Why joints hurt

16 March 2022

Joint pain is not uncommon. Almost half (45%) of all people over the age of 45 complain of joint pain, particularly knee pain. Complaints can also occur at a young age. In most cases, joint pain is caused by signs of wear - here doctors speak of arthrosis. In addition, acute arthritis and trauma are often the cause of joint pain. But there are many other possible reasons.

The description

As common as joint pain is, its types are so diverse that joint pain classifications are based on different criteria. For example, joint pain can be divided into three groups based on when it occurs:

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 (progressive chronic course). Sometimes joint pain occurs only acutely and temporarily (acute relapsing course).

In some cases, joint pain affects only one joint, such as the knee joint. But also the pain can pick up from two to four joints (pain in the trace joints) or even more joints (pain in the joints of the joints).

In addition, joint pain varies, for example, depending on:

Painful rhythm: rest pain, nocturnal pain, morning stiffness of the joints.
Distribution Patterns: Pain in small joints (such as wrist, finger joints) or large joints (such as knee and hip joints), joint pain in carpal joints, etc.
Pain Intensity: Rate the severity of joint pain on a scale of 0 (no pain) to 10 (extreme, unbearable pain).
Aggravating factors: for example, reduction of joint pain during movement (typical of arthritis) or after rest (typical of osteoarthritis).

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

Particularly affected joints

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

Osteoarthritis, one of the leading causes of joint pain, is particularly 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 also cause pain in all other joints.

Rheumatoid arthritis is also a common cause of joint pain. Painful inflammation of the joints, most often appears on the wrists and finger joints. Additionally, pain in the knee, elbow, metatarsophalangeal joints, and shoulder are common in rheumatoid arthritis.

Joint pain during an acute attack of gout almost always affects the leg joint, primarily the metatarsophalangeal joint. The hocks and knee joints are often also affected.

Bursitis can cause hip, elbow, knee and shoulder pain.

Possible causes and diseases

Joint pain can have various 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 joint surfaces and bone changes, the affected joint cannot move freely, it turns red, swells and hurts. 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 consequence of an accident (such as sports injuries) and joint damage due to congenital weakness or joint deformity.
Bursitis:The bursae are located in the form of a shock-absorbing layer in particularly stressed places between the bone and the soft tissues, for example at the level of the joints. They usually consist of a cavity filled with joint fluid. Inflammatory or mechanical irritation (such as sports injuries) can injure the bursa and cause pain in the affected area. For example, elbow pain is often caused by inflammation of the bursa of the elbow joint, shoulder pain due to bursitis or calcification in the shoulder area, knee pain dueinflammation of the bursa in the knee joint and pain in the hip from inflammation of the bursa in the colliculus magnus (bone bulge on the upper outer part of the thigh).
Bacterial inflammation of the joints (bacterial arthritis):Bacterial arthritis primarily affects the knee and hip joints. Bacteria enter the joint through the blood or infect the joint directly (through trauma or surgery to the joint, or during diagnostic injections into the joint). Severe knee or hip pain with severe joint swelling and inflammatory symptoms (such as redness, localized warmth, 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 certain bacteria (Borrelia burgdorferi) which are transmitted from ticks to humans. About four weeks after transmission, fatigue, fever, flushing 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, colitisulcerative). Due to the resulting joint pain and swelling, joint movement is restricted, especially the larger ones (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 in psoriasis (psoriatic arthritis):Psoriasis is sometimes accompanied by inflammation that causes joint pain. In some cases, joint pain precedes the skin manifestations of the disease, that is, joint pain occurs first, and only then scaly skin lesions develop. Psoriatic arthritis can 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, pain in the knee, hip, heel and/or ankle can 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 - an acute attack of gout occurs with severe pain in the joints, swelling and redness in the joint area. First, the big toe joints are affected. But an acute attack of gout can also cause pain in the knee, pain in the wrist, pain in the knuckles of the fingers or in the upper part of the ankle.
Rheumatoid arthritis:It is the most common, progressive, most often chronic, and progressively destroying joint inflammatory disease of the joints. Rheumatoid arthritis can be suspected if joint pain affects the fingers and wrists. Other symptoms of this condition include morning stiffness in the fingers and wrists, joint swelling, and an inability to clench your fist.
Acute articular rhumatism:This inflammatory disease, which occurs mainly in children, is caused by certain bacteria (streptococci) days or weeks after a nose and throat infection that has not been treated with antibiotics. Possible symptoms include inflammatory joint pain, skin symptoms, inflammation of the heart (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 whole body. One form of the disease is Löfgren's syndrome (acute sarcoidosis). It mainly occurs in young women and is manifested by the following symptoms: inflammation, pain in the joints (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):It is a rare autoimmune disease that primarily affects women, often causing joint pain and inflammation. But there are also many other different symptoms, such as a 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 a "chameleon".
Joint bleeding in violation of coagulation.In rare cases of hemophilia, there is an inherited predisposition to uncontrollable bleeding after injury or, in severe cases, even for no apparent reason. Especially often there is bleeding in the muscles and joints. Bleeding into joints can cause joint pain and permanent joint damage if left untreated. In addition to hemophilia, other bleeding disorders can also cause joint bleeding and joint pain, such as bleeding disorders due to an overdose of blood thinners.

