Causes
In medicine, many theories are considered regarding the likelihood of the syndrome occurring. Most scientists agree that the most likely cause of increased joint mobility is collagen extensibility. But the whole point is that it is an integral part of muscles, ligaments, cartilage and other structural tissues. When collagen fibers are stretched beyond normal, the joints can perform a greater range of motion, which causes ligament weakness.
It is worth noting that hypermobility syndrome is a fairly common phenomenon, and in medical practice a similar condition is diagnosed in 15% of the population. However, doctors do not detect it every time, because the symptoms are not expressed enough, and patients tend to think that they have weak ligaments.
Speaking about childhood pathology, most cases have a direct connection with metabolic disorders, low intake of vitamins in food, and rapid growth. Doctors also note that the majority of patients are representatives of the fairer sex. People in the older age group practically do not suffer from hypermobility.
Also, the presented syndrome often develops in conjunction with certain pathologies. Let's take a closer look at what diseases can cause hypermobility.
This pathology is the most common provocateur of the development of hypermobility of articular joints. It was with him that almost all cases of weak ligaments that could be diagnosed were associated. A characteristic feature for patients is excessive thinness, they are tall, their upper limbs are elongated and quite mobile, their joints are excessively flexible. In some cases, it may seem that their limbs are like rubber, and especially their fingers.
Physiotherapy can play a special role in treatment. The use of healthy mud, laser therapy, paraffin treatment, etc. is very effective.
It is also worth saying that an excessive level of joint mobility can be stopped with special medical physical therapy or exercise therapy. In combination, the doctor will suggest performing the correct gymnastic exercises that will help make the joint stable and strong by developing muscle elasticity.
Thus, exercises will be selected not only to force the joints to bend or straighten, but also to tense the muscles. Actions where statics and strength are involved are best suited, while the rhythm of execution should be slow, but weights should not be used.
About the syndrome
If a child has weak joints, then possible reasons are the toxic effect of environmental factors on the developing child’s body (lack of calcium in water and soil, imbalance of microelements in food).
If the joint ceases to function normally, then this indicates either overload (during sports training, for example), or a lack of chondroitin and glucosamine in the joint, as the main components. The first and second (load and disadvantage) are interconnected.
For childhood arthritis, it is recommended to reduce the load on the joints and use drugs that eliminate pain, reduce muscle contraction, and improve the nutrition of cartilage. Plus physiotherapy (ultrasound, Bernard currents), spa treatment (mud, hydrogen sulfide and radon sources), exercise therapy, massage.
It's good for your joints to do exercises with low weights and high repetitions. This will increase the production of growth hormone and, as a result, heal the joints. Pressure and stretch resistance exercises are needed.
Fish and foods with calcium are very useful. Fish oil is very good for joints. Take a teaspoon 3 times a day.
If a small child's joints are cracking
Children's joints are very fragile. Even a slight crunch or clicking noise made by a child's joints can greatly frighten parents.
Some children actually hear cracking sounds in their joints during certain movements. The reason is the immaturity of the ligamentous-muscular system. The connective tissue of a child’s joints is not as dense as in adults and is more elastic. The muscular system is much less developed, which is why the joints crack. As the joints grow (when the child gets older), the crunching goes away, so there’s nothing wrong with that.
But if only one joint cracks, and the crunch does not go away with age, this may be a harbinger of joint pathology or the beginning of any diseases of the musculoskeletal system. Sometimes cracking joints is an anatomical feature; it can be corrected with proper nutrition.
Nutrition for joints
Calcium, phosphorus, vitamin D and manganese are very necessary. You need to drink enough fluids throughout the day, because... water stimulates the production of intra-articular fluid.
General recommendations for joints: less monosaccharides (cookies, pasta, baked goods made from white flour), more polysaccharides (potatoes and other vegetables, fruits, oat and whole grain bread). Ears, pork tails (jellied meat), cottage cheese, milk, hard cheeses, and chicken eggs are useful.
Ears and tails are a natural source of collagen. And collagen is a constituent protein of connective tissue. Connective tissue - muscles, ligaments, bones, cartilage, joints, blood vessels, parenchyma of internal organs, skin, nails, hair, dentin of teeth and joints.
Collagen hydrolyzate can be obtained by cooking - this is what we call jellied meat.
Manganese is a carrier of oxygen from the blood to the cells of the body; it is especially important for the nutrition of cartilage and intervertebral discs, because they do not have direct blood circulation. If there is a lack of manganese, the ossification processes in the skeleton are disrupted - the joints are deformed, the tubular bones become thicker and shorter.
Products that are good for joints
For calcium, it is best to: boil the eggs, peel the film from the shell, and crush them. Take a teaspoon up to three times a day with a drink. The taste is not very pleasant, but it helps a lot with calcium deficiency.
