Why joints hurt

16 March 2022

Joint pain is not uncommon. About half of people over the age of 45 (45 percent) suffer from painful joints, especially knee pain. Complaints can also occur 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 are often the cause of joint pain. But there are many other possible reasons.

Description

No matter how common joint pain is, their types are very different, so the classification of joint pain is based on different criteria. For example, joint pain can be divided into three groups according to the time of onset:

Acute pain in the joints occurs within a few hours.
Subacute pain in the joints 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 remission course).

In some cases, joint pain affects only one joint, such as the knee joint. The pain can also affect two to four joints (pain in the oligo-joints) or more joints (pain in the joints).

In addition, joint pain varies, for example, due to:

Painful rhythm: rest pain, night pain, morning stiffness of the joints.
Spreading methods: Joint pain in small joints (for example, wrist, finger joints) or large joints (such as knee and thigh joints), wrist joints, etc.
Pain intensity: Rate the severity of joint pain on a scale of 0 (painless) to 10 (unbearable, extreme pain).
Aggravating factors: for example, a decrease in joint pain during exercise (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 affected by the pain depends crucially on the cause of the pain. Some examples.

Osteoarthritis, one of the main causes of joint pain, is especially noticeable in joints that experience a lot of stress throughout life. First of all, these are the knee joints, hip joints and hock joints. Osteoarthritis can cause pain in all other joints.

Rheumatoid arthritis is also a common cause of joint pain. Painful inflammation of the joints is most often seen on the wrists and joints of the fingers. In addition, pain in the knees, elbows, metatarsophalangeal joints, and shoulders is common in rheumatoid arthritis.

Joint pain in an acute attack of gout almost always affects the foot joint, mainly the metatarsophalangeal joint. Often the knee and knee joints are also affected.

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

Causes and possible diseases

Joint pain can occur for a variety of reasons. The most important are:

Joint wear (arthritis of the joints):Osteoarthritis is the most common form of joint disease and can affect virtually all joints. Due to the destruction of the cartilage layer on the articular surfaces and bone changes, the affected joint is unable to move freely, becomes red, swollen and painful. Osteoarthritis is often the cause of wrist, hip and knee pain. Joint wear is usually caused by long-term overloading of the joints. In addition, osteoarthritis can be a late outcome of an accident (e. g. , sports injuries), joint damage due to congenital weakness or deformity of the joints.
Bursitis:Bursae are located in particularly tense areas between bone and soft tissue, such as the joints, in the form of a shock-absorbing layer. They usually consist of a cavity filled with joint fluid. Inflammatory or mechanical irritation (e. g. , sports injuries) can damage the bursa and cause pain in the affected area. For example, elbow pain is often caused by inflammation of the bursa in the elbow joint, shoulder pain due to bursitis or calcification in the shoulder area, and pain and soreness in the knee as a result of inflammation of the bursa in the knee joint. Inflammation of the bursa in the large colliculus of the hip (bone protrusion of the upper outer thigh).
Bacterial arthritis (bacterial arthritis):Bacterial arthritis mainly affects the knee and hip joints. Bacteria either enter the joint through the blood or directly infect the joint (through trauma to the joint or surgery, or during a diagnostic injection into the joint). Severe knee or hip pain with severe joint swelling and inflammatory symptoms (e. g. , 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. This is caused by certain bacteria (Borrelia burgdorferi) that are transmitted from ticks to humans. Approximately four weeks after transmission, fatigue, fever, redness, and joint pain occur.
Associated joint inflammation 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). As a result, due to pain and swelling in the joints, there are restrictions on movement in the joints, especially in large joints (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 during psoriasis (psoriatic arthritis):Psoriasis is sometimes accompanied by inflammation that causes joint pain. In some cases, joint pain occurs before the skin manifestations of the disease, ie joint pain occurs first and only then develops paid skin lesions. The cause may be psoriatic arthritis, especially affecting the joints of the fingers and toes and / or the spine.
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, knee pain, hip pain, heel pain, and / or ankle pain may be the cause of Bechterew's disease.
Gout (or acute attack of gout):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 - a sharp attack of gout with severe pain in the joints, swelling and redness in the joint area. First of all, the joints of the thumb are affected. However, 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:It is the most common inflammatory disease of the joints, progressing, mostly chronic, and gradually destroying the joints. If joint pain affects the fingers and wrists, rheumatoid arthritis may be suspected. Other symptoms of this condition include morning stiffness of the fingers and wrists, swelling of the joints, and inability to punch.
Rheumatic fever:This inflammatory disease, which is mainly found in children, is caused by certain bacteria (streptococci) days or weeks after a nasopharyngeal infection that is not treated with antibiotics. Possible symptoms include inflammatory joint pain, skin symptoms, inflammation of the heart (carditis), and sudden involuntary and uncontrolled movements (chorea).
Sarcoidosis arthritis (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 manifests itself 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 weight loss.
Systemic lupus erythematosus (SLE):It is a rare autoimmune disease that mainly affects women, often causing pain and inflammation in the joints. However, there can be 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 red medicine is called "chameleon" in medicine.
Articular hemorrhage with impaired coagulation.In rare cases, there is a hereditary predisposition to hemophilia, uncontrolled bleeding after injury or in severe cases, even for no apparent reason. Especially often there is bleeding in the muscles and joints. If left untreated, bleeding in the joints can cause joint pain and permanent joint damage. In addition to hemophilia, other bleeding disorders can cause joint bleeding and joint pain, such as bleeding disorders caused by an overdose of anticoagulants.

