joint pain Images (Click to view larger image)
arthralgia, pain in the joints
Joint pain is a common symptom with many possible causes.
What is going on in the body?
A joint is the place where two bones come together. For example, the knee joint is the place where the thighbone and shinbone meet. Most people have one or more sore joints at some point in their lives. The joints of the arms and legs are most commonly affected.
What are the signs and symptoms of the condition?
When someone reports joint pain, the doctor will need more information about the pain. Questions may be asked about:
Other questions may also be asked in some settings.
- the exact location of the pain
- when the pain started
- if more than one joint is involved
- whether the pain is constant, or comes and goes
- whether the pain is made worse or better with activity
- if the joint has been hot, red, or swollen
- any family history of joint problems
- if the pain limits motion in the affected joint
- any other symptoms
- what medications or drugs the person takes
- what other medical conditions the person has
What are the causes and risks of the condition?
There are many possible causes of joint pain. The causes can be divided into categories:
Other causes are also possible. In some cases, no cause can be found.
- wear and tear, such as from overuse, injury, or osteoarthritis. Osteoarthritis is the most common form of arthritis, or joint inflammation.
- conditions that affect metabolism, such as gout and pseudogout. These conditions result from materials being deposited into the joints.
- infections of the joint, sometimes called septic arthritis. Infections usually spread to the joint from other areas of the body. Gonorrhoea and syphilis, two sexually transmitted diseases, can cause joint pain. Lyme disease, an infection caught from a tick bite, and other infections can also cause arthritis.
- autoimmune disorders, in which the immune system attacks the person's own body. These disorders include rheumatoid arthritis and systemic lupus erythematosus. Psoriasis, a disorder of the skin, and inflammatory bowel disease, are other autoimmune disorders.
- reactive arthritis, which means joint pain and inflammation caused by infections in other areas of the body. This type of joint pain can result from infectious diarrhoea or the sexually transmitted disease chlamydia.
- bone diseases, such as Paget's disease. This condition causes inflamed bones and bone tumours or cancer near joints.
- medications, such as penicillin or procainamide
- malaise, or just not feeling well, from conditions like the flu
What can be done to prevent the condition?
Prevention is related to the cause of the joint pain. For example, practicing safer sex can prevent some joint pain due to sexually transmitted diseases. Avoiding injuries or certain medications can prevent joint pain from these causes. Many cases cannot be prevented.
How is the condition diagnosed?
Diagnosis of the cause of joint pain starts with a history and physical examination. This may be all that is needed to make the diagnosis in some cases. In other cases, more tests may be needed. Different tests may be ordered, depending on the suspected cause.
Blood tests are often used to help diagnose infections, autoimmune conditions, and metabolism problems. Joint x-rays of the affected joint are also common.
A procedure called arthrocentesis may be needed in some cases. A needle is inserted through the skin and into the affected joint. A sample of joint fluid is then removed with the needle. The fluid can be sent to the laboratory for further examination and testing. This procedure can be used to help diagnose septic arthritis, gout, pseudogout, and other conditions.
What are the long-term effects of the condition?
If joint pain is severe, it can limit the person's ability to perform basic activities. Other long-term effects are related to the cause. For example, a bone cancer may cause death. When the cause is injury or overuse, the joint pain may go away and have no long-term effects.
What are the risks to others?
Joint pain is not contagious. But if an infection, such as a sexually transmitted disease, is the cause, the infection may be contagious.
What are the treatments for the condition?
Analgesics such as aspirin or paracetamol can be given to reduce pain. This may be the only treatment needed after an injury, for example.
Other treatments are directed at the cause of the joint pain. Infections may be treated with antibiotics. Gout is often treated with medications like allopurinol to help improve the metabolism. Autoimmune conditions can be treated with medications that suppress the immune system, such as prednisone. A person with severe osteoarthritis or a bone tumour may need surgery.
What are the side effects of the treatments?
Side effects depend on the treatments used for the joint pain. All medications have possible side effects. For example, aspirin may cause stomach upset, ulcers, or kidney damage. Any surgery carries a risk of bleeding, infection, and allergic reaction to the anaesthesia.
What happens after treatment for the condition?
If the joint pain is caused by a medication, the pain may go away as soon as the medication is stopped. In these cases, a person can return to normal activities when he or she is able. Someone with osteoarthritis or gout often needs lifelong treatment for flare-ups of joint pain.
How is the condition monitored?
A person with joint pain can usually monitor the pain at home. Any new or worsening symptoms should be reported to the doctor. Other monitoring may be needed for the underlying cause of the joint pain. For example, someone with bone cancer may need frequented visits to the doctor and repeated x-rays.
Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request