Joint Pain

Joint pain often occurs in conjunction with other signs and symptoms that vary depending on the underlying disease, disorder or condition. Other joint pain symptoms can include joint swelling, redness, and fever.

Tell your healthcare provider about any additional symptoms you are experiencing. This information will help your healthcare provider diagnose the reason for your pain.

Joint pain may occur with other symptoms related to the joint, including:

• Joint noise (clicking, popping, crackling) 

• Redness

• Reduced mobility (range of motion of the joint)

• Stiffness

• Swelling

• Visible deformity of the affected joint

Joint pain may accompany symptoms that may seem unrelated to the joint, including:

• Abdominal pain

• Aching muscles

• Butterfly-shaped rash over bridge of nose

• Dry mouth and skin

• Fatigue

• Fever not associated with flu symptoms

• Flu-like symptoms such as fever, chills, sore throat, muscle aches, and headache

• Increased urine output

• Rash

• Scaly patches of skin

• Yellow skin and eyes with dark urine output (jaundice)

In some cases, joint pain may occur with other symptoms that might indicate a serious or life-threatening condition, such as rheumatic fever, which should be immediately evaluated in an emergency setting.

Symptoms that may indicate a serious or life-threatening condition include:

• Bleeding from minor injuries

• Chest pain

• Debilitating pain

• Difficulty breathing

• Heart palpitations

• High fever (higher than 101°F)

• Muscle weakness

• Pain in several joints with rash

• Rapid, jerky movements

• Redness

• Swollen lymph nodes

• Unexplained weight loss

Pain is usually the product of inflammation, whether acute or chronic. After any type of tissue injury, the healthy immune response releases chemical substances into the circulation that generate pain signals in the brain. Joint pain can be due to fairly mild conditions, such as an overuse injury or sprain that responds well to rest and self-care measures. Quieting the inflammation will rapidly relieve the pain.

Joint pain can also be due to traumatic injuries (dislocations), infections (septic arthritis or rheumatic fever), autoimmune diseases (Sjogren’s syndrome), chronic degenerative conditions (arthritis), or malignancy (cancer). Some of these diseases, disorders or conditions are serious and potentially life-threatening, especially if they are not treated promptly.

Joint pain may arise from traumatic injuries including:

• Contusions

• Joint dislocation

• Joint separation

• Ligament sprains

• Loose fragments of bone or cartilage

• Overuse injury

• Repetitive motion

• Retained foreign body

• Sports injuries

• Torn ligament or cartilage

Joint pain may arise from infectious diseases including:

• Hepatitis

• Influenza

• Lyme disease

• Measles

• Mumps

• Osteomyelitis (bone infection)

• Rubella

• Septic, or infectious, arthritis

• Syphilis

• Tuberculosis

Joint pain can also be caused by the deterioration of the joint structure, inflammatory conditions, and autoimmune diseases, such as:

• Ankylosing spondylitis (inflammation of joints between the vertebrae of the spine)

• Bursitis (inflammation of a bursa sac that cushions a joint)

• Fibromyalgia (chronic condition that causes pain, stiffness and tenderness)

• Gout (type of arthritis)

• Osteoarthritis

• Psoriasis

• Rheumatic fever

• Rheumatoid arthritis

• Sjogren’s syndrome (an autoimmune disease that affects the mucous membranes and moisture-secreting glands of your eyes and mouth, initially causing dry eyes and mouth)

• Systemic lupus erythematosus

• Tendinitis (inflammation of a tendon)

Other causes of joint pain include:

• Bone cancer

• Hemophilia

• Hyperparathyroidism

• Paget’s disease (abnormal bone formation and turnover)

Minor joint pain often responds to self-care treatments you can do at home. But there are times when seeing a doctor about joint pain is best. For mild joint pain, make an appointment with your doctor if it persists, worsens, or occurs even at rest, despite home treatment.

See a doctor promptly when:

• Joint pain is moderate and lasts for more than 2 to 3 days with self-care.

• Joint pain occurs with increasing swelling or bruising around the joint.

• Joint pain occurs with locking or buckling of the joint.

• You have limited joint movement or cannot fully bend or extend the joint due to pain.

• You have lost weight without intending to do so.

Call 911 or go to your nearest emergency room for joint pain when:

• Joint pain is severe or intense or you have sudden swelling around the joint.

• The joint is deformed or a bone is visible.

• The joint is red, swollen and warm or you have a fever with the joint pain.

• You cannot bear weight on or use the affected limb.

• You have numbness in the area past the joint.

• You have sustained an injury or any kind of trauma to the joint.

