Joint pain – top 10 causes
Your joints are areas where 2 or more bones meet – they usually allow parts of your body to bend and move. Most joints are synovial joints, like the hip, knee and shoulder joints.
Symptoms of joint pain
Joint pain is a common symptom, and the pain can range from mild to debilitating. Joint pain can affect one joint only or can affect multiple joints at the same time. Joint pain may arise from the joint itself, or be caused by surrounding structures, such as tendons or bursae (fluid-filled sacs that cushion your joints).
The pain may be accompanied by swelling, heat, tenderness, stiffness or inflammation.
Joint pain may come on suddenly, or the symptoms may come and go over time. Joint pain is also known as arthralgia.
If you have joint pain accompanied by these symptoms, you should see a doctor:
- loss of range of motion and difficulty moving the joint
- joints that are red or feel warm to the touch
- swelling in the joint
- tenderness of the joint
If these symptoms are present, see a doctor immediately:
- strong pain
- sudden swelling of the joint
- you can’t move the joint
Tests and diagnosis of joint pain
If you have joint pain, your doctor will examine the joint(s), and ask you questions regarding the pain and how it started.
If they suspect gout, rheumatoid arthritis or an autoimmune cause for your joint pain, they may suggest you have specific blood tests to look for antibodies or markers of the disease.
Sometimes they may suggest you have an X-ray. Rarely, other imaging may be relevant, such as an MRI scan, CT scan or bone scan.
Who should you see about joint pain?
Your General Practitioner is a good place to start if you have joint pain. They will be able to refer you to a specialist, such as a Rheumatologist or Sport and Exercise Physician if necessary.
Physiotherapists may also be involved in the treatment of joint pain.
Here are some top causes of joint pain.
Sports injuries are a common cause of joint pain in the elbow, knee, shoulder and ankle joints.
Sprains and strains are common types of sports injuries that can cause joint pain. Mild injuries should heal quickly, but more severe strains or sprains may take longer. Overuse injuries, such as some rotator cuff disorders of the shoulder can also cause shoulder pain.
Knee pain is a common problem and may be due to an overuse injury in runners or cyclists.
The pain in osteoarthritis is thought to be caused by a few factors, including excess fluid in the joint, inflammation of the synovial membrane, and loss of joint space. Surprisingly, cartilage is not the source of the pain, as it has no blood supply or nerves.
Pain due to osteoarthritis may be accompanied by stiffness (especially after waking up or a period of inactivity), tenderness over the joint, swelling and reduced flexibility, as well as grating or grinding feelings in the joint. It may affect only one joint on one side of the body or both. Pain from osteoarthritis tends to come on gradually.
Rheumatoid arthritis (RA) is usually symmetrical, affecting the joints on both sides of the body at once. It is caused by your immune system mistakenly attacking the tissues in your joints. RA causes pain, swelling and stiffness in the joints. The joints may also become deformed. The early-morning stiffness from RA usually lasts longer than an hour, in contrast to that in osteoarthritis, which goes fairly quickly.
Joints that are commonly affected by rheumatoid arthritis are the hands, wrists and feet. The symptoms may not be constant – they can come (flares) and go (periods of remission).
Fibromyalgia is a chronic pain syndrome which has burning and aching in the joints as one symptom. People with fibromyalgia have a heightened sensitivity to pain; they may suffer from chronic fatigue, memory problems, headache or dizziness.
The cause is unknown. Fibromyalgia does not affect or damage the joints.
Gout is a condition that occurs when there are raised levels of uric acid in the blood. The uric acid crystallises out into the joints, causing pain, redness and heat. The joint most commonly affected is the big toe, but the instep, ankle, knee, wrist, elbow and fingers can be affected. The joint may be painful to touch.
More about gout.
Bursitis is inflammation of the small fluid-filled sacs that cushion your joints. One of the most common areas for bursitis is the shoulder joint. Other joints that are commonly affected are the hip joint, knee joint and the elbow joint.
Overuse injuries or repeated pressure, for example from kneeling, can cause bursitis. Infection or sudden injury are other potential causes.
The pain may occur suddenly or may build up gradually. The joint may be swollen.
Find out more about bursitis.
Reactive arthritis is arthritis that develops in response to an infection in your body. Some bacterial infections can cause reactive arthritis, for example, Salmonella, Chlamydia and Clostridium difficile. However, not everyone who gets these infections will develop reactive arthritis – only a small number of people will.
Septic arthritis happens when bacteria or fungi in your bloodstream cause infection in a joint. This usually happens due to an injury or from surgery. The most common organisms causing such infection are Staphylococcus and Streptococcus and the joints most commonly affected are the knee and the hip.
Pain usually comes on suddenly in one joint. The joint may be warm, swollen or red, and it is usually very painful to use the joint.
Treatment should be started immediately to avoid damage to the joint.
Some autoimmune diseases, where the body mistakenly attacks itself, have joint pain as a symptom, e.g. lupus, Sjogren’s syndrome, psoriasis (this is known as psoriatic arthritis) and polymyalgia rheumatica.
Multiple sclerosis is another autoimmune disease which can indirectly lead to joint pain.
Primary bone cancer – that is cancer that starts in the bone – is rare. Secondary bone cancer is cancer in the bone that has spread from cancer in another part of the body. Bone cancer may cause joint pain as well as aching, throbbing or stabbing pain in the bone. The pain may be worse at night or during activity.
Some other causes of joint pain
Last Reviewed: 22/06/2020
1. BMJ Best Practice. Assessment of inflamed joint. Last reviewed May 2020. https://bestpractice.bmj.com/topics/en-gb/1191
2. eTG Complete. Rheumatoid arthritis. Published March 2017. https://tgldcdp.tg.org.au/viewTopic?topicfile=rheumatoid-arthritis#toc_d1e59
3. MSD Manual. Professional version. Pain in and around a single joint. Last reviewed Sept 2019. https://www.msdmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/pain-in-and-around-joints/pain-in-and-around-a-single-joint?query=joint%20pain
4. Therapeutic Guidelines. Osteoarthritis. Published March 2017. © Therapeutic Guidelines Ltd (eTG December 2019 edition). https://tgldcdp.tg.org.au/viewTopic?topicfile=osteoarthritis&guidelineName=Rheumatology&topicNavigation=navigateTopic#toc_d1e71
There are many different types of arthritis, but the most common types are osteoarthritis, rheumatoid arthritis and gout.
Exercising and osteoarthritis
Exercise can reduce joint pain and stiffness and increases flexibility, strength and endurance in people with arthritis. Four main types of exercise are recommended for people with arthritis.
Osteoarthritis causes the joints to become painful and stiff. It occurs when the cartilage on the end of bones becomes permanently damaged.
Find out about the causes and treatment of shoulder pain, including frozen shoulder, rotator cuff syndrome, dislocated shoulder and arthritis.
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