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 knee pain. Complaints can also arise at a young age. In most cases, joint pain is caused by signs of consumption - 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, their types are so diverse that the 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 apparent 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 catch from two to four joints (pain in the oligo-joints) or even more joints (pain in the joints).

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

Painful rhythm: pain at rest, pain at night, morning stiffness of the joints.
Distribution patterns: Pain in small joints (such as wrist joints, finger joints) or large joints (such as knee and hip joints), joint pain in wrist joints, etc.
Pain intensity: Assessment of joint pain severity on a scale from 0 (painless) to 10 (unbearable, extreme 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 physician to determine the causes of joint pain.

Particularly affected joints

Which joints are most often affected by pain depends to a decisive extent on the cause of the pain. Some examples.

Osteoarthritis, one of the leading causes of joint pain, is especially evident in those joints that receive a lot of stress throughout life. First of all, these are the knee joints, the hip joints and the ankle 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 occurs on the wrists and ankles. In addition, pain in the knee, elbow, metatarsophalangeal joints, and shoulder are common in rheumatoid arthritis.

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

Bursitis can cause pain in the groin, elbow, knee and shoulder.

Possible causes and 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 articular surfaces and bone changes, the affected joint can not move freely, redness, swelling and pain. Osteoarthritis is often the cause of pain in the wrist, hips and knee. Consumption of joints is usually caused by long-term overload of joints. 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.
Scholarships:The bursae are located in the form of a shock-absorbing layer in particularly stressed areas 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 damage the bursa and cause pain in the affected area. For example, elbow pain is often caused by bursitis in the elbow joint, shoulder pain from bursitis or calcification in the shoulder area, knee pain from bursitis in the knee joint, and thigh pain from bursitis in the coliclarger (bony bulge 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 either enter the joints through the bloodstream or directly infect the joint (through trauma or joint surgery, or during diagnostic joint injections). Severe knee or hip pain with severe swelling of the joints 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 some bacteria (Borrelia burgdorferi) that are transmitted from ticks to humans. Approximately four weeks after transmission, fatigue, fever, redness, and joint pain appear.
Associated inflammation of the joints during and after infections.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 movements in the joints, especially the large ones (hip joint, knee joint, ankle joint).
Arthritis in Reiter's disease:Reiter 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 associated with inflammation that causes joint pain. In some cases, joint pain precedes the skin manifestations of the disease, i. e. joint pain occurs first and only then do scaly skin lesions develop. Psoriatic arthritis can be the cause, especially if the joints of the toes and feet and / or the spine are affected.
Inflammation of the joints in ankylosing spondylitis.Ankylosing spondylitis is a chronic rheumatic inflammation that mainly 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 gout attack):Gout increases the concentration of uric acid in the blood. Its excess is deposited in the form of uric acid crystals, among others, on the joints - an acute attack of gout occurs with severe pain in the joints, 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 pain in the knee, pain in the wrist, pain in the joints of the fingers or in the upper part of the ankle.
Rheumatoid arthritis:This is the most common inflammatory disease of the joints, progressive, mostly chronic and that gradually destroys 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, swelling of the joints, and inability to make a fist.
Rheumatic fever:This inflammatory disease, which occurs mainly in children, is caused by some bacteria (streptococci) days or weeks after an infection of the nose and throat that has not been treated with antibiotics. Possible symptoms include inflammatory joint pain, skin symptoms, inflammation of the heart (cardiac), and sudden involuntary and uncontrolled movements (chorea).
Arthritis with sarcoidosis (Löfgren 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, joint pain (especially in the ankles), acute inflammation of the subcutaneous adipose tissue (erythema nodosum), swelling of the lymph nodes in the lungs (bronchial lymphadenopathy) and loss.
Systemic lupus erythematosus (SLE):It is a rare autoimmune disease that mainly affects women, often causing joint pain and inflammation. But there are also many other different symptoms, such as 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".
Articular bleeding in violation of coagulation.In rare cases of hemophilia, there is an inherited predisposition to uncontrolled bleeding after injury or, in severe cases, even without any apparent cause. Especially often there is bleeding in muscles and joints. 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 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 beware of the following symptoms:

Joint pain that restricts joint movement.
Ethe.
Redness of the skin in the area of the aching joint.
Swelling of the wrist.

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 joint pain occurs and if there are other complaints (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 faster a physician can limit 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 some joints. Moreover, 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, rheumatoid arthritis is most likely to be present. On the other hand, if the joint pain affects the base of the thumb and ankles, the suspicion is in the direction of osteoarthritis.

Scanning (palpation)

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

Further research on joint pain

Such examinations can help identify the cause of the pain, if the joint pain occurs directly in the joints:

Orthopedic examination:If joint pain is caused by consumption (arthritis), bursitis, rheumatism or an acute attack of gout, relevant information can be found during an orthopedic examination.
Dermatological examination:Skin examinations help identify suspected psoriatic arthritis or sarcoidosis as possible causes of joint pain.
Blood tests: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 bleeding from the joints (due to a coagulation disorder) can cause joint pain. If the cause of joint pain is rheumatoid arthritis, then in the blood is first of all determined rheumatoid factor and other signs of inflammation, which are crucial. And if gout is suspected or an acute attack of gout, 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 are suspected to be the cause of joint pain.
X-rays:radiography shows signs of wear on the joint (arthritis), rheumatoid arthritis and ankylosing spondylitis.
Common hole:if the doctor suspects that the cause of the joint pain is bacterial inflammation of the joints, he will take a sample of joint fluid (joint puncture) From this sample is made bacterial culture: if bacteria grow from the sample of the joint, this indicates bacterial inflammation ofcommon.