To diagnose the underlying cause of joint pain, your doctor will take a medical history and perform an exam. It may also be necessary to order tests.

To diagnose the underlying cause of joint pain, your doctor will ask you several questions about your pain including:

• In what part of the joint do you feel pain? Does it hurt on both sides of the joint?

• On a scale of 1 to 10, with 10 being the worst pain ever, how would you rate your pain?

• Describe the pain. Is it sharp or dull, throbbing or aching, constant or occasional? 

• When did the pain start? How long does it last?

• Are there times of day when the pain is worse?

• Have you had this joint pain before?

• Are there any activities that cause the joint pain?

• What, if anything, makes the pain better or worse?

• Are you experiencing any other symptoms, such as numbness, tingling, and “pins and needles”?

• Are any other joints painful?

• Have you had a recent injury, rash or fever?

• What medical conditions do you have?

Your doctor will also perform a physical exam, focusing on the joint and limb. The exam will check for signs of injury or abnormality, such as swelling, warmth or tenderness. Your doctor may move the joint or ask you to move it to see if motion is limited or too loose. Your doctor will also look for symptoms with motion, such as pain or grating or grinding sounds.

Depending on the results of the exam, your doctor may recommend testing including:

• Blood tests to check for signs of inflammation, infection, or an autoimmune disease

• Imaging exams, such as X-rays, CT (computerized tomography) scans, or MRIs (magnetic resonance imaging)

• Joint aspiration to take a sample of joint fluid or joint arthroscopy to examine the inside of the joint

It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

Joint pain is a symptom, so treating it will depend on the underlying cause and severity of the pain. Treatment goals include providing joint pain relief and correcting any physical cause of the pain. Doctors usually start with conservative treatments unless there is a need for immediate surgery. Joint pain treatment options may include:

• Antibiotics for bacterial infections

• Bracing, casting, splinting, or using a sling to immobilize and support the joint

• Crutches for joint pain involving the leg, to keep weight off the affected joint

• Medications to relieve pain and swelling, including NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve), and corticosteroid joint injections 

• Rest, ice and elevation to relieve pain and reduce swelling due to minor injuries

Physical therapy is often part of the treatment plan for joint pain. It can help ease pain, heal injuries, and restore strength, stability and flexibility to the joint. If all of these conservative treatments fail to improve the pain, doctors may recommend arthroscopy or surgery, such as joint replacement.

Home treatments are often all that is necessary to manage minor joint pain. Home remedies for joint pain include:

• Rest: Stop activities that worsen joint pain or that caused the injury. Allow enough time for healing before returning to these activities. See your doctor if pain recurs when you resume an activity.

• Ice: Apply an ice pack to the joint for 20 minutes at a time. Repeat this several times a day for the first 24 to 48 hours. 

• Elevation: Prop the affected limb up to help reduce swelling.

• Heat: After the first 24 hours, you can apply heat several times a day if it feels better than ice. 

• Over-the-counter pain relievers: Take NSAIDs to relieve pain and swelling from minor injuries. If you cannot take NSAIDs, acetaminophen (Tylenol) may help with pain. It will not help inflammation.

• Protection: Wear pads to protect the joint from bumps and other injuries. 

• Stretching: Tight muscles are more vulnerable to injury. Keep supporting muscles strong and flexible so they can support the joint. Stretch the muscles regularly, especially after exercise. 

Alternative treatments are meant to complement traditional treatments. One popular option for joint pain due to osteoarthritis (OA) is a glucosamine/chondroitin supplement. Studies looking at the effectiveness of the supplement have had mixed results. Some have shown a positive effect on joint pain, while others have not. However, it appears to be safe for most people, so it may be a reasonable option for add-on treatment.

Acupuncture is another popular complementary therapy for joint pain. Research suggests it may be effective for some types of joint pain.

Let your doctor know if you are using alternative treatments. Supplements and other treatments can have side effects and interact with traditional therapy.

Any complications associated with joint pain can be progressive and vary depending on the underlying cause. Because joint pain can be due to serious diseases, failure to seek treatment can result in complications. It is important to contact your healthcare provider when you experience any kind of persistent joint pain or other unusual symptoms.

Once the underlying cause is diagnosed, it is important to follow the treatment plan outlined by your healthcare provider to reduce your risk of potential complications related to joint pain, such as:

• Joint deformity

• Loss of mobility

• Paralysis

• Permanent joint damage

• Permanent joint immobility

• Permanent joint instability

• Permanent loss of sensation

• Physical disability

• Poor quality of life

• Spread of infection