Why do joints hurt

16 March 2022

Joint pain is not uncommon. Nearly half (45 percent) of all people over 45 complain of painful joints, especially knee pain. Complaints can also arise at a young age. In most cases, joint pain is caused by signs of wear and tear - here doctors talk about osteoarthritis. In addition, acute arthritis and trauma are often the cause of joint pain. But there are many other possible reasons.

Description

As common as joint pains are, their types are so diverse, so the classifications of joint pain are based on different criteria. For example, joint pain can be divided into three groups according to the time of onset:

Acute pain in the joints occurs within a few hours.
Subacute pain in the joints becomes noticeable during the day.
Chronic joint pain develops over weeks or months.

Joint pain can often persist and progress (chronic progressive course). Sometimes joint pain occurs only acutely and temporarily (acute remitting course).

In some cases, joint pain affects only one joint, such as the knee joint. But also pain can capture from two to four joints (pain in the oligo-joints) or even more joints (pain in the joints of the joints).

In addition, joint pain varies, for example, in relation to:

Painful rhythm: pain of rest, night pain, morning stiffness of the joints.
Distribution patterns: Pain in small joints (such as the wrist, knuckles of the fingers) or large joints (such as knee and hip joints), joint pain in the carpal joints, etc.
Pain Intensity: Rating the severity of joint pain on a scale from 0 (no pain) to 10 (unbearable, extreme pain).
Aggravating factors: for example, reduction of joint pain during movement (typical of arthritis) or after rest (typical of osteoarthritis).

Such information is important for the doctor to determine the causes of joint pain.

Particularly commonly affected joints

Which joints are most often affected by pain depends to a decisive extent on the cause of the pain. Some examples.

Osteoarthritis, one of the main causes of joint pain, is especially noticeable in those joints that take a lot of stress throughout life. First of all, these are knee joints, hip joints and hock joints. Osteoarthritis can also cause pain in all other joints.

Rheumatoid arthritis is also a common cause of joint pain. Painful inflammation of the joints, most often appear on the wrists and joints of the fingers. In addition, pain in the knee, elbow, metatarsophalangeal joints, and shoulder are common in rheumatoid arthritis.

Joint pain in an acute attack of gout almost always affects the leg joint, mainly the metatarsophalangeal joint. The hocks and knee joints are often also affected.

Bursitis can cause pain in the hip, elbow, knee, and shoulder.

Causes and possible diseases

Joint pain can have a variety of causes. The most important are:

