Why do the joints hurt

16 March 2022

Joint pain is not uncommon. Nearly half (45 percent) of those over the age of 45 complain of painful joints, especially knee pain. Complaints can arise at a young age. In most cases, joint pain is caused by signs of wear and tear - here doctors talk about osteoarthritis. In addition, acute arthritis and trauma often cause joint pain. But there could be many other possible reasons.

Description

As common as joint pain is, their types are so varied, which is why joint pain is classified based on different criteria. For example, joint pain can be divided into three groups according to the initial time:

Acute pain in the joints occurs within a few hours.
The subacute pain in the joints becomes noticeable during the day.
Chronic joint pain develops in weeks or months.

Joint pain often persists and may 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 the pain can also affect two to four joints (pain in the oligo joints) or even more joints (pain in the joints).

In addition, joint pain varies, for example:

Painful rhythm: resting pain, nocturnal pain, morning joint stiffness.
Distribution patterns: Pain in small joints (such as wrists, finger joints) or large joints (such as knee and hip joints), joint pain in the wrists, etc.
Pain intensity: Evaluation of the severity of joint pain on a scale from 0 (no pain) to 10 (unbearable, extreme pain).
Aggravating factors: such as reduction of joint pain during exercise (characteristic of arthritis) or rest (characteristic of osteoarthritis).

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

Joints are particularly often affected

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

Osteoarthritis is one of the main causes of joint pain, especially in joints that are subjected to heavy use during their lives. First, these are the knee, hip, and hip joints. Osteoarthritis can cause pain in all other joints.

Rheumatoid arthritis is also a common cause of joint pain. Painful arthritis, most commonly on the wrists and finger joints. In addition, pain in the knee, elbow, metatarsal joint, and shoulder is common in rheumatoid arthritis.

In acute gout attacks, joint pain almost always affects the foot joint, especially the metatarsal joint. Often the hocks and knee joints are also affected.

Bursitis can cause pain in the hips, elbows, knees and shoulders.

Causes and possible diseases

There are several possible causes of joint pain. The most important are:

Joint wear (arthritis):Osteoarthritis is the most common form of joint disease and can affect any joint in principle. Due to the destruction of the cartilage layer and the bone changes on the joint surfaces, the affected joint cannot move freely, redness, swelling and pain. Osteoarthritis is often the cause of wrist, hip and knee pain. Joint wear is usually caused by long-term joint overload. In addition, osteoarthritis can be a late consequence of an accident (such as a sports injury) and joint damage due to congenital weakness or deformity of the joints.
Bursitis:The bursts are located in the form of an impact-absorbing layer at particularly stressed sites between the bone and soft tissues, such as the joints. They usually consist of a cavity filled with synovial 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 inflammation of the elbow bursa, shoulder pain due to bursitis or calcification of the shoulder area, knee pain due to inflammation of the knee bursa, and inflammation of the hip due to inflammation of the bursa in the larger colliculus (bone bulge in the upper thigh).
Bacterial arthritis (bacterial arthritis):Bacterial arthritis mainly affects the knee and hip joints. Bacteria either enter the joint through the blood or infect the joint directly (during trauma or joint surgery, or during diagnostic injections into the joint). Severe knee or hip pain with severe joint swelling and inflammatory symptoms (such as redness, local heat, fever) may indicate bacterial arthritis.
Lyme disease (Lyme disease):Joint pain in Lyme disease is also based on bacterial inflammation of the joints. This is caused by certain bacteria (Borrelia burgdorferi) that spread from ticks to humans. About four weeks after transmission, fatigue, fever, redness, and joint pain occur.
Associated arthritis 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 in the large ones (hip joint, knee joint, ankle joint).
Arthritis in Reiter's disease:Reiter's syndrome is a rare rheumatic disease. Symptoms include joint pain associated with urethritis and conjunctivitis.
Arthritis in psoriatic arthritis:Psoriasis is sometimes associated with inflammation that causes joint pain. In some cases, the joint pain precedes the skin manifestations of the disease, meaning that joint pain occurs first and only then does peeling skin lesions develop. Psoriatic arthritis can be caused, especially if the joints of the fingers and toes and / or the spine are affected.
Arthritis in ankylosing spondylitis.Ankylosing spondylitis is a chronic rheumatic inflammation that primarily affects the spine but can also spread to large joints. Therefore, knee, hip, heel 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. Excess is deposited in the form of uric acid crystals, including in the joints - an acute gout attack with severe joint pain, swelling and redness in the joints. Above all, the joints of the big toe are affected. But an acute attack of gout can also cause knee and wrist pain, pain in the wrists of the fingers or the top of the ankle.
Rheumatoid arthritis:It is the most common inflammatory disease of the joints, progressive, mostly chronic, and gradually destroys the joints. Rheumatoid arthritis may be suspected if joint pain affects the fingers and wrists. Other symptoms of the condition include morning stiffness in the fingers and wrists, swelling of the joints, and inability to grip the fist.
Rheumatic fever:This inflammatory disease, which mainly affects children, is caused by certain bacteria (streptococci) days or weeks after an untreated nose and throat infection. Possible symptoms include inflammatory joint pain, skin symptoms, heartitis (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 entire body. One form of the disease is Löfgren's syndrome (acute sarcoidosis). It occurs mainly in young women and includes the following symptoms: inflammation, joint pain (especially in the ankles), acute inflammation of the fatty tissue under the skin (erythema nodosum), swelling of the lymph nodes in the lungs (bronchial lymphadenopathy), and weight loss.
Systemic lupus erythematosus (SLE):A rare autoimmune disease that mainly affects women, it often causes joint pain and inflammation. But many other symptoms can occur, such as a butterfly-like rash on the face, pleurisy, pericarditis, kidney or brain inflammation, loss of appetite, and weight loss. Therefore, lupus erythematosus is called "chameleon" in medicine.
Joint bleeding with violation of coagulation.In rare cases, haemophilia shows an inherited tendency to bleed uncontrollably after injury or, in severe cases, even for no apparent reason. Bleeding in the muscles and joints is especially common. Bleeding into the joints can cause joint pain and permanent joint damage if left untreated. In addition to hemophilia, other bleeding disorders can cause joint bleeding and joint pain, such as bleeding disorders due to overdose of anticoagulants.

