Why do my joints hurt

16 March 2022

Joint pain is not uncommon. Nearly half (45 percent) of all people over the age of 45 complain of sore joints, especially knee pain. Complaints can also occur in youth. In most cases, joint pain is caused by signs of wear and tear - here doctors talk about osteoarthritis. In addition, 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, so are their different types, so 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 pain can affect two to four joints (pain in the oligo-joints) or even more joints (joint pain).

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

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

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

Especially often affected joints

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

Osteoarthritis, one of the main causes of joint pain, is especially noticeable in those joints that are under great stress during life. First of all, these are the joints of the knee, hip and ankle. 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 occurs on the wrists and wrists. In addition, pain in the knee, elbow, metatarsophalangeal joints, and shoulder is common in rheumatoid arthritis.

Joint pain in an acute gout attack almost always affects the ankle joint, mainly the metatarsophalangeal joint. Ankle and knee joints are also often affected.

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 (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 changes in the bones, the affected joint cannot move freely, it is red, swollen and painful. Osteoarthritis is often the cause of pain in the joint, hip and knee. Joint wear is usually caused by prolonged joint overload. In addition, osteoarthritis can be a late consequence of an accident (such as sports injuries) and joint damage due to congenital weakness or joint deformity.
bursitis:The bursae are in the form of a layer that absorbs shocks in particularly prominent places between the bones and soft tissues, for example, in the area of the joints. They usually consist of a cavity filled with joint fluid. Inflammatory or mechanical irritations (such as sports injuries) can injure the bursa and cause pain in the affected area. For example, elbow pain is often caused by bursa inflammation in the elbow joint, shoulder pain due to bursitis or calcification in the shoulder area, knee pain due to bursa inflammation in the knee joint and hip pain due to bursa inflammation on the large colic (bone protrusion on the upper colliculus). the outside 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 on the joint, or during diagnostic injections into the joint). Severe pain in the knee or hip with severe swelling of the joints and symptoms of inflammation (such as redness, localized fever, 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. Fatigue, fever, redness, and joint pain occur approximately four weeks after transmission.
Associated inflammation of the joints during and after infection.Inflammatory joint pain can occur during and after common infectious diseases such as hepatitis, rubella, mumps, chicken pox, scarlet fever, tuberculosis, influenza and inflammatory bowel disease (Crohn's disease, ulcerative colitis). Due to the resulting pain in the joints and swelling, there are restrictions on movement in the joints, especially large (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.
Inflammation of the joints in psoriasis (psoriatic arthritis):Psoriasis is sometimes accompanied by inflammation that causes joint pain. In some cases, joint pain precedes cutaneous manifestations of the disease, ie joint pain occurs first, and only then scaly lesions appear on the skin. Psoriatic arthritis can be the cause, especially if the fingers and toes and / or spine are affected.
Inflammation of the joints in ankylosing spondylitis.Ankylosing spondylitis is a chronic rheumatic inflammation that primarily affects the spine, but can also spread to large joints. Therefore, pain in the knee, hip, heel and / or ankle may 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 - there is an acute attack of gout with severe joint pain, swelling and redness in the joints. First of all, the thumb joints are affected. But an acute gout attack can also cause knee pain, joint pain, pain in the finger joints or upper ankle joint.
Rheumatoid arthritis:This is the most common inflammatory disease of the joints, progressive, mostly chronic and which gradually destroys the joints. Rheumatoid arthritis may be suspected if the pain in the joints affects the fingers and wrists. Other symptoms of this condition include morning stiffness of the fingers and wrists, swelling of the joints and inability to squeeze the hand.
Rheumatic fever:This inflammatory disease, which occurs mainly 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 and uncontrolled movements (chorea).
Arthritis with sarcoidosis (Löfgren's syndrome):Sarcoidosis is a rare inflammatory disease of unknown origin that can affect the whole body. One form of the disease is Löfgren's syndrome (acute sarcoidosis). It occurs mainly in young women and is manifested by the following symptoms: inflammation, joint pain (especially in the joints), acute inflammation of the subcutaneous fat (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 mainly affects women, often causing joint pain and inflammation. But there are 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. That is why lupus erythematosus is called "chameleon" in medicine.
Articular bleeding with violation of coagulation.In rare cases of hemophilia, there is an inherited predisposition to uncontrolled bleeding after injury or, in severe cases, even for no apparent reason. Bleeding in muscles and joints is especially common. Bleeding in the joints can cause joint pain and permanent joint damage if left untreated. In addition to hemophilia, other bleeding disorders can also lead to joint bleeding and joint pain, such as bleeding disorders due to anticoagulant overdose.

