Joint Pain

What is joint pain?

Joint discomfort is common and usually felt in the hands, feet, hips, knees, or spine. Pain may be constant or it can come and go. Sometimes the joint can feel stiff, achy, or sore. Some patients complain of a burning, throbbing, or “grating” sensation. In addition, the joint may feel stiff in the morning but loosen up and feel better with movement and activity. However, too much activity could make the pain worse.

Joint pain may affect the function of the joint, and can limit a person’s ability to do basic tasks. Severe joint pain can affect the quality of life. Treatment should focus not only on pain but also on the affected activities and functions.

Who is more likely to experience joint pain?

Joint pain tends to affects those who:

• Have had previous injuries to a joint.
• Repeatedly use and/or overuse a muscle.
• Have arthritis or other chronic medical conditions.
• Suffer from depression, anxiety, and/or stress.
• Are overweight.
• Suffer from poor health.

Age is also a factor in stiff and painful joints. After years of use, and wear and tear on joints, problems may arise in middle-aged or older adults.

What causes joint pain?

The most common causes of chronic pain in joints are:

• Osteoarthritis, a common type of arthritis, happens over time when the cartilage, the protective cushion in between the bones, wears away. The joints become painful and stiff. Osteoarthritis develops slowly and usually occurs during middle age.
• Rheumatoid arthritis is a chronic disease that causes swelling and pain in the joints. Often the joints become deformed (usually occurring in the fingers and wrists).
• Goutis a painful condition where crystals from the body collect in the joint, causing severe pain and swelling. This usually occurs in the big toe.
• Bursitisis caused by overuse. It is usually found in the hip, knee, elbow, or shoulder.
• Viral infections, rash, or fever may make joint movement painful.
• Injuries, such as broken bones or sprains
• Tendinitis is an inflammation of the tendons, or the flexible bands that connect bone and muscle. It is typically seen in the elbow, heel, or shoulder and is usually caused by overuse.

How is joint pain treated?

Although there may not be a cure for the pain, it can be managed to bring the patient relief. Sometimes the pain may go away by taking over-the-counter medication, or by performing simple daily exercises. Other times, the pain may be signaling problems that can only be corrected with prescription medication or surgery.

• Simple at-home treatments, such as applying a heating pad or ice on the affected area, may be recommended for short periods, several times a day. Soaking in a warm bathtub may also offer relief.
• Exercise can help get back strength and function. Walking, swimming, or other low-impact aerobic exercise is best. Those who participate in strenuous workouts or sports activities may need to scale it back or begin a low-impact workout routine. Gentle stretching exercises will also help. Check with the doctor before beginning or continuing any exercise program.
• Weight loss may also be suggested, if needed, to lessen strain on joints.
• Acetaminophen, (Tylenol®) or anti-inflammatory drugs (ibuprofen), may help ease the pain. Both of these medicines are available over the counter, but stronger doses may need a doctor’s prescription. If you have a history of stomach ulcers, kidney disease, or liver disease, check with your physician to see if this is a good option for you.
• Topical treatments, such as ointments or gels that can be rubbed into the skin over the affected joint area, may also help ease pain. Some of these may be found over the counter, or the doctor may write a prescription.
• Dietary supplements, like glucosamine, may help relieve pain. Ask the doctor before taking any over-the-counter supplements.

If those medications or treatments do not ease the pain, the doctor may prescribe:

• Supportive aids, such as a brace, cane, or orthotic device in the shoe, can help support the joint to allow ease of movement. The doctor, physical or occupational therapist, or social worker will be able to assist with the right option(s) available.
• Physical or occupational therapy, along with a balanced fitness program, may gradually help ease pain and improve flexibility.
• Antidepressants may be prescribed to help improve sleep for a patient suffering from joint pain.
• Steroids, often given by injection into the joint, provide short-term relief of pain and swelling.
• Painkilling drugs that help ease pain.

Please note that medicine, even those available over the counter, affects people differently. What helps one person may not work for another. Be sure to follow the doctor’s directions carefully when taking any medicine, and tell him or her if you have any side effects.

What can be done to relieve joint pain?

Surgery may be an option if the joint pain is long lasting and does not lessen with drugs or physical therapy and exercise. Please be sure to discuss this with the doctor to make sure that an operation makes sense.

There are many different surgical options available, including:

Arthroscopy: A procedure where a surgeon makes two or three small incisions in the flesh over the joint and gets into the joint using an arthroscope, or a thin, flexible, fiberoptic instrument, to repair cartilage or remove bone chips in or near the joint.

Joint replacement: If other treatments do not help, surgery may be needed to replace the joint once the cartilage that cushions and protects the ends of the bones gradually wears away. This can be done for hip, knee and shoulder joints.

A surgeon removes parts of the patient’s bone and implants an artificial joint made from metal or plastic. This procedure has had excellent results and the majority of patients feel long-lasting pain relief after this type of surgery.

What symptoms of joint pain are causes for concern?

Symptoms of joint pain range from mild to disabling. Without cartilage, bones rub directly against each other as the joint moves. Symptoms can include:

• Swelling.
• Stiff or enlarged joint.
• Numbness.
• Noisy joints, or clicking, grinding, or snapping sounds when moving the joint.
• Painful movement.
• Difficulty bending or straightening the joint.
• Loss of motion.
• A red and hot and swollen joint (This should be evaluated quickly by a doctor).

When should I see a doctor?

If pain is interfering with normal daily life activities, it is time to talk to a doctor about the problem. It is important to diagnose the cause of the pain quickly and begin treatment to relieve pain and maintain healthy, functioning joints.

You should see a doctor if:

• Pain is accompanied by a fever.
• There is unexplained weight loss (10 pounds or more).
• Pain is preventing you from walking normally.

During the appointment, the doctor will ask many questions to figure out what may be the cause of the pain. The patient should be ready to answer questions about previous injuries to the joint, when the joint pain began, a family history of joint pain, and the type of pain experienced.

An examination of the affected joint will follow to see if there is pain or limited motion. The doctor will also look for signs of injury to the surrounding muscles, tendons, and ligaments.

If necessary, the doctor may also order X-rays or blood tests. X-rays can show if there is joint deterioration, fluid in the joint, bone spurs, or other issues that may be contributing to the pain. Blood tests will help confirm a diagnosis or rule out other diseases that may be causing the pain.