When should you see a doctor?

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

Joint pain that restricts joint movement.
Temperature.
Redness of the skin in the painful joint area.
Swelling of the joint.

If joint symptoms (joint pain, redness, swelling with limited mobility) last for three days or more, worsen, or spread to other joints, you must see a doctor.

What does the doctor do?

To determine 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 (symptoms such as fever or swelling of the joints).

Accurate description of joint pain

This information is very important for the diagnosis of joint pain: the more accurately the patient can describe the joint pain, the faster 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 rheumatoid arthritis, on the other hand, arthralgia is observed in several joints. In addition, the location (localization) of joint pain is an indicator: if the patient feels pain in the wrist and pain in the main and middle joints of the fingers, it is likely that rheumatoid arthritis is present. On the other hand, if joint pain affects the base of the thumb and joints, 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 itself really hurt, or does the presumed joint pain come from an area close to the joints or adjacent bones? In some cases, the doctor can answer this question simply by palpating the painful area. However, additional tests, such as x-rays or ultrasound, are often needed.

Additional Research on Joint Pain

Such examinations can help determine the cause of joint pain if it occurs directly in the joint:

Orthopedic examination:If joint pain is caused by wear and tear (arthritis), bursitis, rheumatism, or an acute attack of gout, appropriate information can be obtained during an orthopedic examination.
Dermatological examination:Skin tests can help identify suspected psoriatic arthritis or sarcoidosis as possible causes of joint pain.
Blood tests:Blood tests are useful to determine the various causes of joint pain, such as bacterial arthritis or Lyme disease. If joint bleeding (due to a coagulation disorder) can sometimes cause joint pain, a blood test may require special measurements, such as a blood clot. If the cause of joint pain is rheumatoid arthritis, rheumatoid factor and other signs of inflammation are identified in the blood, which is crucial in the first place. If you suspect an attack of gout or acute gout, pay attention to the level of uric acid in the blood.
Ultrasound examinations:Ultrasound (ultrasound) is indicated when bursitis, gout or systemic lupus erythematosus is suspected to be the cause of joint pain.
X-ray:X-rays show signs of wear and tear in the joints (arthritis), rheumatoid arthritis and ankylosing spondylitis.
Joint puncture:If the doctor suspects bacterial joint inflammation as the cause of joint pain, they will take a sample of joint fluid (joint puncture). Bacterial culture is performed from this sample: if bacteria grow from the joint sample, it indicates bacterial inflammation of the joints. together.

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 identified, the doctor can begin 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 pounds are an unnecessary extra burden on the joints and help them wear out, which inevitably causes joint pain.
Make sure you get enough rest after exercise.
Do endurance exercises regularly to strengthen your muscles and joint cartilage. For example, swimming and cycling are suitable for joint training. Regular strength exercises (eg, weight lifting, skipping rope) are recommended to strengthen the bones. Consult an experienced trainer or sports physician 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 on your shoulders.
According to Jacobson, for example, it is necessary to reduce mental stress through autogenic training or progressive muscle relaxation. Emotional pressure also puts pressure on the joints, shoulders and bones.
In traditional Chinese medicine, joint pain and other joint complaints are treated with acupuncture. Consult an experienced therapist.