When should you see a doctor?

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

Joint pain that limits joint mobility.
Fever.
Redness of the skin in the area of the painful joint.
Swelling of the wrist.

If the symptoms related to the joints (pain in the joints with limited mobility, redness, swelling) last for three days or longer, 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 joint pain occurs and if there are other ailments (accompanying symptoms such as fever or swelling of the joints).

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 a doctor can narrow down the number of possible causes. For example, an acute gout attack is thought to cause pain in only one joint. In rheumatoid arthritis, on the other hand, arthralgias are seen in several joints. In addition, the location (localization) of joint pain is indicative: if the patient feels pain in the joint and pain in the base and middle joint of the fingers, rheumatoid arthritis is most likely present. On the other hand, if joint pain affects the base of the thumb and joints, it is suspected in the direction of osteoarthritis.

Scanning (palpation)

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

Further research on joint pain

Examinations like these can help determine the cause of pain if joint pain occurs directly in the joint:

orthopedic examination:If the joint pain is caused by wear and tear (arthritis), bursitis, rheumatism or an acute gout attack, relevant information can be found during an orthopedic examination.
Dermatological examination:Skin examinations help identify suspected psoriatic arthritis or sarcoidosis as a possible cause of joint pain.
Blood tests:Blood tests are useful in identifying various causes of joint pain, such as bacterial arthritis or Lyme disease. Sometimes special measurements, such as blood clotting, are needed in a blood test if bleeding in the joints (due to coagulation disorders) can cause joint pain. If rheumatoid arthritis is the cause of joint pain, then rheumatoid factor and other signs of inflammation, which are crucial, are determined in the blood. And if gout or an acute gout attack is suspected, the focus is on the level of uric acid in the blood.
ultrasound examinations:ultrasound (ultrasound) is indicated when bursitis, gout or systemic lupus erythematosus is suspected as the cause of joint pain.
X-ray:X-ray shows signs of joint wear (arthritis), rheumatoid arthritis and ankylosing spondylitis.
joint puncture:if the doctor suspects bacterial inflammation of the joints as a cause of joint pain, he will take a sample of joint fluid (joint puncture). Bacterial culture is done from this sample: if bacteria grow from a joint sample, it indicates bacterial inflammation of the wrist joint.

It is not always possible to find disease or pathological tissue change as the cause of joint pain. Doctors talk about "joint sensitivity". If the cause of joint pain is found, the doctor can start appropriate treatment and treat the underlying condition with medication or surgery.