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 the movement of the joint.
Fever.
Redness of the skin in the area of the painful joint.
Swelling of the joint.

If joint-related symptoms (joint pain with reduced mobility, redness, swelling) persist for three or more days, worsen or spread to other joints, you should definitely seek medical attention.

What does the doctor?

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

Accurate description of joint pain

This information is very important for diagnosing joint pain: the more accurately a patient can describe joint pain, the sooner a doctor can narrow down 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 several joints. In addition, the location (localization) of joint pain is indicative: if the patient experiences pain in the wrist and pain in the joints of the base and middle of the fingers, rheumatoid arthritis is most likely present. On the other hand, if the joint pains affect the base of the thumb and the joints, the suspicion goes 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 is the supposed joint pain coming from an area near the adjacent joints or bones? In some cases, the doctor can find the answer to this question simply by feeling the painful area. However, very often, additional examinations, such as X-rays or ultrasounds, are necessary.

Further research on joint pain

Such examinations can help identify the cause of the pain, if the joint pain is occurring directly in the joint:

Orthopedic examination:If joint pain is caused by wear and tear (arthritis), bursitis, rheumatism or an acute attack of gout, relevant information can be found during an orthopedic examination.
Dermatological examination:Skin exams help identify suspected psoriatic arthritis or sarcoidosis as possible causes of joint pain.
Blood tests:blood tests are useful for 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 joint bleeding (due to a bleeding disorder) may be causing joint pain. If rheumatoid arthritis is the cause of joint pain, then in the blood, first of all, rheumatoid factor and other signs of inflammation are determined, which are crucial. And if gout or an acute attack of gout is suspected, the focus is on the level of uric acid in the blood.
Ultrasound examinations:ultrasonography (ultrasound) is indicated when bursitis, gout, or systemic lupus erythematosus is suspected to be the cause of joint pain.
X-ray:x-ray shows signs of joint wear (arthritis), rheumatoid arthritis and ankylosing spondylitis.
Articular puncture:If the doctor suspects bacterial inflammation of the joints as the cause of the joint pain, they will take a sample of joint fluid (joint puncture). A bacterial culture is taken from this sample: if bacteria grows from the joint sample, this indicates bacterial inflammation of the joint.

It is not always possible to find a disease or a pathological tissue change as the cause of joint pain. Doctors speak of "joint tenderness". If the cause of joint pain is found, the doctor can start 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 kilogram is an unnecessary additional load 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.
Do regular endurance exercises to strengthen your muscles and joint cartilage. For example, swimming and cycling are suitable for joint training. Regular strength training (such as weightlifting, jumping rope) is also recommended to strengthen 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 over your shoulder.
According to Jacobson, it is necessary to reduce mental stress by, for example, autogenic training or progressive muscle relaxation. Emotional pressure also puts pressure on the joints, shoulders and bones.
Joint pain and other joint conditions are treated in traditional Chinese medicine with acupuncture. See an experienced therapist.

