Joint Pain

Joint pain can affect one or more joints.

Stiffness in a joint; Pain – joints; Arthralgia

Joint pain can be caused by many types of injuries or conditions. It may be linked to arthritis, bursitis, and muscle pain. No matter what causes it, joint pain can be very bothersome. Some things that can cause joint pain are:

• Autoimmune diseases such as rheumatoid arthritis and lupus
• Bursitis
• Chondromalacia patellae
• Crystals in the joint: Gout (especially found in the big toe) and CPPD arthritis (pseudogout)
• Infections caused by a virus
• Injury, such as a fracture
• Osteoarthritis
• Osteomyelitis (bone infection)
• Septic arthritis (joint infection)
• Tendinitis
• Unusual exertion or overuse, including strains or sprains

Follow your health care provider’s recommendation for treating the cause of the pain.

For nonarthritis joint pain, both rest and exercise are important. Warm baths, massage, and stretching exercises should be used as often as possible.

Acetaminophen (Tylenol) may help the soreness feel better.

Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen may help relieve pain and swelling. Talk to your provider before giving aspirin or NSAIDs such as ibuprofen to children.

Contact your provider if:

• You have fever that is not associated with flu symptoms.
• You have lost 10 pounds (4.5 kilograms) or more without trying (unintended weight loss).
• Your joint pain lasts for more than 3 days.
• You have severe, unexplained joint pain and swelling, particularly if you have other unexplained symptoms.

Your provider will perform a physical exam and ask you questions about your medical history and symptoms, including:

• Which joint hurts? Is the pain on one side or both sides?
• What started the pain and how often have you had it? Have you had it before?
• Did this pain begin suddenly and severely, or slowly and mildly?
• Is the pain constant or does it come and go? Has the pain become more severe?
• Have you injured your joint?
• Have you had an illness, rash, or fever?
• Does resting or moving make the pain better or worse? Are certain positions more or less comfortable? Does keeping the joint elevated help?
• Do medicines, massage, or applying heat reduce the pain?
• What other symptoms do you have?
• Is there any numbness?
• Can you bend and straighten the joint? Does the joint feel stiff?
• Are your joints stiff in the morning? If so, for how long does the stiffness last?
• What makes the stiffness better?

Tests that may be done include:

• CBC or blood differential
• C-reactive protein
• Joint x-ray
• Sedimentation rate
• Blood tests specific to various autoimmune disorders

Physical therapy for muscle and joint rehabilitation may be recommended. A procedure called arthrocentesis may be needed to remove fluid from the sore joint.

Bykerk VP, Crow MK. Approach to the patient with rheumatic disease. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 256.

Schaible H-G. Joint pain: basic mechanisms. In: McMahon SB, Koltzenburg M, Tracey I, Turk DC, eds. Wall & Melzack’s Textbook of Pain. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 44.