Why do joints hurt

16 March 2022

Joint pain is not uncommon. Nearly half (45%) of 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 wear and tear -- doctors talk about osteoarthritis here. In addition, acute arthritis and trauma are often causes of joint pain. But there are many other possible reasons.

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Although joint pains are common, their types are so diverse that the classification of joint pains is based on different criteria. For example, joint pain can be divided into three groups according to the time of onset:

Acute joint pain can occur within a few hours.
Subacute pain in the joints becomes apparent during the day.
Chronic joint pain persists for weeks or months.

Joint pain usually persists and progresses (chronic progressive course). Sometimes joint pain is only acute and temporary (course of acute relief).

In some cases, joint pain affects only one joint, such as the knee. But pain can also be captured from two to four joints (oligoarticular pain) or even more joints (joint joint pain).

Also, joint pain can vary, for example, in the following ways:

Painful rhythms: Pain at rest, pain at night, morning stiffness in joints.
Distribution pattern: pain in small joints (such as wrist, knuckles) or large joints (such as knee, hip), wrist pain, etc.
Pain intensity: Scale the severity of joint pain from 0 (no pain) to 10 (unbearable, extremely painful).
Aggravating factors: For example, decreased joint pain during exercise (classic arthritis) or after rest (classic osteoarthritis).

This information is important for doctors to determine the cause of joint pain.

Particularly common joints affected

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

Osteoarthritis is one of the leading causes of joint pain, especially in those joints that have been under tremendous stress throughout their lives. First, these are the knee, hip and hock 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 in the wrist and finger joints. In addition, knee, elbow, metatarsophalangeal, and shoulder pain are common in rheumatoid arthritis.

Joint pain during a gout flare almost always affects the leg joints, mainly the metatarsophalangeal joints. The hock and knee joints are also frequently affected.

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

Causes and possible diseases

Joint pain can have many causes. the most important is:

Joint wear and tear (arthritis of the joints):Osteoarthritis is the most common form of joint disease, affecting in principle all joints. Due to the destruction of the cartilage layer on the articular surface and changes to the bones, the affected joint cannot move freely and it becomes red, swollen and painful. Osteoarthritis is often the cause of wrist, hip, and knee pain. Joint wear is often caused by chronic overloading of the joint. Additionally, osteoarthritis can be a late consequence of accidents such as sports injuries, as well as joint damage due to congenital joint weakness or deformity.
Bursitis:The bursa acts as a shock absorbing layer in places where there is a particular stress between bone and soft tissue, such as in the joint area. They usually consist of a cavity filled with synovial fluid. Inflammation or mechanical stimulation (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 caused by shoulder bursitis or calcification of the shoulder, knee pain caused by inflammation of the knee bursa, inflammation of the bursa in the large hill (thigh)The bony bulge in the upper lateral side) caused by the buttocks.
Bacterial joint inflammation (bacterial arthritis):Bacterial arthritis mainly affects the knee and hip joints. Bacteria enter the joint either through the bloodstream or directly infect the joint (either through trauma or surgery to the joint, or during diagnostic injection into the joint). Severe knee or hip pain with severe joint swelling and symptoms of inflammation (eg, redness, localized warmth, warmth) 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 passed from ticks to humans. Fatigue, fever, redness, and joint pain occur about 4 weeks after transmission.
Associated joint inflammation 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). Movement of joints, especially large joints (hip, knee, ankle) is limited due to joint pain and swelling.
Wright disease arthritis:Reiter syndrome is a rare rheumatic disorder. Symptoms include joint pain associated with urethritis and conjunctivitis.
Psoriatic joint inflammation (psoriatic arthritis):Psoriasis is sometimes accompanied by inflammation that causes joint pain. In some cases, joint pain precedes the cutaneous manifestations of the disease, i. e. joint pain occurs first, followed by scaly skin lesions. Psoriatic arthritis may be the cause, especially if the joints of the fingers and toes and/or the spine are affected.
Joint inflammation in ankylosing spondylitis.Ankylosing spondylitis is a chronic rheumatic inflammation that primarily 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 gout flares):Gout increases the concentration of uric acid in the blood. An excess of it deposits in the joints in the form of uric acid crystals - acute attacks of gout occur with severe joint pain, swelling and redness in the joint area. First, the joint of the big toe is affected. But acute attacks of gout can also cause knee pain, wrist pain, finger joints, or upper ankle pain.
Rheumatoid Arthritis:This is the most common inflammatory disease of the joints and is progressive, mostly chronic, and progressively destroys the joints. Rheumatoid arthritis may be suspected if joint pain affects the fingers and wrist. Other symptoms of this condition include morning stiffness in the fingers and wrists, swollen joints, and the inability to make a fist.
Rheumatic fever:This inflammatory disease, which occurs mostly in 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, inflammation of the heart (carditis), and sudden involuntary and uncontrolled movements (chorea).
Sarcoid arthritis (Löfgren syndrome):Sarcoidosis is a rare inflammatory disease of unknown origin that affects the entire body. One form of this disease is Löfgren syndrome (acute sarcoidosis). It occurs mainly in young women and is associated with the following symptoms: inflammation, joint pain (especially in the ankles), acute inflammation of the subcutaneous fat tissue (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 and often causes joint pain and inflammation. But there can also be many other different symptoms, such as a butterfly 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 violates coagulation.In rare cases of hemophilia, there is a genetic predisposition to uncontrollable bleeding after an injury, or, in severe cases, even no apparent cause. In particular, there is often bleeding from muscles and joints. If left untreated, joint bleeding can lead to joint pain and permanent joint damage. In addition to hemophilia, other bleeding disorders, such as those caused by overdose of anticoagulants, can cause joint bleeding and joint pain.