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

You can do it yourself

General tips for joint pain

Lose excess weight. Each extra pound is an unnecessary extra load on the joints and contributes to their consumption, which inevitably leads to joint pain.
Make sure you get enough rest after your workout.
Do regular endurance exercises to strengthen the muscles and cartilage of the joints. For example, swimming and cycling are suitable for joint exercise. Regular strength training (like lifting weights, jumping rope) is also recommended to strengthen bones. Consult an experienced trainer or sports doctor to determine the correct dose and develop a balanced exercise program that strengthens all muscles equally.
Avoid unilateral loads such as carrying heavy bags over the shoulder.
According to Jacobson, it is necessary to reduce mental stress, for example, with autogenic exercise or progressive muscle relaxation. Emotional pressure also puts pressure on the joints, shoulders and bones.
Joint pain and other joint complaints are treated in traditional Chinese medicine with acupuncture. Consult an experienced therapist.

Tips for treating joints

If osteoarthritis is diagnosed, i. e. severe recent inflammation of the joints with pain, swelling and redness, you should immobilize the affected joint (bed rest). Hold it so that the muscles connected to it are not tense. Give yourself wet and cold compresses (like a quark wrap) to relieve joint discomfort. The effect of anti-inflammatory drugs and pain you get from your doctor can be improved with the help of medicinal herbs. Arnica is suitable (as a decoction for compresses or as an ointment or gel for rubbing in 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 oil. 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 talks about 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, the spine and joints relax.
In addition, you should regularly use meditative relaxation techniques (such as gradual muscle relaxation, autogenic training) if you often suffer from muscle tension under stress.
Regular exercises and exercises that improve the supply of synovial fluid and nutrients to the articular cartilage. Useful sports are swimming, cycling and water gymnastics. In contrast, running on hard pavement is not recommended, especially if osteoarthritis has already damaged the knee and hip joints. If possible, run on soft forest terrain and wear soft-soled sneakers 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 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 osteoarthritis caused by arthritis). Arachidonic acid is found mainly in fatty pork, egg yolks, salmon, 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 in the germs of wheat, soy and sunflower.
Osteoarthritis-related joint pain and other joint complaints can often be alleviated by applying circulating stimulating heat, such as fango bags, paraffin, senna, rosemary baths.
For osteoarthritis of the finger joints, decoction with warm clay or clay can help with joint pain and swelling. Regular finger exercises in hot sand are also highly recommended. It is especially good for morning stiffness and joint pain.
Massage and rubbing with essential oils of eucalyptus, juniper, rosemary, lavender or lemon help improve blood circulation and consequently fight inflammation of the joints.
For inactive osteoarthritis, devil’s claw root tea is recommended: pour a tablespoon of coarsely ground root into two cups of boiling water and simmer 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 the devil's claws infusion appears around the third week of treatment.
For the treatment of inactive osteoarthritis, a tea mixture with currant leaves, willow bark, nettle grass, horse tail and meadow flowers (20 g of each component) is also recommended. Take two teaspoons of this mixture and pour a glass of boiling water, let it cook for half an hour and then drain. Drink 5-6 cups of this tea throughout the day. Has anti-inflammatory and analgesic effect.
Also helpful in treating arthritis irritations are dry cups and caterpillar therapy (also anti-inflammatory). Treatment with someone's blood is questionable, 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 tips, recommendations for current use of arnica and devil's claw root. Additional tips that can help with rheumatoid arthritis and other joint problems:

During periods of mild discomfort (inactive state of rheumatoid arthritis), you can use physical therapy and massage to keep your joints flexible.
During an exacerbation of the inflammatory process (active rheumatoid arthritis), you can prepare an anti-inflammatory tea mixture from meadow sweets, willow bark, golden currant, grape grass and nettle (20 g each herb). Pour a tablespoon of this mixture into a glass of cold water and leave for an hour. Then heat to a boil, but do not boil! Remove from the heat, let stand for five to ten minutes and then drain. Drink three to four cups of this tea a day.
For acute inflammation of the joints, the consumption of enzymes that digest proteins, such as bromelain, should help.
Highly recommended for rheumatic diseases like rheumatoid arthritis, tai chi and qigong. These are Chinese holistic 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 smooth, fluid movements and breathing exercises relieve blockages in the body and cause life force (Qi) to 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. Generally, cooling is recommended for acute inflammation of the joints to stop the inflammation. In chronic diseases, warmth is generally more pleasant, such as warm baths (such as senna flowers), fango packs, or mud treatments.
Even creams and ointments on medicinal plants show anti-inflammatory and analgesic effects. These include ready-to-use preparations containing willow or rosemary and eucalyptus oils. In addition, peppermint oil can ease the perception of pain by irritating cold receptors on the skin.
Ayurvedic therapists recommend cleansing procedures (panchakarma treatment) for rheumatic diseases to remove toxins (called ama) from the body. According to this lesson, ama accumulation is the cause of disease. For acute inflammation of the joints with joint pain, Indian incense (shallaki) and triphala (herbal mixture) are used. Both have strong anti-inflammatory effects.