Joint pain: Causes, Symptoms and Treatments

Joint pain can be caused by a variety of factors, including various medical conditions, injuries, and lifestyle factors. It’s also important to realise that causes of joint pain in adults can be different from those causing joint pain in children. Sometimes, the cause is obvious and immediate - such as with a sporting injury or a broken bone - but at other times, the cause can be linked to different parts of a joint, such as the joint bones, the joint lining and the tendons, muscles or ligaments around the joint. Occasionally, pain can be felt in a joint when there is no damage to the joint itself but is caused by nerve pain in the area of the joint - this is known as ‘referred pain’, such as can occur in conditions such as sciatica. Common causes of joint pain include:

• Arthritis - a common cause of joint pain. It’s a result of inflammation to the joints that can cause swelling, cracking knees, stiffness, and pain.
• Osteoarthritis. This is the most common type of arthritis (OA) and is caused by the wearing down of the joint cartilage in a joint. Often known as ‘wear and tear’ arthritis, it occurs when the protective cartilage that cushions the joints gradually wears down over time. This degenerative condition commonly affects weight-bearing joints like the knees, hips, and spine, causing pain, stiffness, and reduced mobility. Most people with OA find that one joint is initially affected but others can then develop it over time.
• Rheumatoid arthritis - known as RA, this is an autoimmune condition in which the body’s own immune system attacks the joints, causing inflammation and pain. It occurs when the body's immune system mistakenly attacks the synovial membrane, resulting in inflammation, pain, swelling, and potential joint deformities. Rheumatoid arthritis commonly affects multiple joints symmetrically, such as the hands, wrists, and feet. Symptoms of RA can be worse in the morning, and vary widely from mild to disabling with long-term RA causing significant joint damage in some people.

• Reactive arthritis. This less common type of arthritis develops when there is infection somewhere in the body, and a joint reacts to this infection. The infection is not usually in the joint but in the bowel or urinary system.
• Psoriatic arthritis. The skin condition psoriasis typically causes plaques of scaly skin on the body but can also sometimes cause swelling, pain and inflammation in the joints of someone with it.

• Tendonitis - is an inflammation of the tendon, which is a band of tissue that connects the muscle to the bone. It can be caused by overuse, injury, or infection. Tendonitis commonly occurs as a result of repetitive motions or overuse of a particular tendon. It can affect any tendon in the body, but it is most frequently seen in the tendons of the shoulders, elbows, wrists, knees, and heels.
• Bursitis - is an inflammation of the bursa, which is a small fluid-filled sac that cushions the bones, tendons, and muscles near a joint. It is often caused by repetitive motions or overuse of the joint.
• Sprains - joint injuries that involve the stretching or tearing of ligaments, which are the connective tissues that hold bones together. This type of joint pain typically occurs from sudden movements, falls, or sports-related activities. Symptoms of a sprain include pain, swelling, bruising, and difficulty moving the affected joint.
• Gout - this is a type of joint pain characterised by sudden and severe attacks of joint inflammation, typically causing intense pain in one or more joints. It occurs due to the buildup of uric acid crystals in the joints, leading to intense pain, redness, swelling, and warmth. Gout often affects the big toe, but it can also go on to occur in other joints like the ankles, knees, elbows, and wrists.

• Vitamin D deficiency. Vitamin D is a fat-soluble multi-functional hormone that is essential for human health. Most of our vitamin D is generated from exposure to sunlight with the rest coming from our diet. A deficiency of vitamin D can cause symptoms such as fatigue and tiredness, muscle pain and weakness, and joint pain (which can be significant).

Other possible triggers for joint pain include the menopause - where lack of the hormone oestrogen can cause joint pain and stiffness - ankylosing spondylitis and fibromyalgia. Although many of these conditions can cause joint pain in younger people, there are also specific conditions that can cause joint pain in children and teenagers. These include:

• Osgood-Schlatter disease. This is commonly seen in teenagers, especially in those who do a lot of sports such as running or jumping. It causes pain and tenderness at the front of the knee, just below the kneecap.
• Juvenile idiopathic arthritis (JIA). This affects children under the age of 16 and is the commonest type of arthritis in children. It typically causes pain and inflammation in the joints of the hands, elbows, wrists, knees and ankles but can affect other parts of the body too. JIA used to be called ‘juvenile rheumatoid arthritis’ but this term is no longer used as we now know it is not simply a children’s version of adult rheumatoid arthritis.
• Henoch-Schonlein purpura (HSP) is a condition where blood vessels become inflamed and usually affects children between the ages of 2 and 10. Its cause is unknown but can be triggered by a viral infection, and is most common in the spring months. Typically causing a rash known as purpura it can also cause pain in any joint but especially the knees and ankles.

