Why do joints hurt?

16 March 2022

Joint pain is not uncommon. Nearly half (45 percent) of all people over 45 years old 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 degenerative joint disease. In addition, acute arthritis and trauma are often causes of joint pain. But there are many other possible reasons.

Description

Joint pain is so common, their types are diverse, so the classification of joint pain is based on different criteria. For example, joint pain can be divided into three groups by 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 be persistent and progressive (chronic progression). Sometimes joint pain is acute and temporary (acute remission).

In some cases, joint pain affects only one joint, such as the knee joint. But there can also be pain in 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, related to:

Rhythm of pain: pain at rest, pain at night, stiffness in the morning.
Distribution: Pain in small joints (such as wrists, finger joints) or large joints (such as knees and hips), pain in wrist joints, etc. v.
Pain intensity: Rate the severity of joint pain on a scale of 0 (no pain) to 10 (tolerable, extremely painful).
Aggravating factors: eg, reduced joint pain with movement (typical of arthritis) or after rest (typical of osteoarthritis).

This information is important for your doctor to determine the cause of your joint pain.

Special joints are often affected

Which joints are most commonly affected depends to a large extent on the cause of the pain. Few examples.

Osteoarthritis, one of the major causes of joint pain, is especially noticeable in joints that have been subjected to a lot of stress throughout life. First of all, it is the knee, hip and ankle joints. Osteoarthritis can also cause pain in all other joints.

Rheumatoid arthritis is also a common cause of joint pain. Pain in inflammatory joints, most often appearing in the wrist and finger joints. In addition, pain in the knee, elbow, ankle, and shoulder joints is common in rheumatoid arthritis.

Arthralgia during acute gout attacks almost always affects the joints of the legs, mainly the ankle joints. The ankle and knee joints are also commonly affected.

Bursitis can cause pain in the hips, elbows, knees, and shoulders.

Causes and possible diseases

Joint pain can have many causes. The most important thing is:

Wear and tear (arthritis of the joints):Osteoarthritis is the most common form of joint disease and can affect all joints in principle. Due to the destruction of cartilage on the surface of the joint and changes in the bone, the affected joint cannot move freely, it turns red, swollen and painful. Osteoarthritis is often the cause of wrist, hip, and knee pain. Joint wear is usually caused by a joint being overloaded for a long time. In addition, osteoarthritis can be a late consequence of an accident (such as a sports injury), and joint damage due to congenital weakness or deformity of the joint.
Bursitis:Bursae is located in the form of a shock-absorbing layer in places of special tension between bones and soft tissues, such as in the area of \u200b\u200the joints. They usually consist of a cavity filled with synovial fluid. Inflammatory or mechanical irritation (such as a sports injury) can damage the capsule and cause pain in the affected area. For example, elbow pain is often caused by elbow bursitis, shoulder pain is caused by bursitis or shoulder calcification, knee pain is caused by knee bursitis, and pain is internal. hip due to bursitis in the larger meniscus (a bony bulge in the upper outer thigh).
Bacterial arthritis (bacterial arthritis):Bacterial arthritis mainly affects the knee and hip joints. The bacteria enter the joint through the bloodstream or directly infect the joint (through trauma or joint surgery, or during diagnostic injections into the joint). Severe knee or hip pain accompanied by severe joint swelling and symptoms of inflammation (such as redness, local heat, fever) may be a sign of bacterial arthritis.
Lyme disease (Lyme arthritis):Joint pain in Lyme disease is also based on bacterial arthritis. It is caused by certain bacteria (Borrelia burgdorferi) that are transmitted from ticks to humans. About four weeks after transmission, fatigue, fever, redness, and joint pain occur.
Arthritis associated during and after infection.Inflammatory joint pain can occur during and after common infectious diseases such as hepatitis, rubella, mumps, chickenpox, scarlet fever, tuberculosis, influenza, and inflammatory bowel diseases (Crohn's disease, ulcerative colitis). Because the joints are painful and swollen, movement in the joints is limited, especially the large joints (hip, knee, ankle).
Arthritis in Reiter's disease: Reiter's syndrome is a rare rheumatic disease. Symptoms include joint pain associated with urethritis and conjunctivitis.
Arthritis in psoriasis (psoriatic arthritis):Psoriasis is sometimes accompanied by inflammation that causes painful joints. In some cases, joint pain precedes the cutaneous manifestations of the disease, i. e. joint pain occurs first and only then scaly skin lesions develop. Psoriatic arthritis may be the cause, especially if the joints of the fingers, toes, and/or spine are affected.
Arthritis in ankylosing spondylitis.Ankylosing spondylitis is a chronic inflammatory rheumatic disease that affects mainly 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 uric acid levels in the blood. Its excess is deposited as uric acid crystals, among other things, in the joints - acute gout attacks occur 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 knees, wrists, joints of the fingers or the upper part of the ankles.
Rheumatoid arthritis:This is the most common inflammatory arthritis, severe progression, mostly chronic, and gradually destroys the joints. Rheumatoid arthritis may be suspected if joint pain affects the fingers and wrists. Other symptoms of this condition include stiffness in the fingers and wrists in the morning, swollen joints, and an inability to make a fist.
Rheumatism:This inflammatory disease, which mainly occurs in children, is caused by certain bacteria (streptococcal) days or weeks after an infection of the nose and throat that has not been treated with antibiotics. Possible symptoms include inflammatory joint pain, skin symptoms, inflammation of the heart (heart inflammation), and sudden involuntary and uncontrolled movements (chorea).
Arthritis with sarcoidosis (Löfgren's syndrome):Sarcoidosis is a rare inflammatory disease of unknown cause that can affect the entire body. One form of the disease is Löfgren's syndrome (acute sarcoidosis). It occurs mainly in young women and has the following symptoms: inflammation, joint pain (especially in the ankles), acute inflammation of the subcutaneous fatty tissue (erythema nodosum), swollen 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 pain and inflammation in the joints. But there can also be a variety of 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 "chameleon".
Bleeding joints due to violation of blood clotting.In rare cases of hemophilia, there is a genetic predisposition to uncontrolled bleeding after an injury or, in severe cases, even for no apparent reason. Especially often there is 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 caused by 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 beware of the following symptoms:

