Why do joints hurt?

16 March 2022

Joint pain is not uncommon. Almost half (45 percent) of all people over the age of 45 complain of joint pain, especially pain in the knees. Complaints can also arise at a young age. In most cases, joint pain is caused by signs of wear and tear; here the doctors speak of osteoarthritis. Also, acute arthritis and trauma are often the cause of joint pain. But there are many other possible reasons.

Description

As common as joint pain is, its types are so diverse that 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 joint pain occurs within a few hours.
Subacute joint pain 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 the pain can capture 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: rest pain, night pain, morning stiffness of the joints.
Distribution Patterns: Pain in small joints (such as wrist, finger knuckles) or large joints (such as knee and hip joints), joint pain in carpal joints, etc.
Pain intensity: rate the severity of joint pain on a scale of 0 (no pain) to 10 (extreme and unbearable 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.

Joints especially affected

Which joints are most often affected by pain depends largely on the cause of the pain. Some examples.

Osteoarthritis, one of the main causes of joint pain, is especially noticeable in those joints that endure a lot of stress throughout life. First of all, these are the 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 swelling of the joints, appears most often in the wrists and finger joints. Also, 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, primarily the metatarsophalangeal joint. The hocks and knee joints are often affected as well.

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 (joint arthritis):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 joint surfaces and bone changes, the affected joint cannot move freely, becomes red, swollen and painful. Osteoarthritis is often the cause of wrist, hip, and knee pain. Joint wear and tear is usually caused by long-term overloading of the joints. In addition, osteoarthritis can 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 found in the form of a cushioning layer in particularly stressed places between bone and soft tissue, for example in the joint area. They usually consist of a cavity filled with joint fluid. Inflammatory or mechanical irritation (such as sports injuries) can injure the bursa, causing pain in the affected area. For example, elbow pain is often caused by inflammation of the bursa in the elbow joint, shoulder pain from bursitis or calcification in the shoulder area, knee pain from inflammation of the bursa in the joint knee and hip pain due to inflammation of the bursa in the greater colliculus (lump of bone on the upper outer thigh).
Bacterial inflammation of the joints (bacterial arthritis):Bacterial arthritis mainly affects the knee and hip joints. The bacteria enter the joint through the blood or directly infect the joint (through trauma or surgery to 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 warmth, 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 develop.
Associated joint swelling 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 joint pain and swelling, there are restrictions in the movements of the joints, especially the 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.
Joint inflammation 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 later do scaly skin lesions develop. Psoriatic arthritis may be the cause, especially if the joints of the fingers, 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 joint pain, 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 knee pain, wrist pain, pain in the knuckles of the fingers or the top 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, joint swelling, and inability to make a fist.
Rheumatic fever:This inflammatory disease, which occurs mainly in children, is caused by certain bacteria (streptococcus) 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, pain in the joints (especially in the ankles), acute inflammation of the subcutaneous fatty tissue (erythema nodosum), swelling of the lymph nodes in the lungs (bronchial lymphadenopathy) and weightloss.
Systemic lupus erythematosus (SLE):It is a rare autoimmune disease that mainly affects women and often causes pain and inflammation in the joints. But there may also be many other different symptoms, such as a butterfly 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".
Joint bleeding in violation of coagulation.In rare cases of hemophilia, there is an inherited predisposition to bleeding uncontrollably after injury or, in severe cases, even for no apparent reason. Especially often there is bleeding in the muscles and joints. Joint bleeding can cause joint pain and permanent joint damage if left untreated. In addition to hemophilia, other bleeding disorders can also cause bleeding and joint pain, such as bleeding disorders due to overdose of anticoagulants.

When should I see a doctor?

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

Joint pain that limits movement of the joint.
Fever.
Redness of the skin in the area of the painful joint.
Joint swelling.

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 his medical history (medical history). For example, when and where the joint pain occurs and whether there are other complaints (accompanying symptoms such as fever or joint swelling).

Accurate description of joint pain.

This information is very important in diagnosing joint pain: the more accurately a patient can describe joint pain, the sooner the doctor can narrow down the number of possible causes. For example, an acute attack of gout 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, then most likely it is rheumatoid arthritis. On the contrary, if the joint pain affects the base of the thumb and the knuckles, the suspicion is directed towards osteoarthritis.