• ‘Growing pains’. These are common but are not in fact due to children growing, although their exact cause is unclear. This causes pain - typically in the legs - between areas of joints rather than in the joints themselves. Fortunately they are not serious and settle by themselves over time. If your child has hip pain, this should always be assessed by a healthcare professional as there are a number of conditions in children that can cause this. Some are harmless and settle by themselves over a few weeks - such as irritable hip - but others are potentially more serious. These include hip dysplasia (aged 0-3), Perthes’ disease (aged 4-8 and most commonly seen in boys) and a condition called slipped femoral epiphysis (aged 10-17).

Factors contributing to joint pain

Contributing factors to joint pain can vary depending on the individual and the specific condition, however some common factors include:

• Ageing - This is one of the biggest reasons for joint pain developing - as we age, the risk of experiencing joint pain increases. This is due to natural wear and tear on the joints over time. Conditions like osteoarthritis, which commonly affect older adults, can lead to joint pain and stiffness.
• Genetic predispositions - some people are born with genetic predispositions that mean they are more likely to develop certain conditions, such as rheumatoid arthritis. Genetics can also influence the individual’s susceptibility to joint pain and severity.
• Lifestyle and activity level - lack of regular exercise or engaging in excessive high-impact activities can weaken the muscles and put additional stress on the joints. For instance, it’s common to experience hip pain when driving if you commonly take long car journeys. Similarly, driving can cause ankle pain.
• Injuries and trauma - joint pain can result from acute injuries such as sprains, strains, fractures, or dislocations. These injuries can damage the structures within the joint, leading to pain and inflammation.
• Occupational hazards - individuals who perform physically demanding jobs or repetitive motions that strain the joints may be at a higher risk of developing joint pain over time.
• Infections - certain infections can target the joints and cause inflammation and pain. Examples include bacterial infections like septic arthritis and viral infections like viral arthritis.
• Hormonal changes - hormonal imbalances, such as those seen in menopause or certain endocrine disorders, can contribute to joint pain and increase the risk of conditions like osteoporosis.
• Diet and nutrition - certain dietary factors can play a role in joint pain. For example, a diet high in processed foods, sugar, and unhealthy fats may contribute to inflammation, exacerbating joint pain. Conversely, a diet rich in anti-inflammatory foods, such as fruits, vegetables, and omega-3 fatty acids, may help alleviate joint pain.
• Psychological factors - stress, anxiety, and depression can influence the perception of pain, including joint pain. Psychological factors can exacerbate the discomfort associated with joint conditions and impact overall well-being.

Symptoms of joint pain

Joint pain can present itself in various ways. Common symptoms include swelling, stiffness, tenderness, redness, and a limited range of motion. The severity and specific symptoms can vary depending on the underlying cause of joint pain. They can also differ from person to person, and depend on different factors such as the underlying cause, how long you've had the condition and individual lifestyle factors. It's important to remember that joint pain can have various causes, including injury, inflammation, degenerative conditions like osteoarthritis, autoimmune disorders, and infections.

Consulting a healthcare professional is crucial for an accurate diagnosis and appropriate management.

Joint pain treatment options

Joint pain can significantly impact daily life and hinder mobility. Fortunately, numerous treatment options are available to alleviate joint pain and improve overall quality of life.

Medications

Over-the-counter medication is commonly used to treat joint pain. Most joint pain can be relieved using non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen, which is typically used to alleviate early signs of joint pain relief.

NSAIDs are often taken as tablets but are also available in the form of pain relief gels, which help target the pain directly at the source. Common gels include Flexiseq and Voltarol. For those seeking relief for arthritic knees, explore our guide on the Best Creams for Arthritic Knees.

In severe cases, healthcare providers may prescribe stronger pain medications or corticosteroids to alleviate joint pain and inflammation.

Physical therapy

A physical therapist can design tailored exercises to strengthen muscles around the affected joint, improve flexibility, and reduce pain. They may suggest techniques like joint mobilisation, massage, or manipulation to alleviate pain, improve range of motion, and enhance joint function.