You can make it yourself

General tips for joint pain

Lose extra pounds. Any extra weight is an unnecessary additional burden on the joints and contributes to their wear, which inevitably leads to joint pain.
Make sure you get enough rest after your workout.
Do endurance exercises regularly to strengthen your muscles and articular cartilage. For example, swimming and cycling are suitable for joint training. Regular strength training (such as lifting weights, jumping rope) is also recommended for strengthening bones. Consult an experienced trainer or sports doctor 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 shoulders.
According to Jacobson, it is necessary to reduce mental stress, for example, by autogenic training or progressive muscle relaxation. Emotional pressure also puts pressure on the 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, or recent severe joint inflammation with pain, swelling, and redness, is diagnosed, you must immobilize the affected joint (lying down). Hold it so that the muscles connected to it are not tense. Give yourself moist and cool compresses (such as quark compresses) to alleviate joint discomfort. You can increase the effect of anti-inflammatory and painkillers that you get from your doctor with the help of herbs. Arnica is suitable (as a decoction for dressings or as an ointment or gel for rubbing into the joints). In addition, there are, for example, anti-inflammatory and analgesic preparations based on willow bark, as well as combined preparations with rosemary and eucalyptus oils. In addition, peppermint oil can facilitate the perception of pain due to its cooling effect.
When the pain in the joints, including redness and swelling, subsides, the doctor talks about inactive osteoarthritis. In this phase of the disease, prevention of the continuation of active joint problems is carried out. Adequate, healthy sleep on an orthopedic mattress contributes to that, because the muscles relax well, and the spine and joints rest.
In addition, you should regularly use meditative relaxation techniques (such as gradual muscle relaxation, autogenic training) if you often suffer from stressed muscle tension.
Regular exercises and exercises that improve the supply of articular cartilage with synovial fluid and nutrients. Useful sports are swimming, cycling and water aerobics. In contrast, running on hard roads is not recommended, especially if osteoarthritis has already damaged the knee and hip joints. If possible, run on soft forest lawn and wear sneakers with soft soles that provide good performance. Better yet, walk instead of jogging.
Avoid sports with sudden changes of direction (e. g. tennis, squash) as they create great stress on the joints (e. g. 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 osteoarthritis caused by arthritis). Arachidonic acid is mainly found in fatty pork, egg yolks, fats, 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 oil (eat fish at least once a week! ).
Make sure you get enough vitamin E, which is important for synovial fluid because it provides antioxidant action against inflammation. Vitamin E is found in vegetable oils, especially wheat, soybean and sunflower sprouts.
Joint pain associated with osteoarthritis and other joint problems can often be alleviated by applying heat that stimulates circulation, such as fango bags, paraffin, hay, rosemary baths.
In osteoarthritis of the finger joints, kneading with warm clay or clay can help with joint pain and swelling. It is also recommended to exercise your fingers regularly in the heated sand. It is especially good for morning stiffness and joint pain.
Massage and rubbing with essential oils of eucalyptus, juniper, rosemary, lavender or lemon help to improve blood circulation, and thus in the fight against arthritis.
In inactive osteoarthritis, devil's claw root tea is recommended: pour one tablespoon of coarsely ground root into two cups of boiling water and leave it to stand for eight hours. Before use, boil and then strain, divide the prepared amount of tea into three portions and drink during the day. The effect of taking the devil's claw infusion occurs around the third week of treatment.
For the treatment of inactive osteoarthritis, a tea mixture of currant leaves, willow bark, nettle grass, horsetail and meadow flowers (20 g of each component) is also recommended. Take two teaspoons of this mixture and pour a glass of boiling water, leave for half an hour, then strain. Drink 5-6 cups of this tea during the day. It has anti-inflammatory and analgesic effects.
Dry bathing and leech therapy (also anti-inflammatory) also help treat arthritis irritation. 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 tips for osteoarthritis should also be applied to people with rheumatoid arthritis. These include dietary tips, recommendations for local use of arnica and devil's claw root. Additional tips that can help with rheumatoid joint pain and other joint problems:

During the period of mild discomfort (inactive state of rheumatoid arthritis), you can use physical therapy and massage to keep your joints flexible.
When the inflammatory process worsens (active rheumatoid arthritis), you can prepare an anti-inflammatory tea mixture from meadow, willow bark, goldenrod, currant grass and nettle (20 g of each plant). Pour a tablespoon of this mixture into a cup of cold water and leave for an hour. Then heat to boiling, but do not boil! Remove from the heat, let stand for five to ten minutes, then strain. Drink three to four cups of this tea a day.
Consumption of protein-digesting enzymes, such as bromelain, should help with acute joint inflammation.
It is recommended for rheumatic diseases such as rheumatoid arthritis, tai chi and qigong. These are holistic Chinese forms of movement that can improve patient mobility, muscle strength, endurance, quality of life and mood, studies show. The effect, according to Chinese medicine, is that calm, fluid movements and breathing exercises relieve blockages in the body and promote vitality (Qi). Exercises are also suitable for patients whose mobility is already limited due to pain and inflammation of the joints.
Inflammatory joint pain can be relieved with cold or heat treatments - try what works best for you. In general, cooling is recommended for acute joint inflammation to stop the inflammation. In chronic diseases, the heat is generally more comfortable, such as warming baths (such as hay flowers), fango packs, or mud treatments.
Even creams and ointments on medicinal herbs exhibit anti-inflammatory and analgesic effects. This includes ready-to-use preparations containing willow bark or rosemary and eucalyptus oils. In addition, peppermint oil can alleviate 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 the disease. Indian incense (shallaki) and triphala (herbal mixture) are used for acute inflammation of the joints with joint pain. Both have strong anti-inflammatory effects.