Joint pain limits joint movement.
Fever.
The skin of the joint area is painful, red, and swollen.
Joint swelling.

If your joint-related symptoms (joint pain that limits movement, redness, swelling) persist for three days or more, get worse, or spread to other joints, you should definitely see your doctor.

What does the doctor do?

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

Accurate description of joint pain

This information is important for diagnosing joint pain: the more accurately a patient can describe joint pain, the sooner doctors can narrow down the number of possible causes. For example, an acute gout attack is thought to cause pain in only one joint. In contrast, for rheumatoid arthritis, occlusions were observed in several joints. In addition, the location (localization) of the joint pain is an indicator: if the patient feels pain in the wrist and pain in the base and middle joints of the fingers, it is very likely that he has rheumatoid arthritis. Conversely, if the joint pain affects the base of the thumb and knuckles, then suspect it is the direction of osteoarthritis.

Scan (palpate)

Regardless of where the joint pain occurs, the doctor should clarify the question: is the joint really painful, or is the joint pain thought to be coming from an area near the joint or adjacent bone? In some cases, the doctor can find the answer to this question simply by palpating the painful area. However, very often additional testing, such as X-ray or ultrasound, is needed.

More research on joint pain

Such examinations can help determine the cause of the pain, if the joint pain occurs directly in the joint:

Orthopedic check:If joint pain is caused by wear and tear (arthritis), bursitis, rheumatism, or an acute attack of gout, you can find relevant information during your chiropractic exam.
Dermatological examination:Skin examination helps identify suspected psoriatic arthritis or sarcoidosis as possible causes of joint pain.
Blood tests:Blood tests are helpful in identifying various causes of joint pain, such as bacterial arthritis or Lyme disease. Sometimes specific measurements, such as blood clotting, are needed in a blood test if joint bleeding (due to a clotting disorder) could be causing joint pain. If rheumatoid arthritis is the cause of joint pain, then in the blood, it is necessary to first identify rheumatoid factor and other inflammatory markers, which is the decisive factor. And if gout or an acute episode of gout is suspected, the focus is on uric acid levels in the blood.
Ultrasound test:Ultrasound (ultrasound) is indicated when bursitis, gout, or systemic lupus erythematosus are suspected as the cause of joint pain.
X ray:X-rays show signs of wear and tear in the joints (arthritis), rheumatoid arthritis, and ankylosing spondylitis.
Joint perforation:If your doctor suspects bacterial arthritis is the cause of your joint pain, he or she will take a sample of joint fluid (arthrocentesis). Bacterial cultures are taken from this sample: if bacteria grow from the joint specimen, this indicates bacterial inflammation of the joints.

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

You can do it yourself

General advice for joint pain

Reduce excess weight. Any extra kilos is an unnecessary extra load on the joints and contributes to their wear and tear, leading to joint pain.
Make sure you get enough rest after your workout.
Perform endurance exercises regularly to strengthen muscles and joint cartilage. For example, swimming and cycling are suitable for general fitness. Regular endurance exercise (such as lifting weights, jumping rope) is also recommended for strong bones. Consult with an experienced trainer or sports physician to determine the correct dosage and develop a balanced exercise program that strengthens all muscles evenly.
Avoid side loads such as carrying heavy bags over your shoulder.
According to Jacobson, mental stress should be reduced through spontaneous exercise or progressive muscle relaxation. Emotional pressure also puts pressure on joints, shoulders, and bones.
Joint pain and other joint diseases are treated with acupuncture in traditional Chinese medicine. Consult an experienced therapist.