When should you see a doctor?

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

Joint pain that limits joint movement.
fever.
Redness of the skin in the painful joint area.
Swollen joints.

You should definitely see your doctor if joint-related symptoms (pain, redness, swelling in the joint with limited mobility) persist for three days or more, worsen, or spread to other joints.

What does a doctor do?

To figure out the cause of joint pain, doctors will first ask about the patient's medical history (medical history). For example, when and where the joint pain occurred and whether there was other discomfort (accompanying symptoms such as fever or joint swelling).

Accurate description of joint pain

This information is important for diagnosing joint pain: the more accurately patients describe joint pain, the sooner doctors 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, arthralgia is observed in several joints. In addition, the location (localization) of the joint pain is indicative: if the patient presents with pain in the wrist and joint pain in the base and middle of the fingers, rheumatoid arthritis is most likely present. On the other hand, if the joint pain affects the base of the thumb and finger joints, the direction of osteoarthritis is suspected.

Scan (palpation)

No matter where the joint pain occurs, the doctor should clarify this question: Is the joint itself really painful, or does the so-called joint pain come from an area close to the joint or adjacent bones? In some cases, doctors can find the answer to this question by simply palpating the painful area. However, additional tests, such as X-rays or ultrasound, are usually required.

Further research on joint pain

If the joint pain does occur directly in the joint, such tests can help determine the cause of the pain:

Orthopedic examination:If joint pain is caused by abrasion (arthritis), bursitis, rheumatism, or an acute attack of gout, information can be found during an orthopaedic exam.
Dermatological examination:A skin examination can help identify suspected psoriatic arthritis or sarcoidosis as possible causes of joint pain.
blood test:Blood tests can be used to identify various causes of joint pain, such as bacterial arthritis or Lyme disease. If joint bleeding (due to a blood clotting disorder) can cause joint pain, specific measurements in blood tests, such as blood clotting, are sometimes required. If rheumatoid arthritis is the cause of joint pain, it is critical to first identify rheumatoid factor and other signs of inflammation in the blood. If gout or a gout flare is suspected, focus on the level of uric acid in the blood.
Ultrasonography:Ultrasonography is required when bursitis, gout, or systemic lupus erythematosus is suspected as the cause of joint pain.
X-ray:X-rays show signs of wear and tear on joints (arthritis), rheumatoid arthritis, and ankylosing spondylitis.
Arthrocentesis:If doctors suspect bacterial arthritis is the cause of joint pain, they will take a sample of joint fluid (arthrocentesis). Bacterial culture from this sample: If bacteria do grow from the joint sample, this indicates bacterial inflammation of the joint.

It is not always possible to find disease or pathological tissue changes as the cause of joint pain. Doctors talk about "sensitive joints". If the cause of joint pain is found, doctors can initiate appropriate treatment and treat the underlying condition with medication or surgery.

you can do it yourself

General Tips for Joint Pain

Lose excess weight. Any extra kilo is an unnecessary extra burden on the joints and causes wear and tear on the joints, which inevitably leads to joint pain.
Make sure you get enough rest after your workout.
Regular endurance exercise to strengthen muscles and joint cartilage. For example, swimming and cycling are suitable for joint training. Regular strength training (eg, weightlifting, skipping) is also recommended to strengthen bones. Consult an experienced trainer or sports physician to determine the correct dosage and develop a balanced exercise program that strengthens all muscles equally.
Avoid unilateral loading, such as carrying a heavy bag over your shoulder.
According to Jacobson, it is necessary to reduce mental stress through, for example, self-training or progressive muscle relaxation. Emotional stress can also stress the joints, shoulders, and bones.
Joint pain and other joint discomforts are treated with TCM acupuncture. Consult an experienced therapist.