Magnesium is found in dates, prunes, raisins, dried apricots, beans, soybeans, buckwheat honey, oatmeal and buckwheat, nuts, bran, whole grain bread, dark chocolate, cocoa.
Selenium is interconnected with vitamin E - consumption of one requires proportional consumption of the other.
Vitamin D prevents the leaching of calcium from bones: it is found in fish liver, butter, cottage cheese, cheese, dairy products and egg yolk.
Joints need vitamins B, C, E, A, K, as well as microelements. Vitamin F is a complex of polyunsaturated fatty acids that has an anti-inflammatory effect. Salads made from raw vegetables, seasoned with olive or other vegetable oil, are very good for joint health.
Collagen is a complex protein that forms the basis of all human connective tissue, which is approximately 25-35% of the total protein mass in the body.
A lot of polyunsaturated fatty acids are found in fatty sea fish: regular herring works well here; it is better to buy it frozen or lightly salted. Salted herring can be soaked in milk, and after that it can be given even to children from 2 years old.
Fruits and vegetables should be cooked as little as possible, and peeled and cut immediately before consumption to preserve vitamin C.
Collagen synthesis in the body is a complex biochemical process that involves a large number of vitamins and minerals. With age, or as a result of diseases or poor nutrition, the body’s process of synthesis of its own collagen slows down, which begins to negatively affect the condition of connective tissue - it ceases to be replenished and is destroyed. In this case, the use of collagen hydrolyzate can compensate for the lack of collagen and stimulate the body to produce its own protein.
Hyaluronic acid and joints
Hyaluronic acid is one of the main components of the extracellular matrix and is found in many biological fluids (saliva, synovial fluid, etc.).
In the joint cavity there is a special synovial fluid that has a unique biological composition and properties. Its composition is similar to blood plasma, but it contains less proteins and contains hyaluronic acid, which is necessary to ensure that the fluid is viscous and the joints are constantly lubricated.
Hyaluronic acid is the main component of synovial fluid, responsible for its viscosity. Along with lubricin, hyaluronic acid is the main component of biological lubricant - an important component of articular cartilage.
The joints are covered with synovial membranes, which contain synovial fluid; and as soon as its composition deteriorates, the membranes cease to protect the joints from friction. The synthesis of hyaluronic acid in cells due to poor nutrition and negative influences slows down and even stops; In this case, the synovial fluid ceases to perform its function, and the tissues of the joints begin to quickly deteriorate. Then even children and young children develop arthrosis and arthritis.
Hyaluronic acid is part of many tissues (skin, cartilage, vitreous), and this is what determines its use in the treatment of diseases associated with these tissues (cataracts, osteoarthritis): synovial fluid endoprostheses; surgical environment for ophthalmic operations; preparations for mild tissue augmentation and wrinkle filling (including in the form of intradermal injections) in cosmetic surgery.
To ensure that the amount of hyaluronic acid in the cartilage and connective tissues, as well as in the interarticular fluid, does not decrease, it is necessary to consume foods containing mucopolysaccharides - these substances are vital for joints. An important property of these products is their gelling ability.
These are seaweed, mussels, shrimp and other seafood, as well as ligaments, bones and cartilage of fish, birds and animals - it is from these products that jellies, jellied meats, and jellied meats are prepared. Often these useful parts are considered waste; chicken feet, fish heads, beef and pork bones are thrown away.
Try not to throw away such waste, but cook, for example, fish soup from a fish head - the fish soup will turn out to be very rich, tasty and healthy. The fish can be any, river or sea: catfish, perch, pike, salmon, halibut, salmon fish.
Wash the heads (1-2 pieces) thoroughly, remove the gills, cut into several parts, put in a pan with cold water, cook over low heat for about an hour. It is good to cook with black pepper (6-7 peas) and bay leaf; You can also add fins and a tail.
Next, add 2 chopped onions, carrots, bell pepper and tomato, dry seaweed (2 tsp), add sea salt to taste, cook for another 5-7 minutes. Place a slice of lemon on each plate of the finished fish soup and pour in a little lemon juice. Sprinkle with fresh herbs. Excellent fish soup for joints!
Running and joints
Multiple micro-concussions of the joints during running cause microtrauma to the articular surfaces, which is why professional runners always have problems with their joints. Therefore, track and field athletes spend a lot of time developing their running technique, when they try to minimize these harmful effects on the joint. And you need special shoes.
But walking is very beneficial for joints. Both sports and ordinary. So walk more.