When to 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 restricts joint movement.
Fever.
Redness in the area of the sore joint.
Swelling of the joint.

If joint symptoms (joint pain, redness, swelling) persist for three days or more, worsen, or spread to other joints, a doctor should be consulted.

What is the doctor doing?

To clarify the cause of the joint pain, the doctor first asks the patient about his or her medical history (history). For example, when and where joint pain occurs and whether there are other complaints (accompanying symptoms such as fever or joint swelling).

An accurate description of joint pain

This information is very important in 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 gout attack is thought to cause pain in only one joint. In contrast, in rheumatoid arthritis, joint pain is observed in many joints. In addition, the localization (localization) of joint pain is indicative: if the patient experiences wrist pain and the lower and middle joints of the fingers, it is most likely rheumatoid arthritis. On the other hand, if the joint pain affects the base of the thumb and the wrists, the suspicion is directed at osteoarthritis.

Scanning (touch)

Regardless of where the joint pain occurs, the doctor needs to clarify the question: does the joint itself really hurt, or does the putative joint pain come from an area close to the joints or adjacent bones? In some cases, the doctor will find an answer to this question by touching the painful area. Very often, however, additional tests such as X-rays or ultrasounds are needed.

Further research on joint pain

Such tests can help identify the cause of the pain if the joint pain occurs directly in the joint:

Orthopedic examination:If the joint pain is caused by wear (arthritis), bursitis, rheumatism or an acute gout attack, you may need to find out about it during an orthopedic examination.
Dermatological examination:Skin tests help identify suspected arthritis or sarcoidosis as possible causes of joint pain.
Blood collection:Blood tests are useful in identifying various causes of joint pain, such as bacterial arthritis or Lyme disease. Sometimes specific measurements, such as blood clotting, are needed during a blood test if joint bleeding (due to a clotting disorder) can cause joint pain. When joint pain is caused by rheumatoid arthritis, rheumatoid factor and other signs of inflammation in the blood are determined above all else and are crucial. And if you suspect gout or an acute gout attack, the focus is on the level of uric acid in your blood.
Ultrasound examinations:ultrasound (ultrasound) is recommended if bursitis, gout, or systemic lupus erythematosus is suspected.
X-ray:X-rays show traces of joint wear (arthritis), rheumatoid arthritis and ankylosing spondylitis.
Articular puncture:if the doctor suspects bacterial arthritis as the cause of the joint pain, a joint fluid sample is taken (joint puncture), and bacterial culture is performed on this sample: if bacteria multiply from the joint sample, this indicates bacterial inflammation. the joint.

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

You can make it too

General tips for treating joint pain

Take the excess weight. Every extra pound puts an unnecessary extra strain on the joints and contributes to their wear and tear, which inevitably leads to joint pain.
Make sure you get enough rest after your workout.
Perform regular endurance exercises to strengthen muscles and articular cartilage. For example, swimming and cycling are suitable for joint training. Regular strength training (e. g. weight lifting, skipping rope) is also recommended to strengthen the bones. Consult an experienced trainer or sports doctor to determine the right dose and develop a balanced workout program that strengthens all muscles equally.
Avoid unilateral loads such as carrying heavy bags on your shoulders.
According to Jacobson, mental stress should be reduced through, for example, autogenic training or progressive muscle relaxation. Emotional pressure also puts pressure on the joints, shoulders and bones.
Joint pain and other joint complaints are treated with acupuncture in traditional Chinese medicine. Consult an experienced therapist.

