Joint Pain

Joint Pain 2018-07-18T13:46:07+00:00

What Is Joint Pain?

If you’re suffering from pain in your knee, hip, shoulder, elbow, or other joints, there are ways to manage your pain. Joint pain is an extremely common ailment, and is known as arthralgia by medical professionals. A survey by the U.S. Centers for Disease Control and Prevention estimates that approximately one in four adults suffer from joint pain caused by arthritis. Along with other causes of joint pain, many more adults suffer from this condition.

The anatomy of our joints

Joints are the spaces between bones. They are the part of the musculoskeletal system that supports the body and helps it move.

Did you know there are multiple types of joints in the body? Ball and socket joints are like those found in the hip and shoulders. These allow a full range of motion. The spherical head of one bone joins with the cavity of another. This makes the shoulder the most mobile joint in the body, while the hip is a stable weight-bearing joint. Cartilage lining the sockets helps to keep the bones in place, with ligaments extending to the bones to provide strength.

Hinge-type joints allow movement in one direction. Think fingers, toes, elbows and knees. The knee is the largest joint in the body and it is unique because it can swivel. This gives a larger range of motion to the foot.

Gliding, or pivot, joints allow sideways movement. Think of the neck’s ability to sway from side to side, or up and down. The same joint is found in the wrist and ankle, allowing twisting motions.

Finally, saddle joints allow for even more movement than a hinge or gliding joint, by providing movement in two directions. The thumb is able to move across the palm of the hand due to this joint. The spine holds the most joints in the human form and connects each pair of vertebrae to the spinal column. These joints give the spine the ability to twist and move, all while protecting the precious nerves enclosed in the spinal column.

What does joint pain feel like?

Joint pain affects everyone differently. Symptoms of swelling, pain, tenderness, and weakness vary widely person to person. These symptoms may be acute or chronic. Symptoms can adversely affect some people mildly and others severely. Lastly, the pain can be intermittent.

Joint pain can affect any joint in the body, but the most common ones affected include the:

However, some people also experience pain in the big toe joint, the joints in the hands, wrists, and more. Here’s what you should know about treating and managing chronic joint pain.

Causes Of Joint Pain

Joint pain has many different causes. Some of the most common joint pain causes include the following:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Gout
  • Bursitis
  • Tendinitis
  • Trauma and injuries

Rarer causes of joint pain include:

  • Infections
  • Advanced cancers
  • Fibromyalgia
  • Lupus
  • Lyme disease
  • Osteoporosis
  • Sarcoidosis
  • Avascular femoral head necrosis (caused by an incomplete blood supply to the bones)

Arthritis

Arthritis is one of the major causes of pain in the joints. It affects up to one in four U.S. adults.

Osteoarthritis is caused by inflammation in the bones and joints. It is the most common form of arthritis. This condition can result from years of hard wear on joints or specific injuries, such as fractures. The condition is usually progressive and culminates in the deterioration of the cartilage that cushions and protects your joints. Cartilage, when lost, cannot be repaired. When it deteriorates, bone spurs can form causing inflammation of the area and chronic pain. End-stage of this disease results in bone rubbing upon bone, which is extremely painful and can result in joint replacement surgery.

Most Americans age 70 and older report osteoarthritic pain. While the cause of osteoarthritis isn’t known, it is thought several factors come into play. Risk factors may include:

  • Genetics
  • Weight gain
  • Obesity
  • Gender
  • Muscle weakness
  • Joint overuse and repetitive use
  • Trauma
  • Joint instability

Rheumatoid arthritis can also lead to joint pain. This chronic autoimmune disease causes joint pain because the immune system attacks a person’s own joints. It typically affects the small joints of the hands and feet, which can result in painful swelling, bony erosions, and joint deformities. This disease affects women more commonly than men.

Finally, gout is a common form of arthritis that leads to joint pain. It is one of the oldest diseases known to man. The disease results from blood becoming supersaturated with uric acid. Uric acid then precipitates and forms crystals that settle into joints. The uric acid crystals irritate joints and can lead to inflammation and joint pain. The disease can occur in any large joint, but most commonly occurs in the joints of the big toe.

Overuse injuries

One form of joint pain can stem from bursitis, typically in the hips. This is inflammation of a bursa, but it can also cause joint pain. A bursa is a small fluid-filled sac near a joint. The most commonly affected joints include the elbow, shoulder, and hip. The disease is a result of joint overuse or injury.

Likewise, inflammation of a tendon, the tissues that connect muscle to bone, can lead to tendinitis. Common sites for this condition include the shoulder, elbow, knee, lower leg, and Achilles tendon.

Other causes

Beyond these causes, certain infections such as osteomyelitis, hepatitis B virus, parvovirus B-19, and Lyme disease can lead to pain in the joints. Also, trauma, sprains, strains, tears, and fractures can also cause joint pain.

Other causes of joint pain include:

  • Advanced cancers
  • Fibromyalgia
  • Lupus
  • Lyme disease
  • Osteoporosis
  • Sarcoidosis
  • Avascular femoral head necrosis (caused by an incomplete blood supply to the bones)

Joint Pain Treatments

If you’re suffering from joint pain, there are treatments that can help. Many are simple lifestyle modifications to reduce symptoms or pain flare-ups. Others are more interventional or longer-lasting treatments to address the underlying cause of your pain, when possible.

When talking to your doctor about your pain, discuss how treatment can address:

  • Pain relief
  • Restoration and maintenance of your joint function
  • Prevention of further joint damage

Always talk to your doctor before attempting any treatments for your pain. Get a diagnosis before anything else. Some treatments that are helpful for mild or acute cases of pain could actually exacerbate or increase pain if you’re suffering from a more severe condition.