Combination Therapy Skills

If osteoarthritis is diagnosed, a recent severe joint inflammation with pain, swelling, and redness, the affected joint must be immobilized (bed rest). Hold it so that the muscles associated with it are not tense. Put yourself a clammy compress (such as a quark wrap) to relieve joint discomfort. The anti-inflammatory and pain relievers you get from your doctor can be enhanced with the help of medicinal plants. Arnica is great (as a compressed decoction or rubbed into joints as an ointment or gel). In addition, there are, for example, anti-inflammatory and analgesic preparations based on willow bark, as well as combination preparations with rosemary and eucalyptus oils. In addition, peppermint oil has a cooling effect and can relieve pain sensations.
Once the joint pain, including redness and swelling, subsides, doctors say it's inactive osteoarthritis. At this stage of the disease, prevention restores positive complaints about the joints. This benefits from adequate, healthy sleep on an orthopaedic mattress, as the muscles relax well and the spine and joints are rested.
Also, if you frequently experience muscle tension under stress, you should use meditative relaxation techniques (eg, progressive muscle relaxation, self-training) on a regular basis.
Regular exercise and exercises that improve the synovial fluid and nutrient supply to the joint cartilage. Useful exercises are swimming, cycling, and water aerobics. In contrast, running on hard surfaces is not recommended, especially if osteoarthritis has already damaged the knee and hip joints. If possible, run on soft forest turf with soft-soled sneakers that work well. Better yet, walk instead of jogging.
Avoid sports that suddenly change direction (eg tennis, squash) as they can put a lot of stress on joints (eg knees) and can quickly cause joint pain.
Try not to stand or sit in one position for long periods of 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, lard, tuna, liver, beef and camembert cheese.
Take omega-3 fatty acids regularly, as they act as a competing analog of arachidonic acid in the inflammatory response. 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 anti-inflammatory antioxidants. Vitamin E is found in vegetable oils, especially the germ of wheat, soybeans, and sunflowers.
Joint pain and other joint discomfort associated with osteoarthritis can often be relieved with the use of heat that promotes circulation, such as sachets, paraffin, senna, and rosemary baths.
For osteoarthritis of the finger joints, kneading with warm clay or loam can help relieve joint pain and swelling. Regular finger exercises in hot sand are highly recommended. It is especially good for morning stiffness and joint pain.
Massaging and rubbing with eucalyptus, juniper, rosemary, lavender or lemon essential oils can help improve blood circulation and thus fight joint inflammation.
For inactive osteoarthritis, magic claw root tea is recommended: steep one tablespoon of coarsely ground root in two cups of boiling water for eight hours. Boil before use, then filter, divide the prepared tea into three portions and drink it throughout the day. The effect of taking the magic claw infusion appeared around the third week of treatment.
For the treatment of inactive osteoarthritis, a tea blend of gooseberry leaves, willow bark, nettle, horsetail, and spiraea flowers (20 grams each) is also recommended. Take two teaspoons of this mixture, pour it into a cup of boiling water, cook for half an hour, then strain. Drink 5-6 cups of this tea throughout the day. It has anti-inflammatory and analgesic properties.
Dry cupping and leech therapy (which can also be anti-inflammatory) can also help with arthritis irritation. Treating with your own blood is controversial, especially if the treated fluid is injected into the joint (risk of infection! ).

Rheumatoid Arthritis Tips

Some osteoarthritis tips should also apply to people with rheumatoid arthritis. These include nutritional advice, recommendations for topical use of arnica and devil's claw root. Other tips to help with rheumatoid joint pain and other joint problems:

During periods of mild discomfort (the inactive state of rheumatoid arthritis), you can use physical therapy and massage to keep your joints flexible.
During an increased inflammatory process (active rheumatoid arthritis), you can prepare an anti-inflammatory tea blend from meadowsweet, willow bark, daylily, gooseberry and nettle (20 grams of each herb). Pour a tablespoon of this mixture into a glass of cold water and let it sit for an hour. Then heat to a boil, but don't boil! Remove from heat and let stand for five to ten minutes, then strain. Drink three to four cups of this tea a day.
For acute inflammation of the joints, consuming protein-digesting enzymes, such as bromelain, should help.
Highly recommended for rheumatic diseases such as rheumatoid arthritis, tai chi and qigong. Research shows that these are holistic Chinese forms of exercise that can improve patients' mobility, muscle strength, endurance, quality of life, and mood. According to traditional Chinese medicine, the effect is that calm, fluid movements and breathing exercises release blockages in the body and allow the flow of life force (qi). Slow exercise is also suitable for patients with limited mobility due to joint pain and inflammation.
Inflammatory joint pain can be relieved with cold or heat therapy - try whichever works best for you. In general, for acute joint inflammation, cooling is recommended to stop the inflammation. In chronic illnesses, warmth is often more pleasant, such as a warm bath (such as senna), a fruit bag, or a mud therapy.
Even creams and ointments on medicinal plants are anti-inflammatory and analgesic. These include ready-to-use formulations containing willow bark or rosemary and eucalyptus oils. Additionally, peppermint oil can reduce pain sensations by stimulating cold receptors in the skin.
Ayurvedic healers recommend a cleansing procedure (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 disease. For acute inflammation of the joints with joint pain, use Indian frankincense (shallaki) and triphala (a mixture of herbs). Both have strong anti-inflammatory effects.