Pharmacy products for joints
Pharmacies sell various products to strengthen joints. There are many medications whose purpose is to strengthen joints and maintain the elasticity of articular joints. Such preparations contain glucosamine and collagen, because it is these substances that restore the elasticity of the cartilage structure and form the basis of connective tissue.
Chondroprotectors (Chondroitin, Glucosamine). Preserve and restore the elasticity and flexibility of cartilage;
have an anti-inflammatory effect; improve the moisture saturation of cartilage tissue;
contribute to the proper construction of new cartilage tissue;
restore joint mobility; reduce pain.
Calcium active, dietary supplement.
Collagen ultra.
Geladrink Forte - collagen, chondroitin, glucosamine, three in one, Czech drug.
If there is an excessive intake of hyaluronic acid in the form of medical drugs or during cosmetic procedures, the skin after a certain period of time ceases to produce it on its own.
Medicinal substances that contain hyaluronic acid are divided into two types:
Hyaluronic acid preparations of animal origin are produced by distillation of animal tissue.
Medical products in which hyaluronic acid is produced by special microorganisms.
If the joints pop out
If the joints pop out, it is called a habitual dislocation. This phenomenon is also called chronic dislocation. It is expressed primarily in the weakness of the ligaments. May be as a result of a dislocation. To prevent this from happening, you need to train your muscles. Slowly, with moderate loads. Make sure that the joint does not pop out during training. But before you start training, go to the doctor. You may have torn ligaments as a result of a sprain.
How to treat this phenomenon?
First you need to reduce inflammation. Use anti-inflammatory drugs such as ketorol or voltaren. Well, limit the movement of the sore joint. And of course, massage, physiotherapy, and moderate physical activity are required.
If the pain is severe, you can apply ice to the joint.
Muscles need to be strengthened. Then there will be significantly fewer dislocations and the joints will be trained. Trained muscles are themselves a protection against popping joints.
The total duration of treatment for such dislocations is about six weeks.
But you shouldn’t give up physical activity in the future. This will only be beneficial. Exercise is life and therefore you should not stop training, even if the course of treatment is already over. Think for yourself. After all, if you quit, sooner or later the pain will return. Such is the nature of man and his organs. Where there is no load, stagnation and degradation develop. It is for these reasons that we do not recommend that you quit gymnastics.
Exercises to strengthen ligaments and tendons
This video shows techniques for strengthening ligaments and tendons. Using the example of the shoulder and elbow joints. You can train the hip and knee joints in a similar way.
We are sure: flexible joints are a sign of youth and health; the more flexible the better. However, such a thing as excessive joint flexibility still exists.
TEARS OF THE GUTTA PERCH BOY
People with joint pain look forward to late autumn with anxiety. It is at this time that their health often sharply and inexplicably deteriorates, as if the diseased joints feel the onset of cold weather. A trip to the doctor does not help: no abnormalities are found either in the tests or in the x-rays, ordinary anti-inflammatory drugs do not help, and the doctor begins to look sideways at the patient with doubt: has he really invented this mysterious pain? Most likely no. The joints of such a poor fellow are indeed not entirely ordinary, although outwardly they are the same as those of other people - even more flexible.
NATURALITY AND SUPERNATURALITY
Everyone had to admire the performances of artistic gymnasts and circus performers, capable of performing movements unimaginable for an ordinary person. Of course, at the heart of this ease and flexibility is hard work. But is everyone capable of achieving such perfection through perseverance?
Unfortunately no. Have you ever watched how children are selected for gymnastics sections? A coach comes to the junior school and invites everyone to the first training session. In the gym, he asks the guys to do several exercises. Then, with some sadness, he reports that most of those present will hardly benefit from gymnastics, but you, you and you - stay. Next begins the painstaking, long-term work of forming a champion. But from the very beginning it is absolutely clear to the coach that in order to achieve high results, special innate flexibility of the body is necessary. Only a few standing proudly on pedestals personify the supernatural capabilities of man. They are truly supernatural, because excessive joint flexibility and complete health are a rare combination.
…DOES NOT MEAN HEALTHY
We are sure: flexible joints are a sign of youth and health; the more flexible the better. And, as you know, there can never be too much of a good thing. However, such a thing as excessive joint flexibility still exists. Most often it occurs in women and children, very often in representatives of eastern peoples. In some families this property is inherited, but in general it is not typical for European residents.
This became especially obvious when yoga came into fashion. To perform many exercises, joint mobility is completely unusual for a European. Yes, it can be developed through titanic efforts - but if you have ever seen documentaries about India, you will have noticed that Indians calmly talk in the lotus position, listen to lectures and simply eat.
What is allowed to Jupiter is not allowed to the bull. You cannot mechanically transfer the standards of one people to others. By the way, this also applies to sexual culture: the well-known Kama Sutra for the average European hardly has any practical significance. Well, we are not given this - other genes!