Joint Treatment Tips

If osteoarthritis is diagnosed, ie there is a recent severe inflammation of the joints with pain, swelling and redness, you should immobilize the affected joint (bed rest). Hold it so that the muscles associated with it are not tense. Give yourself moist and cool compresses (like a quark bandage) to relieve joint discomfort. The effects of the anti-inflammatory and analgesic medications you receive from your doctor can be enhanced with the help of herbs. Arnica is well suited (decoction for compresses or as an ointment or gel to rub into the joints). In addition, there are, for example, anti-inflammatory and analgesic drugs based on willow bark, as well as drugs in combination with rosemary and eucalyptus oils. In addition, peppermint oil can facilitate the perception of pain due to its cooling effect.
After the joint pain has subsided, including redness and swelling, the doctor talks about inactive osteoarthritis. At this stage of the disease, the recovery of active joint-related complaints is prevented. This is facilitated by adequate, healthy sleep on an orthopedic mattress, because the muscles relax well, the spine and joints relax.
In addition, if you often suffer from muscle tension under stress, you should regularly use meditative relaxation techniques (for example, gradual muscle relaxation, autogenic exercise).
Regular exercises and workouts that improve the supply of synovial fluid and nutrients to the articular cartilage. Useful sports are swimming, cycling and water aerobics. On the contrary, it is not recommended to run on hard pavements, especially if osteoarthritis has already damaged the knee and hip joints. If possible, avoid the soft forest grass and wear soft-soled sneakers that work well. Better yet, walk instead of running.
Avoid sports with sudden changes in direction (eg, tennis, squash), as they put too much strain 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 reactions (such as osteoarthritis caused by arthritis). Arachidonic acid is found mainly in fatty pork, egg yolks, fat, tuna, liver, beef and cambert.
Take omega-3 fatty acids regularly, as they act as competing analogues of arachidonic acid in inflammatory reactions. 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 an antioxidant effect against inflammation. Vitamin E is found in vegetable oils, especially wheat, soy and sunflower microbes.
Osteoarthritis-related joint pain and other joint complaints can often be alleviated by applying heat that stimulates circulation, such as fango packs, paraffin, senna, and rosemary baths.
Kneading with hot clay or clay for arthrosis of the finger joints can help with joint pain and swelling. Regular finger exercises in heated sand are also highly recommended. Especially good for morning stiffness and joint pain.
Massaging and rubbing with essential oils of eucalyptus, juniper, rosemary, lavender or lemon helps to improve blood circulation and therefore 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 infuse for eight hours. Boil before use, then strain, divide the prepared tea into three portions and leave for a day. The effect of the infusion of the devil's paw is visible in the third week of treatment.
A mixture of currant leaves, willow bark, nettle grass, horsetail and meadow flowers (20 g of each component) is also recommended for the treatment of inactive osteoarthritis. Take two teaspoons of this mixture and pour a glass of boiling water, infuse for half an hour, then strain. For 5-6 cups of this tea a day. Has anti-inflammatory and analgesic effects.
Dry wraps and leech therapy (as well as anti-inflammatory) are also helpful in treating arthritic irritants. Self-medication is controversial, especially if the treated fluid is injected into the joint (risk of infection! ).

Tips for rheumatoid arthritis

Some osteoarthritis tips should also be applied to people with rheumatoid arthritis. These include nutrition 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 periods of mild anxiety (inactive state of rheumatoid arthritis), you can use physical therapy and massage to keep your joints elastic.
In case of exacerbation of the inflammatory process (active rheumatoid arthritis), you can prepare an anti-inflammatory tea mixture of grass, willow bark, rosehip, currant and nettle (20 g of each herb). Pour a tablespoon of this mixture into a glass of cold water and leave for an hour. Then bring to a boil, but do not boil! Remove from the heat, sit for five to ten minutes, then strain. Drink three to four cups of this tea a day.
For acute inflammation of the joints, the consumption of protein-digesting enzymes such as bromelain should help.
Highly recommended for rheumatic diseases such as rheumatoid arthritis, tai chi and qigong. Studies show that these are the only Chinese forms of movement that can improve patients' mobility, muscle strength, endurance, quality of life and mood. According to Chinese medicine, exposure, calm, fluid movements and breathing exercises remove congestion in the body and cause a flow of life energy (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 treatment - try the one that works best for you. Generally, cooling is recommended for acute joint inflammation to stop the inflammation. In chronic diseases, warming is generally more pleasant, for example, hot baths (for example, 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 oils. In addition, peppermint oil can relieve pain by irritating cold receptors on the skin.
Ayurvedic therapists recommend cleansing procedures (pancreas treatment) for rheumatic diseases to remove toxins (but so-called) from the body. According to this teaching, but accumulation is the cause of the disease. Indian incense (shallaki) and triphala (herbal mixture) are used for acute inflammation of the joints with painful joints. Both have a strong anti-inflammatory effect.