Joint Pain

Causes

What are the causes of joint pain?

The most common causes of joint pain include:

• Osteoarthritis: A prevalent form of arthritis that develops over time as the cartilage cushioning the bones erodes, leading to joint pain and stiffness. Osteoarthritis typically progresses gradually and is most often diagnosed after the age of 45.
• Rheumatoid Arthritis (RA): A chronic condition characterised by pain and swelling in the joints, often resulting in joint deformation, particularly in the fingers and wrists.
• Gout: This painful disorder results from the accumulation of uric acid crystals in the joints, causing acute discomfort and swelling, commonly affecting the big toe.
• Bursitis: Caused by overuse, this condition primarily affects the knee, hip, shoulder, or elbow.
• Tendinitis: The inflammation of tendons, the elastic bands connecting bone and muscle. This is usually observed in the shoulder, heel, or elbow and often results from overuse.

Additionally, conditions such as rashes, viral infections, or fever can exacerbate joint pain. Injuries, including sprains or fractures, can also be a contributing factor.

Joint Pain Risk Factors

Joint pain commonly affects individuals who:

• Have arthritis or any chronic medical condition.
• Have a history of joint injuries.
• Frequently overuse certain muscles.
• Are experiencing depression, stress, or anxiety.
• Are overweight, with a body mass index (BMI) over 25, or are classified as obese (BMI above 30).

Age is another factor; problems often begin after the age of 45 due to prolonged use and wear and tear on the joints.

Care and Treatment

How is joint pain treated?

While joint pain may not always have a definitive cure, effective management methods exist. In some cases, pain may subside with over-the-counter (OTC) medications or simple daily exercises. In other instances, the pain may indicate underlying issues requiring prescription medications or surgical intervention.

Treatment options for joint pain include:

• At-home remedies: Your doctor may suggest applying an ice pack or heating pad to the affected area for short periods several times a day. Soaking in a warm bath can also provide relief.
• Exercise: Regular physical activity can help regain strength and functionality. Swimming, walking, or other low-impact aerobics are recommended. Those who engage in high-impact sports may need to reduce intensity or switch to a gentler routine. Moderate stretching is also beneficial. Consult your doctor before starting or continuing any exercise regimen.
• Weight loss: If necessary, your doctor might recommend losing weight to alleviate pressure on the joints.
• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (e.g., Tylenol®) can help relieve discomfort. While both are available OTC, stronger doses may require a prescription. It’s essential to discuss your medical history with your provider if you have conditions such as kidney disease, liver disease, or stomach ulcers.
• Topical treatments: Your physician may recommend gels or ointments applied to the skin over the affected joint to relieve pain. Some of these products can be purchased OTC, while others may require a prescription.
• Dietary supplements: Glucosamine is a common supplement that may provide relief. Consult your doctor before using any non-prescription supplements.

If these options do not alleviate the pain, your doctor may recommend:

• Supportive aids: Such as a cane, brace, or orthotics to support the joint and facilitate movement.
• Physical and occupational therapy: Along with a balanced fitness plan, to gradually relieve pain and improve flexibility.
• Antidepressants: To aid in better sleep.
• Steroids: Often administered via injection directly into the joint to provide temporary relief from discomfort and swelling.
• Painkillers: To help reduce pain.

Keep in mind that medications, including OTC options, can have varying effects on individuals. What works for one person may not work for another, so it's vital to adhere to your practitioner’s guidelines and report any side effects.

Surgical Options for Joint Pain Relief

Surgery may be considered if joint pain is persistent and does not improve with medications, exercise, or physical therapy. Surgical treatments that may be recommended include:

• Arthroscopy: A procedure in which the surgeon makes two or three small incisions near the affected joint. A thin, flexible fibreoptic device called an arthroscope is then inserted to correct cartilage or remove bone chips within or around the joint.
• Joint fusion: This procedure fuses the ends of the bones to eliminate the joint. Plates, pins, screws, or rods are used to keep the bones aligned as they heal, typically performed on the hands, spine, or ankles.
• Osteotomy: In this procedure, the surgeon reshapes or realigns the long bones in the leg or arm to reduce pressure on the damaged joint, helping to alleviate pain and restore mobility.
• Joint replacement: If other treatments fail, your doctor may recommend joint replacement surgery, where damaged cartilage and bone ends are replaced with an artificial joint made of plastic or metal. This procedure can be performed on the knee, shoulder, or hip, and many patients report long-term pain relief afterward.

When to Call the Doctor

What joint pain symptoms warrant concern?

Joint pain symptoms can vary from mild discomfort to debilitating pain. When cartilage wears away, bones may rub against each other, leading to symptoms such as:

• Swelling
• Joint stiffness or enlargement
• Numbness
• Noisy joints, including grinding, clicking, or snapping sounds during movement
• Painful movement
• Difficulty bending or straightening the joint
• Loss of motion
• A swollen and hot joint (this requires immediate medical attention)

When should you seek medical treatment for joint pain?

If joint pain interferes with your daily activities, consult a practitioner. Early diagnosis and treatment are crucial for alleviating pain and ensuring healthy joint function. It's also advisable to see a doctor if:

• The pain is accompanied by fever.
• You experience unexplained weight loss of 10 pounds (4.5 kilograms) or more.
• The pain affects your ability to walk normally.

During your visit, be prepared to discuss:

• Any previous joint injuries
• When the joint pain began
• Family history of joint problems
• The nature of your pain

Your practitioner will examine the affected joint for discomfort and limited range of motion and may check for injuries to surrounding tendons, muscles, and ligaments. If necessary, your doctor may recommend blood tests or X-rays to identify fluid accumulation, joint deterioration, bone spurs, or other issues causing pain.

A Note from MD.co.uk

Joint pain often serves as a warning sign that something isn't right. However, identifying the exact cause and finding a solution can be challenging. It’s important to consult a doctor if you are experiencing joint pain. You will be asked various questions to understand your condition. Although it may take time and some trial and error, relief is possible, allowing you to return to the activities you enjoy.