Joint wear (arthritis of the joints):Osteoarthritis is the most common form of joint disease and can affect, in principle, all joints. Due to the destruction of the cartilage layer on the articular surfaces and bone changes, the affected joint cannot move freely, it turns red, swells and hurts. Osteoarthritis is often the cause of wrist, hip, and knee pain. Joint wear is usually caused by long-term overload of the joints. In addition, osteoarthritis may be a late consequence of an accident (such as sports injuries), and joint damage due to congenital weakness or deformity of the joints.
Bursitis:Bursae are located in the form of a shock-absorbing layer in particularly stressed places between the bone and soft tissues, for example, in the area of \u200b\u200bthe joints. They usually consist of a cavity filled with joint fluid. Inflammatory or mechanical irritation (such as sports injuries) can injure the bursa and cause pain in the affected area. For example, pain in the elbow is often caused by inflammation of the bursa in the elbow joint, pain in the shoulder from bursitis or calcification in the shoulder area, pain in the knee from inflammation of the bursa in the knee joint, and pain in the hip from inflammation of the bursa at the greater colliculus (bulge of bone on the upperouter thigh).
Bacterial joint inflammation (bacterial arthritis): Bacterial arthritis mainly affects the knee and hip joints. The bacteria either enter the joint through the blood or directly infect the joint (through injury or surgery on the joint, or during diagnostic injections into the joint). Severe knee or hip pain with severe joint swelling and inflammatory symptoms (such as redness, localized heat, fever) may indicate bacterial arthritis.
Lyme disease (Lyme arthritis):Joint pain in Lyme disease is also based on bacterial inflammation of the joints. It is caused by certain bacteria (Borrelia burgdorferi) that are transmitted from ticks to humans. Approximately four weeks after transmission, fatigue, fever, redness, and joint pain occur.
Associated joint inflammation during and after infections.Inflammatory joint pain can occur during and after common infectious diseases such as hepatitis, rubella, mumps, chickenpox, scarlet fever, tuberculosis, influenza, and inflammatory bowel disease (Crohn's disease, ulcerative colitis). Due to the resulting pain in the joints and swelling, there are restrictions on movements in the joints, especially large ones (hip joint, knee joint, ankle joint).
Arthritis in Reiter's disease:Reiter's syndrome is a rare rheumatic disease. Symptoms include arthralgia associated with urethritis and conjunctivitis.
Inflammation of the joints in psoriasis (psoriatic arthritis):Psoriasis is sometimes accompanied by inflammation that causes joint pain. In some cases, joint pain precedes the skin manifestations of the disease, that is, joint pain occurs first and only then scaly skin lesions develop. Psoriatic arthritis may be the cause, especially if the joints of the fingers and toes and/or the spine are affected.
Joint inflammation in ankylosing spondylitis.Ankylosing spondylitis is a chronic rheumatic inflammation that primarily affects the spine but can also spread to large joints. Therefore, knee pain, hip pain, heel pain and/or ankle pain may be the cause of Bechterew's disease.
Gout (or acute attack of gout):Gout increases the concentration of uric acid in the blood. Its excess is deposited in the form of uric acid crystals, among other things, in the joints - an acute attack of gout occurs with severe pain in the joints, swelling and redness in the joint area. First of all, the joints of the big toe are affected. But an acute attack of gout can also cause pain in the knee, pain in the wrist, pain in the knuckles of the fingers or the upper part of the ankle.
Rheumatoid arthritis:This is the most common inflammatory disease of the joints, progressive, mostly chronic, and gradually destroying the joints. Rheumatoid arthritis may be suspected if joint pain affects the fingers and wrists. Other symptoms of this condition include morning stiffness of the fingers and wrists, swelling of the joints, and an inability to make a fist.
Rheumatic fever:This inflammatory disease, which occurs mainly in children, is caused by certain bacteria (streptococci) days or weeks after a nose and throat infection that has not been treated with antibiotics. Possible symptoms include inflammatory joint pain, skin symptoms, inflammation of the heart (carditis), and sudden involuntary and uncontrolled movements (chorea).
Arthritis with sarcoidosis (Löfgren's syndrome):Sarcoidosis is a rare inflammatory disease of unknown origin that can affect the entire body. One form of the disease is Löfgren's syndrome (acute sarcoidosis). It occurs mainly in young women and presents with the following symptoms: inflammation, joint pain (especially in the ankles), acute inflammation of the subcutaneous fatty tissue (erythema nodosum), swelling of the lymph nodes in the lungs (bronchial lymphadenopathy), and weight loss.
Systemic lupus erythematosus (SLE):It is a rare autoimmune disease that mainly affects women, often causing joint pain and inflammation. But there are also possibly many other different symptoms, such as a butterfly-shaped rash on the face, pleurisy, pericarditis, inflammation of the kidneys or brain, loss of appetite and weight loss. Therefore, lupus erythematosus in medicine is called a "chameleon".
Articular bleeding in violation of coagulation.In rare cases of hemophilia, there is a hereditary predisposition to uncontrollable bleeding after injury or, in severe cases, even for no apparent reason. Especially often there are bleeding in the muscles and joints. Bleeding in the joints can cause joint pain and permanent joint damage if left untreated. In addition to hemophilia, other bleeding disorders can also lead to joint bleeding and joint pain, such as bleeding disorders due to an overdose of anticoagulants.

When should you see a doctor?

Joint pain sometimes goes away on its own or can be relieved with simple home remedies. But be careful with the following symptoms:

Joint pain that limits joint movement.
Fever.
Redness of the skin in the area of the aching joint.
Swelling of the joint.

If joint-related symptoms (joint pain with limited mobility, redness, swelling) persist for three days or more, worsen, or spread to other joints, you should definitely see a doctor.

What does the doctor do?

To clarify the cause of joint pain, the doctor will first ask the patient about their medical history (medical history). For example, when and where does the joint pain occur and if there are other complaints (accompanying symptoms such as fever or joint swelling).

Accurate description of joint pain

This information is very important for diagnosing joint pain: the more accurately a patient can describe joint pain, the sooner a doctor can narrow down the number of possible causes. For example, an acute gout attack is thought to cause pain in only one joint. In rheumatoid arthritis, on the contrary, arthralgias are observed in several joints. In addition, the location (localization) of joint pain is indicative: if the patient experiences pain in the wrist and pain in the base and middle joints of the fingers, rheumatoid arthritis is most likely present. On the other hand, if the joint pain affects the base of the thumb and knuckles, the suspicion is in the direction of osteoarthritis.