To determine the cause of the joint pain, your physician will take a history and comprehensive physical exam. During this, they’ll look at tenderness at the joint, range of motion, swelling, and crepitus (the crackling sound sometimes heard in a joint). If they think you’re suffering from osteoarthritis, they may order an X-ray to examine the joint space and cartilage loss. Other diagnostic tools, including MRI and ultrasound, may provide additional insights.

Once you have a diagnosis, a doctor can help guide your overall treatment plan so you experience the best quality pain relief.

Treatments for mild pain

The following at-home practices can be used to treat mild joint pain:

  • The use of certain braces or wraps during exercise
  • Strengthening and stretching of the muscles surrounding the joints
  • Icing or heat therapy to control inflammation or after strenuous exercise
  • Acetaminophen (Tylenol) for mild joint pain with little or no swelling
  • Topical agents such as capsaicin and methyl salicylate (BenGay) can also be helpful

Complementary treatments

In addition to at-home treatments, there are a variety on non-interventional treatments that can help with your joint pain. Before taking medications or undergoing more interventional treatments, it’s typically best to start with these (depending on the cause of your pain).

Complementary therapies include:

Physical therapy can stabilize, strengthen, and improve range of motion in joints. If you’re recovering from surgery or an injury, a physical therapy regimen can help you strengthen the stabilizing muscles around the joints and increase mobility.

Weight loss can reduce stress on joints since it reduces the overall pressure on them. While weight loss can be difficult when suffering from joint pain, there are low-impact exercises, such as swimming and bicycling, that can help along with overall calorie reduction.

Supplements of chondroitin and glucosamine may also be helpful if you’re experiencing pain in the joints. These two compounds are found in native cartilage. They exist in tablet, capsule, powder, and liquid forms. They are available over-the-counter and have no significant side effects, and can help restore joint mobility.

Regenerative therapies, like PRP therapy, can also help in some instances of joint pain. They are a newer treatment option, but may provide healing in non-responsive cases of knee pain. Find out more about stem cell therapy for knee pain here.

Medications for joint pain

For mild to moderate pain, medications can also help control flare-ups of pain. The most helpful are acetaminophen or NSAIDs. Examples of NSAIDs include:

  • Aspirin
  • Ibuprofen (Advil, Motrin)
  • Naproxen sodium (Aleve)

These medications are all available over-the-counter. Some prescription NSAIDs used to treat joint pain include:

  • Colchicine (Indocin)
  • Meloxicam (Mobic)
  • Celecoxib (Celebrex)

Care should always be taken when using NSAIDs as they can have side effects such as liver and kidney damage, inflammation of the stomach, bleeding, and stomach ulcers. Special care should be taken with celecoxib (Celebrex) as it has been shown to increase the risk of heart attacks and strokes.

Oral steroids and opioids may have a place in the treatment of severe joint pain. They should be considered in cases of joint pain that are non-responsive to NSAIDs, manual therapies, and topical agents. Oral steroids such as prednisone are powerful inhibitors of inflammation, while opioids such as hydrocodone and oxycodone specifically target pain. Oral steroids and opioids have no place in the long-term treatment of joint pain due to their toxicities and risk of addiction, however.

Joint injections

Those with moderate to severe joint pain may also consider joint injections. Steroid joint injections reduce inflammation, and as a result reduce pain. Hyaluronan (Synvisc) injections can be particularly helpful in those with severe osteoarthritis of the knee. Hyaluronan is a synthetic form of the body’s natural synovial fluid that bathes joints.

These procedures are typically done on an outpatient basis. They involve sterilizing the area, numbing the skin, using X-ray or ultrasound guidance to insert the needle into the joint, and injecting the medication. Considering that the joint is tender prior to the procedure, patients should typically ice the area afterward to reduce pain and inflammation. Afterward, you can use the period of reduced pain to undergo physical therapy in order to treat the underlying cause of your pain. As a general rule, joint injections should not be given more than three times a year.

The following video shows you what you can expect during a knee joint injection.

Finally, those with chronic joint pain that hasn’t responded to other treatments may consider joint replacement surgery. The most commonly replaced joints are the knee and hip. While these can be a good option in severe, un-responsive cases, you should usually attempt other less-invasive options first.

Conclusion

Joint pain is an extremely common condition and can severely affect your overall quality of life. There are a multitude of causes for joint pain, which can be acute or chronic. Those who suffer from joint pain are wise to pay attention to the old adage: an ounce of prevention is worth a pound of cure. Regular exercise and a healthy diet may prevent many joint related issues. Making an appointment with a pain specialist in the early stages of joint pain is also wise, because many conservative treatment options are available to reduce pain.

Treatments for joint pain include pharmacological, non-pharmacological, and surgical methods. Treatment methods for pain can also range from conservative to more interventional. Always talk to your doctor before undergoing any treatments for pain, and ensure that you have a diagnosis in place. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.

Find Your Pain Doctor

References

  1. Arend WP, Lawry GV. Approach to the patient with rheumatic disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th Philadelphia, PA: Saunders Elsevier; 2011:chap 264.
  2. Ayral X. Injections in the treatment of osteoarthritis. Best Pract Res Clin Rheumatol. 2001;15(4):609-26.
  3. QuickStats: Percentage of adults reporting joint pain or stiffness. National Health Interview Survey. 2006: United States.
  4. Martin TJ, Eisenach JC. Pharmacology of opioid and non-opioid analgesics in chronic pain states. J Pharmacol Exp Ther. 2001;299(3):811-7.
  5. Schaible HG, Eberseberger A, Von Banchet GS. Mechanisms of pain in arthritis. Ann NY Acad Sci. 2002;966:343-54.
  6. Sluka KA. Pain mechanisms involved in musculoskeletal disorders. J Orthop Sports Phys Ther. 1996;24(4):240-54.

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