Lifestyle modifications

In some cases, lifestyle changes can help relieve joint pain. Maintaining a healthy weight reduces stress on joints, particularly weight-bearing ones like knees and hips. Additionally, engaging in activities such as swimming, cycling, or yoga helps maintain fitness while minimising joint strain. (Remember though that avoiding repetitive motions and using proper body mechanics can protect your joints from further damage.)

Assistive devices

Assistive devices, such as supportive braces, orthotics, and mobility aids, are commonly used to reduce joint pain. These provide stability and relieve pressure on the joint, promoting healing and reducing pain. For instance, knee supports are commonly worn by those experiencing knee joint pain.

Surgical and medical interventions

In more severe cases of joint pain, surgical intervention may be required. One intervention known as arthroscopy is a minimally invasive procedure used to diagnose and treat joint problems. It works by inserting a small camera into the joint and - if appropriate - allowing the joint to be cleaned or smoothed.. In more severe cases of joint damage, joint replacement surgery may be necessary to alleviate pain and restore function.

Joint pain can vary from being mildly annoying to causing severe pain that ruins your day-to-day life. It can sometimes go away on its own after a few weeks if it’s acute joint pain however in chronic cases of joint pain, it can last for several weeks or months. Whatever type of joint pain you have, it can sometimes be managed at home with medication and other simple first aid measures. You can start treating your joint pain by:

• Resting and elevating the injured joint on the onset of an acute injury. (It is important to avoid completely stopping moving it for too long though, or it will become stiffer.)
• Icing the area (be sure not to place ice directly on skin, use a towel to protect the skin) and compressing the injured leg or arm with an elastic bandage.
• Using painkillers such as anti-inflammatories to help ease joint pain.
• Losing weight if you’re classed as overweight as this can help to reduce the amount of pressure on your joints.
• Not carrying anything heavy while dealing with joint pain.

If you are suffering from pain then some painkillers and anti-inflammatories are a good next step.

Whether or not you should see your doctor about your joint pains depends on the severity of it and how it started.

You should seek medical attention (urgently if required) if:

• you have joint pain with redness, swelling and warmth around the painful joint
• you've had a significant injury, particularly if your joint looks abnormal or you are unable to use it
• you're in severe pain.
• the pain has lasted more than two weeks
• painkillers do not ease the pain
• you feel generally unwell and/or have a high temperature
• you have symptoms of weight loss or night sweats

If you have multiple joints that are painful, stiff and swollen, and any other symptoms like feeling very tired or low in energy, you should book an appointment with your doctor, so they can diagnose you properly and suggest the appropriate treatment that is needed.

Diagnosing joint pain involves getting an evaluation by a healthcare provider. This may include a physical examination, medical history review, imaging tests (such as X-rays or MRIs), and laboratory tests to rule out certain conditions. Early detection and diagnosis can help identify the root cause of joint pain and guide the treatment plan.

Your doctor will ask you about the symptoms related to your joint pain, your medical history, and any relevant family medical history.

They will then examine your joints, and if necessary may arrange some further tests such as blood tests to check things like your inflammatory marker levels. Your doctor may also arrange some imaging (X-ray, ultrasound) to further assess the affected joints.

Your doctor may also suggest injections if you don’t get pain relief using oral or topical medications. These are more specialist recommendation and would often require referral. Types of injections they may suggest include:

• Steroids: (possibly combined with local anaesthetics) may be injected into a joint every 3 to 4 months. Mostly done in cases of arthritis and tendinitis, steroid injections can mask injuries, which could potentially lead to overuse of the joint and further damage. While the treatments are effective, often the effects can be temporary.
• Platelet-rich plasma therapy: Platelet-rich plasma (PRP) is made using your own blood and then injected into the joint causing pain. Joints consist of a large number of platelets and proteins which have anti-inflammatory and immune-modulating effects.
• Prolotherapy: A series of injections into joints, ligaments, and tendons are done using an irritant (usually a sugar based solution). The goal is to stimulate local healing of injured tissues. This treatment could last several months.

What is the outcome of joint pain?

This depends on what is causing your joint pain. Fortunately, the majority of cases of joint pain gradually settle away without causing any long-term problems. If you have conditions such as rheumatoid arthritis or osteoarthritis, you may need long-term treatment as there may be problems with persisting joint discomfort and difficulty in moving the affected joint.

If you are needing some advice on joint pain, you can contact our friendly team today who will be happy to provide you with more support.

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