Why do joints hurt?

16 March 2022

Joint pain is not uncommon. Nearly half (45%) of all people over the age of 45 complain of joint pain, 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. 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 joint pain classifications 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. But also the pain can capture two to four joints (oligo joint pain) or even more joints (joint joint pain).

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

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

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

Joints particularly affected

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

Osteoarthritis, one of the leading causes of joint pain, is especially noticeable in joints that experience a lot of lifelong stress. First and foremost 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 in the wrists and finger joints. In addition, pain in the knee, elbow, metatarsophalangeal joints, and shoulder is common in rheumatoid arthritis.

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

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

Causes and possible diseases

Joint pain can have many causes. The most important are:

Joint wear and tear (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 joint 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 and tear is usually caused by long-term stress on the joints. Additionally, osteoarthritis can be a late consequence of an accident (such as sports injuries) and joint damage due to congenital weakness or joint deformity.
Bursitis:Bursae are located in the form of a shock-absorbing layer in especially stressed places between bone and soft tissues, for example in the area of 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, elbow pain is often caused by inflammation of the pouch in the elbow joint, shoulder pain from bursitis or calcification in the shoulder area, knee pain from inflammation of the pouch in the knee joint, and hip pain from inflammation of the knee joint. bursa in the greater colliculus (bulge of bone in the upper outer part of the thigh).
Bacterial inflammation of the joints (bacterial arthritis):Bacterial arthritis mainly affects the knee and hip joints. 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 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 joint pain and swelling, there are restrictions on movement in 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 cutaneous manifestations of the disease, that is, joint pain occurs first and only then do scaly skin lesions develop. Psoriatic arthritis may be the cause, especially if the finger and toe joints 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 can be the cause of Bechterew's disease.
Gout (or acute gout attack):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. Firstly, the joints of the big toe are affected. But an acute gout attack can also cause knee pain, wrist pain, joint pain in your fingers or upper ankle.
Rheumatoid arthritis:This is the most common inflammatory disease of the joints, progressive, mostly chronic, and gradually destroying the joints. Rheumatoid arthritis can 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 mostly occurs 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, 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 mainly occurs in young women and has 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 mostly 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 "chameleon".
Joint bleeding in violation of coagulation.In rare cases of hemophilia, there is an inherited predisposition to uncontrollable bleeding 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 lead to 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 watch out for the following symptoms:

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

If joint-related symptoms (pain in joints 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 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 for 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 believed to cause pain in only one joint. In rheumatoid arthritis, on the contrary, arthralgias are observed in several joints. Also, the location (location) of the joint pain is indicative: if the patient experiences wrist pain and joint pain in the base and middle of the fingers, rheumatoid arthritis is likely present. On the other hand, if joint pain affects the base of the thumb and knuckles, the suspicion is in the direction of osteoarthritis.

Digitization (palpation)

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

More 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: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 exam:Skin exams help identify suspected psoriatic arthritis or sarcoidosis as possible causes of joint pain.
Bloodtests: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, 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:ultrasound (ultrasound) is indicated when bursitis, gout, or systemic lupus erythematosus are suspected as causes of joint pain.
X-ray:X-rays show signs of wear and tear on the joints (arthritis), rheumatoid arthritis, and ankylosing spondylitis.
Joint puncture:if the doctor suspects bacterial inflammation in the joints as the cause of joint pain, they 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. 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 tenderness. "If the cause of joint pain is found, the doctor may initiate appropriate treatment and treat the underlying condition with medication or surgery.

you can do it yourself

General tips for joint pain

Lose excess weight. Any extra pound is an unnecessary additional load on the joints and contributes to wear and tear, which inevitably leads to joint pain.
Make sure you get enough 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 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 through, 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, i. e. recent severe inflammation of the joints with pain, swelling and redness, is diagnosed, the affected joint should be immobilized (bed rest). Hold it so the muscles associated with it don't tense up. Give yourself cool, wet compresses (such as a quark wrap) to relieve joint discomfort. The effect of anti-inflammatory and pain relievers that you get from your doctor can be potentiated with the help of medicinal plants. Arnica is 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. 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 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. On the other hand, 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 a good effect. Better yet, walk instead of running.
Avoid sports with sudden changes in direction (eg tennis, squash) as they put a lot of stress on the joints (eg knee joint) and cause joint pain quickly.
Try not to stand or sit in one position for too long.
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 wheat, soy and sunflower germs.
Joint pain related to osteoarthritis and other joint complaints can usually be relieved by the application of circulation-stimulating heat, such as sachets of mud, paraffin, senna, rosemary baths.
For osteoarthritis of the finger joints, kneading with clay or hot clay can help with joint pain and swelling. Regular exercise with your fingers in the heated sand is also highly recommended. It is especially good for morning stiffness and joint pain.
Massaging and rubbing with eucalyptus, juniper, rosemary, lavender or lemon essential oils help to improve blood circulation and therefore fight joint inflammation.
For inactive osteoarthritis, devil's claw root tea is recommended: pour a 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 portions and drink throughout the day. The effect of taking devil's claw infusion appears around the third week of treatment.
For the treatment of inactive osteoarthritis, a mixture of blackcurrant leaf tea, 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 and strain. Drink 5-6 cups of this tea throughout the day. It has anti-inflammatory and analgesic effect.
Cupping therapy and leech therapy (also anti-inflammatory) are also useful in treating arthritis irritations. Treatment with your 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 a worsening of the inflammatory process (active rheumatoid arthritis), you can prepare an anti-inflammatory tea mixture of meadowsweet, willow, goldenrod, currant grass and nettle (20 g of each herb). Pour a tablespoon of this mixture into a glass of cold water and leave it for an hour. Then heat until boiling, but do not boil! Remove from heat, let rest for five to ten minutes, then strain. Drink three to four cups of this tea daily.
For acute joint inflammation, consumption of protein-digesting enzymes such as bromelain should help.
Highly recommended for rheumatic diseases like 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 smooth, fluid movements and breathing exercises release blockages in the body and make the vital 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 illnesses, heat is usually more pleasant, such as heating baths (like senna flowers), mud packs, or mud treatments.
Even creams and ointments in 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 ease 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 illness. For acute inflammation of the joints with joint pain, Indian incense (shallaki) and triphala (herbal mixture) are used. Both have strong anti-inflammatory effects.