Scanning (palpation)

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

Additional research on joint pain

These tests can help identify the cause of the pain, if the joint pain occurs directly in the joint:

Orthopedic exam:Whether 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 exams help identify suspected psoriatic arthritis or sarcoidosis as possible causes of joint pain.
Blood test:Blood tests are helpful in identifying various causes of joint pain, such as bacterial arthritis or Lyme disease. Specific measurements, such as blood coagulation, are sometimes needed in a blood test if joint bleeding (due to a bleeding disorder) may be causing joint pain. If rheumatoid arthritis is the cause of pain in the joints, then in the blood, first of all, the 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 exams:sonography (ultrasound) is indicated when bursitis, gout, or systemic lupus erythematosus is suspected to be the cause of joint pain.
Bone scan:The x-ray shows signs of wear and tear on the joints (arthritis), rheumatoid arthritis, and ankylosing spondylitis.
Joint puncture:If the doctor suspects that bacterial joint inflammation is the cause of joint pain, he or she will take a sample of joint fluid (joint puncture). Bacterial culture is done from this sample: if bacteria 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 speak of "joint tenderness. "If the cause of the joint pain is found, the doctor can begin the appropriate treatment and treat the underlying condition with medication or surgery.

you can do it on your own

General tips for joint pain

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

Tips for treating joints

If osteoarthritis, ie recent severe inflammation of the joints with pain, swelling and redness, is diagnosed, the affected joint should be immobilized (bed rest). Hold it so that the muscles associated with it are not tense. Give yourself cold, wet compresses (such as a quark wrap) to relieve joint discomfort. The effect of anti-inflammatory and analgesic drugs that you receive from your doctor can be enhanced with the help of medicinal plants. Arnica is very suitable (as a decoction for compresses or as an ointment or gel to rub on the joints). In addition, there are, for example, anti-inflammatory and analgesic preparations based on willow bark, as well as preparations combined with rosemary and eucalyptus oils. Additionally, 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 proper and healthy sleep on an orthopedic mattress, as the muscles relax well and the spine and joints rest.
Also, 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 joint cartilage. Useful sports are swimming, cycling, and water aerobics. Conversely, running on hard pavement is not recommended, especially if osteoarthritis has already damaged the knee and hip joints. If possible, run on soft forest grass and wear soft-soled shoes that provide good spin. Even better, walk instead of jogging.
Avoid sports with sudden changes in direction (eg, tennis, squash), as they put a lot of pressure on the joints (eg, the 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 found primarily in pork fat, egg yolks, lard, tuna, liver, beef, and Camembert cheese.
Take omega-3 fatty acids regularly, as they act as competitive analogs 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 wheat, soybean and sunflower germs.
Joint pain related to osteoarthritis and other joint discomfort can often be relieved by applying circulation-stimulating heat, such as mud packs, 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 hot sand are also recommended. It is especially good for morning stiffness and joint pain.
Massaging and rubbing with essential oils of eucalyptus, juniper, rosemary, lavender or lemon help improve blood circulation and therefore fight 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 amount of tea prepared into three portions and drink throughout the day. The effect of taking the devil's claw infusion 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.
Dry cupping and leech therapy (also anti-inflammatory) are also useful in treating arthritis irritations. Treatment with one's own blood is controversial, especially if the treated fluid is injected into the joint (risk of infection! ).

Rheumatoid Arthritis Tips

Some advice about osteoarthritis should also apply to people with rheumatoid arthritis. These include nutritional advice, recommendations for the 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 of meadowsweet, willow bark, goldenrod, currant and nettle (20 g of each herb). Pour a tablespoon of this mixture in a cup of cold water and leave for an hour. Then heat until boiling, 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 joint inflammation, consuming 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, flowing movements and breathing exercises release blockages in the body and get the life force (Qi) flowing. 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 hot or cold treatments; try the one that works best for you. In general, cooling is recommended for acute joint inflammation to stop the swelling. In chronic ailments, warmth is often more pleasant, such as warming baths (such as senna flowers), mud packs, or mud treatments.
Even creams and ointments made from medicinal plants have anti-inflammatory and analgesic effects. These include ready-to-use preparations containing willow bark or oils of rosemary and eucalyptus. Additionally, peppermint oil can ease the perception of pain by irritating 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 joint pain, Indian frankincense (shallaki) and triphala (herbal mixture) are used. Both have strong anti-inflammatory effects.