Joint treatment tips

If osteoarthritis is diagnosed, that is, a recent severe arthritis that causes pain, swelling, and redness, the affected joint should be fixed (bed rest). Hold so that the muscles attached to it do not strain. Give yourself a moist and cool compress (such as a cottage cheese wrap) to relieve joint discomfort. The effect of anti-inflammatory and analgesic drugs obtained from a doctor can be enhanced with the help of herbs. The arnica is excellent (as a decoction for a compress or as an ointment or gel to rub the joints). In addition, there are, for example, willow bark-based anti-inflammatory and analgesic compositions, as well as compositions combined with rosemary and eucalyptus oils. In addition, peppermint oil can relieve pain sensation 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, they prevent the recurrence of active joints-related complaints. This is aided by proper, healthy sleep on an orthopedic mattress, as the muscles relax well and the spine and joints relax.
In addition, regularly use meditative relaxation techniques (e. g. , gradual muscle relaxation, autogenic training) if you often suffer from stressful muscle tension.
Regular exercise and exercises that improve the fluid and nutrient supply to the articular cartilage. Useful sports are swimming, cycling and water aerobics. In contrast, running on a hard sidewalk is not recommended, especially if osteoarthritis has already damaged the knee and hip joints. If possible, run on soft forest lawns and wear soft-soled sneakers that provide good performance. Better yet, walk instead of jogging.
Avoid sports that involve a sudden change of direction (e. g. , tennis, squash) as they place a heavy load on the joints (e. g. , the knee joint) and quickly cause joint pain.
Try not to stand or sit in a position for long periods of time.
Eat a low arachidonic acid diet. This omega-6 fatty acid plays a central role in inflammatory reactions (e. g. , osteoarthritis caused by arthritis). Arachidonic acid is found mainly in fatty pork, egg yolk, lard, tuna, liver, beef and camembert.
Take omega-3 fatty acids regularly as they act as competing analogues of arachidonic acid in inflammatory reactions. Several of these fatty acids are found in fish oils (eat fish at least once a week! ).
Make sure you get enough vitamin E, which is important for joint fluid as it provides an antioxidant effect against inflammation. Vitamin E is found in vegetable oils, especially in the germs of wheat, soybeans and sunflowers.
Arthritis and other joint complaints associated with arthritis can often be alleviated by using circulatory heat such as fango sachets, paraffin, senna, rosemary baths.
In case of osteoarthritis of the finger joints, kneading with warm clay or adobe can help with joint pain and swelling. Regular finger exercises are also highly recommended in heated sand. It is especially good for morning stiffness and joint pain.
Massaging and rubbing with essential oils of eucalyptus, juniper, rosemary, lavender or lemon improves blood circulation so you can fight arthritis.
For inactive osteoarthritis, devil’s claw root tea is recommended: pour a tablespoon of coarsely ground root into two cups of boiling water and soak for eight hours. Bring to a 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 claw infusion occurs in the third week of treatment.
A mixture of currant leaves, willow bark, nettle, horseradish and meadow flowers (20 g per component) is also recommended for the treatment of inactive arthritis. Take two teaspoons of this mixture, pour a glass of boiling water, let stand for half an hour, then strain. Drink 5-6 cups of tea during the day. It has anti-inflammatory and analgesic effects.
Dry cupping and leech therapy (also anti-inflammatory) are also helpful in treating irritations from arthritis. 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 application of arnica and devil’s root. Other tips that can help with rheumatic joint pain and other joint problems:

During periods of mild discomfort (an inactive state of rheumatoid arthritis), you may use physiotherapy and massage to maintain joint flexibility.
When the inflammatory process gets worse (active rheumatoid arthritis), you can make an anti-inflammatory tea mixture from meadow grass, willow bark, goldenrod, currant and nettle (20 g per herb). Pour a tablespoon of the mixture into a cup of cold water and let stand for an hour. Then bring to a boil, but do not boil! Remove from the heat, let stand for five to ten minutes, then strain. Drink three to four cups of tea a day.
In acute arthritis, consumption of protein-digesting enzymes such as bromelain may help.
It is especially recommended for the treatment of rheumatic diseases such as 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 calm, fluid movements and breathing exercises release blockages in the body and flow life force (Qi). 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 the one that works best for you. In general, refrigeration is recommended to stop inflammation in the case of acute arthritis. For chronic illnesses, heat is usually more pleasant, such as warming baths (such as senna flowers), fango packs, or mud treatments.
Even creams and ointments on herbs have anti-inflammatory and analgesic effects. These include ready-to-use preparations containing willow bark or rosemary and eucalyptus oil. In addition, peppermint oil can relieve pain sensation by irritating the skin’s cold receptors.
Ayurvedic therapists recommend cleansing procedures (panchakarma treatment) for rheumatic diseases to remove toxins from the body (called ama). According to this teaching, the accumulation of ama is the cause of disease. Indian incense (sallaki) and triphalate (a mixture of herbs) are used for acute arthritis with joint pain. Both have a strong anti-inflammatory effect.