Joint Treatment Tips

If osteoarthritis is diagnosed, ie recent severe inflammation of the joints with pain, swelling and redness, you must immobilize the affected joint (bed in bed). Hold it so that the muscles associated with it are not strained. Treat yourself to cool, moist compresses (such as a quark wrap) to relieve joint discomfort. The effect of anti-inflammatories and analgesics that you receive from your doctor can be improved with the help of herbal medicines. Arnica is well suited (as a decoction for compresses or as an ointment or gel to rub the joints). 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. Additionally, peppermint oil can lessen the perception of pain with its cooling effect.
Once joint pain, including redness and swelling, subsides, the doctor speaks of inactive osteoarthritis. At this stage of the disease, the prevention of the resumption of active complaints about the joints is carried out. This is facilitated by sound and adequate sleep on an orthopedic mattress, as the muscles relax well and the spine and joints rest.
In addition, you should regularly use meditative relaxation techniques (such as progressive muscle relaxation, autogenic training) if you often suffer from muscle tension under stress.
Regular exercise and exercises that improve the supply of synovial fluid and nutrients to joint cartilage. Useful sports are swimming, cycling and water aerobics. On the other hand, running on hard pavement is not recommended, especially if osteoarthritis has already damaged the knee and hip joints. If possible, run on soft forest turf and wear soft-soled sneakers that give a good spin. Better yet, walk instead of run.
Avoid sports with sudden changes in direction (e. g. tennis, squash) as they put a lot of strain on the joints (e. g. 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 arthritis-induced osteoarthritis). Arachidonic acid is mainly found in fatty pork, egg yolks, lard, 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 wheat, soy and sunflower germs.
Joint pain related to osteoarthritis and other joint problems can often be relieved by the application of circulation-stimulating heat, such as fango sachets, paraffin, senna, rosemary baths.
For osteoarthritis of the finger joints, kneading with hot clay or loam can help relieve joint pain and swelling. Regular finger exercises in heated sand are also highly recommended. 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 and therefore fights joint inflammation.
For inactive osteoarthritis, devil's claw root tea is recommended: pour one tablespoon of coarsely ground root into two cups of boiling water and steep 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 devil's claw infusion appears around the third week of treatment.
For the treatment of inactive arthrosis, a tea mixture of black currant leaves, willow bark, nettle, horsetail and meadowsweet flowers (20 g of each component) is also recommended. Take two teaspoons of this mixture and pour a glass of boiling water, leave to infuse for half an hour, then strain. Drink 5-6 cups of this tea throughout the day. It has an anti-inflammatory and analgesic effect.
Dry cupping and leech (also anti-inflammatory) are also helpful in treating arthritic irritations. Treatment with one's own blood is controversial, especially if the treated liquid is injected into the joint (risk of infection! ).

Advice for rheumatoid arthritis

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

During times of mild discomfort (the inactive state of rheumatoid arthritis), you can use physical therapy and massage to keep your joints flexible.
During an aggravation of the inflammatory process (active rheumatoid arthritis), you can prepare an anti-inflammatory tea mixture based on meadowsweet, willow bark, goldenrod, black currant and nettle (20 g of each herb). Pour a tablespoon of this mixture into a cup 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, then strain. Drink three to four cups of this tea daily.
For acute joint inflammation, consuming protein-digesting enzymes, such as bromelain, should help.
Highly recommended for rheumatic diseases such as rheumatoid arthritis, tai chi and qigong. They are holistic Chinese forms of movement that can improve patients' mobility, muscle strength, endurance, quality of life and mood, according to studies. The effect, according to Chinese medicine, is that calm, flowing movements and breathing exercises release blockages in the body and circulate 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 whichever works best for you. In general, cooling is recommended for acute joint inflammation to stop the inflammation. In chronic conditions, heat is usually more pleasant, such as heated baths (like senna flowers), fango packs, or mud treatments.
Even herbal creams and ointments exhibit anti-inflammatory and analgesic effects. These include ready-to-use preparations containing willow bark or rosemary and eucalyptus oils. Additionally, peppermint oil can dull the perception of pain by irritating cold receptors in the skin.
Ayurvedic therapists recommend cleansing procedures (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 joint inflammation accompanied by joint pain, Indian frankincense (shallaki) and triphala (herbal mixture) are used. Both have powerful anti-inflammatory effects.