Tips for treating joints

If you are diagnosed with osteoarthritis, i. e. a recently severely inflamed joint with pain, swelling, and redness, you must immobilize the affected joint (bed rest). Hold it so that the muscles involved in it are not tense. Wet and cool compresses (such as a quark wrap) to reduce joint discomfort. The effects of anti-inflammatory and pain-relieving medications that you get from your doctor can be enhanced with the help of medicinal plants. Arnica is very suitable (in the form of a decoction for application or as an ointment or gel for rubbing into the joints). In addition, there are anti-inflammatory and analgesic preparations based on willow bark, as well as combination preparations with rosemary and eucalyptus oils. Additionally, peppermint oil can soothe pain due to its cooling effect.
Once the joint pain, including swelling and redness, has subsided, your doctor will refer to inactive osteoarthritis. At this stage of the disease, prevention of the recovery of active complaints about the joints is carried out. This is facilitated by adequate, healthy sleep on an orthopedic mattress, as the muscles are well relaxed, the spine and joints rested.
In addition, you should regularly use meditative relaxation techniques (such as gradual muscle relaxation, autogenic training) if you frequently experience muscle tension when under stress.
Regular exercise and exercises help improve the delivery of joint fluid and nutrients to joint cartilage. Useful sports are swimming, cycling and water aerobics. Conversely, running on hard pavement is not recommended, especially if degenerative joint disease has damaged the knee and hip joints. If possible, run on soft forest grass and wear soft-soled sneakers for good results. Better yet, walk instead of jogging.
Avoid sports that have a sudden change of direction (eg tennis, squash) because they put a lot of stress on the joints (eg the knee) and quickly cause joint pain.
Try not to stand or sit in one position for long periods of time.
Eat a diet low in arachidonic acid. This omega-6 fatty acid plays a central role in inflammatory responses (such as osteoarthritis caused by arthritis). Arachidonic acid is mainly found in fatty pork, egg yolks, lard, tuna, liver, beef and beef.
Supplement with omega-3 fatty acids regularly because they act as competitive 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 because it provides antioxidant effects that fight inflammation. Vitamin E is found in vegetable oils, especially in wheat germ, soybeans, and sunflower.
Joint pain associated with osteoarthritis and other joint ailments can often be alleviated by using heat that stimulates circulation, such as fango packs, paraffin, senna, rosemary baths.
For osteoarthritis of the fingers, kneading with warm clay or loam can help reduce pain and swelling in the joints. Regular finger exercises in the hot sand are also highly recommended. It is especially good for morning stiffness and joint pain.
Massaging and applying with essential oils of eucalyptus, juniper, rosemary, lavender or lemon improves blood circulation and thus combats arthritis.
For inactive cases of osteoarthritis, devil's claw root tea is recommended: pour one tablespoon of ground root into two cups of boiling water and steep for eight hours. Boil before use, then filter the water, divide the prepared tea into three parts and drink during the day. The effects of Devil's Claw infusion appear around the third week of treatment.
For the treatment of inactive osteoarthritis, a tea blend of grape leaves, willow bark, nettle, horsetail, and reed flowers is also recommended (20 g each). Take two teaspoons of this mixture and pour a cup of boiling water, let it steep for half an hour, then strain. Drink 5-6 cups of this tea throughout the day. It has anti-inflammatory and pain-relieving effects.
Also useful in treating inflammatory arthritis are cupping and leech therapy (which also has anti-inflammatory effects). 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 bone and joint health tips should also be applied to rheumatoid arthritis patients. These include nutritional advice, recommendations for topical use of alfalfa and devil's claw root. Additional tips that may help relieve rheumatoid arthritis pain and other joint problems:

During periods of mild discomfort (the dormant state of rheumatoid arthritis), you can use physical therapy and massage to keep joints flexible.
In the period of exacerbation of the inflammatory process (active rheumatoid arthritis), you can prepare a mixture of anti-inflammatory teas from reeds, willow bark, goldenrod, currant and nettle (20 geach herb). Pour a spoonful of this mixture into a glass of cold water and leave for an hour. Then boil, but do not boil! Remove heat, let stand 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, will be helpful.
Highly recommended for rheumatic diseases such as rheumatoid arthritis, tai chi and qigong. Studies show these are holistic forms of Chinese exercise that can improve patients' mobility, muscle strength, endurance, quality of life, and mood. The effect, according to Chinese medicine, is soothing movements, fluids and breathing exercises that release blockages in the body and make life force (Qi) circulate. Slow exercises are also appropriate for patients with limited mobility due to pain and arthritis.
Arthritis pain from inflammation can be relieved with heat or cold treatments - try whichever works best for you. In general, cooling is recommended for acute arthritis to suppress inflammation. For chronic conditions, warmth is often more tolerable, such as a warm bath (such as a senna), fango, or mud therapy.
Even creams and ointments on medicinal plants have anti-inflammatory and analgesic effects. These include ready-to-use preparations containing willow bark or rosemary and eucalyptus oils. Additionally, peppermint oil can alleviate pain by stimulating 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 illness. For acute arthritis accompanied by aching joints, Indian frankincense (shallaki) and triphala (herbal mixture) are used. Both have strong anti-inflammatory effects.