There is no particular benefit from excessive joint flexibility. But harm is possible, and considerable.
HIDDEN PROBLEMS
How mobile our joints are depends on several factors.
The first is the shape of the bones. In the so-called ball-and-socket joints, it allows movement in almost all planes (for example, the shoulder joint).
The second factor is the condition of the surrounding muscles. When muscle tone decreases (for example, after a stroke), the joints may become loose.
Finally, the third is the condition of the ligaments and connective tissue capsule of the joint. Their strength and extensibility of ligaments depend on the collagen protein. It also determines the elasticity of the skin, the condition of blood vessels, and forms the “suspension” of internal organs.
With a gross genetic breakdown of the mechanism of collagen synthesis, severe and, fortunately, rare hereditary diseases arise: osteogenesis imperfecta (excessive flexibility of joints plus multiple bone fractures) and Ehlers-Danlos syndrome (the same excessive flexibility, very extensible skin and the possibility of spontaneous rupture of blood vessels) . But more often, a weak degree of collagen deficiency is observed: a person leads an ordinary life, but at a certain moment problems appear.
WHAT MAY CONCERN
Since collagen is necessary for the normal functioning of almost all body systems, its deficiency in each area manifests itself differently. A dermatologist can detect acrogeria (early appearance of wrinkles) in a patient, a cardiologist can detect heart valve prolapse (excessive sagging of the valves), a therapist can detect prolapse of the kidneys and stomach; gynecologist – prolapse of the walls of the vagina, uterus; vascular surgeon – early and severe varicose veins; traumatologist and surgeon – usual dislocations and hernias...
Of course, these numerous ailments will not necessarily develop in every person with overly flexible joints. But what you will almost certainly experience is pain in the joints and spine. From this moment on, an essentially healthy person becomes a patient with joint hypermobility syndrome.
The first symptoms can appear at 5 or 50 years of age, but most patients see a doctor at the age of 14–18 years. During this period, the body grows rapidly, weight increases, and the motor pattern changes. The previously established balance between the load on the joints and their ability to bear these loads is disrupted. A teenager suddenly begins to ache and “click” in his joints - one or several at once, his back ache from standing for a long time, and a stoop appears. The pain varies from severe, when it is difficult to walk, to simple discomfort in a cross-legged sitting position. During the examination, the doctor either finds nothing, or discovers moderate orthopedic deviations - scoliosis, flat feet. The latter, by the way, is very typical for joint hypermobility syndrome.
Pregnancy, weight gain of 6–10 kg, minor injury, increased or decreased load can cause deterioration.
After 30 years, persistent lower back pain comes to the fore, which in general is not so rare in ordinary people. Signs of early aging appear in the knee and hip joints and periarticular tissues. Women are tormented by problems associated with complicated flat feet: chronic fatigue of the feet, the inability to wear dress shoes, “corns”, deformation of the fingers... The reason is the inability of hypermobile joints to constantly withstand everyday stress.
MEDICATIONS ARE NOT ALWAYS NEEDED
First of all, you should make sure that the pain syndrome is caused precisely by hypermobility of the joints, and not by any rheumatic disease. After all, hypermobility does not protect its owner from other, including inflammatory, joint diseases.
In the simplest cases, it is enough to understand that you have a special organism that is sensitive to stress, and you just need to avoid certain situations. Often, pain in the spine is associated with the habit of carrying a bag, even a light one, on one shoulder. If so, replace the bag with a backpack.
In youth, joint pain, explained by hypermobility, can either disappear spontaneously or appear. That’s why they used to call it growing pains.
If treatment is necessary, you do not have to take pills. For persistent pain, elastic orthoses (knee pads) and bandages help. It is impossible to strengthen weak ligaments - they will remain stretched and, most likely, you will pass this defect on to your children. But it is very useful to strengthen the muscles surrounding the painful joint. Isometric gymnastics with significant muscle tension, but with a minimal range of movements in the joints, will help with this. Working out in the gym with weights is also not forbidden - but only if there is a complete absence of painful sensations both during and after training.
If the doctor discovers that you have scoliosis or flat feet, he will suggest special gymnastics, reclinators, or orthopedic insoles. It is important here, since each patient needs products with an individual profile and a certain degree of rigidity. Elastic insoles, for example, are comfortable for older women, while hard leather products are suitable for young women. In very advanced situations with gross irregularities in the shape of the toes, only surgical treatment is possible.
If the pain is caused by a moderate inflammatory process in the periarticular tissues, ointments and gels with non-steroidal anti-inflammatory drugs or injections of drugs that suppress local inflammation will help.
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FLEXIBILITY TEST Try the following movements.
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