Scanning (palpation)

Regardless of where the joint pain occurs, the doctor should clarify the question: does the joint itself really hurt, or does the supposed joint pain come from an area close to the joints or adjacent bones? In some cases, the doctor can find the answer to this question simply by palpating the painful area. However, very often additional examinations, such as x-rays or ultrasounds, are needed.

Further Research on Joint Pain

Such examinations can help identify the cause of pain, if joint pain does occur directly in the joint:

Orthopedic examination:If joint pain is caused by wear and tear (arthritis), bursitis, rheumatism, or an acute attack of gout, relevant information can be found during an orthopedic examination.
Dermatological examination:Skin examinations help identify suspected psoriatic arthritis or sarcoidosis as possible causes of joint pain.
Blood tests:blood tests are useful in identifying various causes of joint pain, such as bacterial arthritis or Lyme disease. Sometimes a blood test needs specific measurements, such as blood clotting, if joint bleeding (due to a coagulation disorder) may be causing joint pain. If rheumatoid arthritis is the cause of joint pain, then in the blood, first of all, rheumatoid factor and other signs of inflammation are determined, which are crucial. And if gout or an acute attack of gout is suspected, the focus is on the level of uric acid in the blood.
Ultrasound examinations:ultrasound (ultrasound) is indicated when bursitis, gout, or systemic lupus erythematosus are suspected as causes of joint pain.
X-ray:x-ray shows signs of wear and tear on the joints (arthritis), rheumatoid arthritis and ankylosing spondylitis.
Joint puncture:if the doctor suspects bacterial joint inflammation as the cause of the joint pain, they will take a sample of the joint fluid (joint puncture). Bacterial culture is done from this sample: if bacteria do grow from the joint sample, this indicates bacterial inflammation of the joint.

It is not always possible to find a disease or pathological tissue change as the cause of joint pain. Doctors talk about "joint sensitivity". If the cause of the joint pain is found, the doctor can begin appropriate treatment and treat the underlying condition with medication or surgery.

You can make it on your own

General tips for joint pain

Lose excess weight. Any extra kilogram is an unnecessary additional load on the joints and contributes to their wear and tear, which inevitably leads to joint pain.
Make sure you get enough rest after your workout.
Do regular endurance exercises to strengthen your muscles and articular cartilage. For example, swimming and cycling are suitable for joint training. Regular strength training (such as weight lifting, jump rope) is also recommended to strengthen bones. Consult with an experienced trainer or sports physician to determine the correct dose and develop a well-balanced exercise program that strengthens all muscles equally.
Avoid one-sided loads such as carrying heavy bags over your shoulder.
According to Jacobson, it is necessary to reduce mental stress by, for example, autogenic training or progressive muscle relaxation. Emotional pressure also puts pressure on joints, shoulders, and bones.
Joint pain and other joint complaints are treated in traditional Chinese medicine with acupuncture. Consult an experienced therapist.

Joint Treatment Tips

If osteoarthritis is diagnosed, that is, recent severe inflammation of the joints with pain, swelling and redness, you must immobilize the affected joint (bed rest). Hold it so that the muscles associated with it are not tense. Give yourself wet and cool compresses (like a quark wrap) to relieve joint discomfort. The effect of anti-inflammatory and pain medications that you get from your doctor can be enhanced with the help of medicinal plants. Arnica is well suited (as a decoction for compresses or as an ointment or gel for rubbing into the joints). In addition, there are, for example, anti-inflammatory and analgesic preparations based on willow bark, as well as combination preparations with rosemary and eucalyptus oils. In addition, peppermint oil can ease the perception of pain due to its cooling effect.
Once the joint pain, including redness and swelling, has subsided, the doctor speaks of inactive osteoarthritis. At this stage of the disease, prevention of the resumption of active complaints about the joints is carried out. This is facilitated by adequate, healthy sleep on an orthopedic mattress, as the muscles relax well, and the spine and joints rest.
In addition, you should regularly use meditative relaxation techniques (such as gradual muscle relaxation, autogenic training) if you often suffer from muscle tension under stress.
Regular exercise and exercises that improve the supply of synovial fluid and nutrients to the articular cartilage. Useful sports are swimming, cycling and water aerobics. In contrast, running on hard pavement is not recommended, especially if the osteoarthritis has already damaged the knee and hip joints. If possible, run on soft forest turf and wear soft-soled sneakers that provide a good effect. Even better, walk instead of jogging.
Avoid sports with sudden changes in direction (e. g. tennis, squash) as they put a lot of stress on the joints (e. g. knee joint) and quickly cause joint pain.
Try not to stand or sit in one position for a long time.
Eat a diet low in arachidonic acid. This omega-6 fatty acid plays a central role in inflammatory responses (such as arthritis-induced osteoarthritis). Arachidonic acid is mainly found in fatty pork, egg yolks, lard, tuna, liver, beef and camembert.
Take omega-3 fatty acids regularly as they act as competing analogues of arachidonic acid in inflammatory responses. You can find more of these fatty acids in fish oils (eat fish at least once a week! ).
Make sure you get enough vitamin E, which is important for synovial fluid as it provides its antioxidant effect against inflammation. Vitamin E is found in vegetable oils, especially in the germs of wheat, soy and sunflower.
Osteoarthritis-related joint pain and other joint complaints can often be alleviated by the application of circulation-stimulating heat, such as fango sachets, paraffin, senna, rosemary baths.
For osteoarthritis of the finger joints, kneading with warm clay or loam can help with joint pain and swelling. Regular finger exercises in heated sand are highly recommended as well. It is especially good for morning stiffness and joint pain.
Massaging and rubbing with essential oils of eucalyptus, juniper, rosemary, lavender or lemon help to improve blood circulation and therefore combat joint inflammation.
For inactive osteoarthritis, devil's claw root tea is recommended: pour one tablespoon of coarsely ground root into two cups of boiling water and steep for eight hours. Boil before use, then strain, divide the prepared amount of tea into three servings and drink throughout the day. The effect of taking the infusion of the devil's claw appears around the third week of treatment.
For the treatment of inactive osteoarthritis, a tea mixture of currant leaves, willow bark, nettle grass, horsetail and meadowsweet flowers (20 g of each component) is also recommended. Take two teaspoons of this mixture and pour a glass of boiling water, let it brew for half an hour, then strain. Drink 5-6 cups of this tea throughout the day. It has anti-inflammatory and analgesic effect.
Also helpful in treating arthritis irritations are dry cupping and leech therapy (also anti-inflammatory). Treatment with one's own blood is controversial, especially if the treated fluid is injected into the joint (risk of infection! ).

Tips for rheumatoid arthritis

Some osteoarthritis tips should also apply to people with rheumatoid arthritis. These include nutritional advice, recommendations for topical use of arnica and devil's claw root. Additional tips that can help with rheumatoid joint pain and other joint problems:

During periods of mild discomfort (the inactive state of rheumatoid arthritis), you can use physical therapy and massage to keep your joints flexible.
During an aggravation of the inflammatory process (active rheumatoid arthritis), you can prepare an anti-inflammatory tea mixture from meadowsweet, willow bark, goldenrod, currant grass and nettle (20 g of each herb). Pour a tablespoon of this mixture into a cup of cold water and leave for one hour. Then heat to a boil, but do not boil! Remove from heat, let sit for five to ten minutes, then strain. Drink three to four cups of this tea daily.
For acute inflammation of the joints, the consumption of protein-digesting enzymes, such as bromelain, should help.
Highly recommended for rheumatic diseases such as rheumatoid arthritis, tai chi and qigong. These are holistic Chinese forms of movement that can improve patients' mobility, muscle strength, endurance, quality of life and mood, studies show. The effect, according to Chinese medicine, is that calm, fluid movements and breathing exercises release blockages in the body and make the life force (Qi) flow. Slow exercises are also suitable for patients whose mobility is already limited due to joint pain and inflammation.
Inflammatory joint pain can be relieved with cold or heat treatments - try whichever works best for you. In general, cooling is recommended for acute joint inflammation to stop the inflammation. In chronic ailments, heat is generally more pleasant, such as warming baths (such as senna flowers), fango packs, or mud treatments.
Even creams and ointments on medicinal plants exhibit anti-inflammatory and analgesic effects. These include ready-to-use preparations containing willow bark or rosemary and eucalyptus oils. In addition, peppermint oil can alleviate the perception of pain by irritating the cold receptors in the skin.
Ayurvedic therapists recommend cleansing procedures (panchakarma treatment) for rheumatic diseases to remove toxins (called ama) from the body. According to this teaching, the accumulation of ama is the cause of disease. For acute inflammation of the joints with pain in the joints, Indian frankincense (shallaki) and triphala (herbal mixture) are used. Both have strong anti-inflammatory effects.