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Joint pain: causes, diagnosis, treatment, tips

by Josephine Andrews
Published: Last Updated on 285 views

Joint pain is common. Almost half (45 percent) of all people over the age of 45 suffer from painful joints. The knee joints are most commonly affected. Signs of wear and tear (wear and tear) usually trigger the pain, doctors then speak of arthrosis. Inflamed (arthritis) or injured joints are also often associated with painful symptoms. However, there are many other possible causes of joint pain. Here you can read everything you need to know about the causes and treatment of joint pain.

quick overview

  • Description : Joint pain can be very different, for example affecting only a single joint or several joints, only small joints (e.g. on the fingers) or large joints (e.g. hip joint). They can be acute or chronic. Sometimes they only occur at rest (rest pain) or at night (night pain).
  • Causes : e.g. joint wear and tear ( arthrosis ), bursitis (bursitis), bacterial joint inflammation (bacterial arthritis), rheumatoid arthritis, rheumatic fever , gout, accompanying joint inflammation during and after infections (such as Lyme disease), reactive arthritis (Reiter’s disease), psoriasis (psoriasis arthritis), ankylosing spondylitis, sarcoidosis , systemic lupus erythematosus, joint bleeding in coagulation disorders.
  • When to the doctor? Limited mobility of the painful joint, fever, reddened skin over the painful joint, swollen joint.
  • Diagnostics: Collection of the medical history (anamnesis), palpation of the painful joints, possibly further examinations such as orthopedic examination, dermatological examination, blood test, ultrasound , X- ray , joint puncture.
  • What you can do yourself : e.g. reduce excess weight, avoid one-sided strain, endurance training that is easy on the joints (such as swimming , cycling), moist and cooling compresses or heat applications, finger exercises in warmed sand (for arthrosis in the fingers), medicinal plants (e.g. as tea or ointment ), essential oils (for massage).

Joint pain: description

Joint pain can manifest itself in many different ways. Different criteria help to describe the symptoms more precisely.

Classification according to the onset of joint pain

  • Acute joint pain sets in within hours.
  • Subacute joint pain becomes noticeable within days.
  • Chronic joint pain lasts for weeks or months.

Classification according to the number of affected joints

  • Monoarticular joint pain affects only one joint.
  • Oligoarticular joint pain extends to two to four joints.
  • Polyarticular joint pain affects more than four joints.

Classification according to the pain rhythm

  • rest pain
  • night pain
  • Morning stiffness of the joints

Classification according to the distribution pattern

  • Joint pain in the small joints (like wrists, finger joints)
  • Joint pain in the large joints (e.g. knee and hip joint)
  • Joint pain in the finger joints

Classification according to pain intensity

The patient can rate the pain intensity using a scale from 0 (no pain) to 10 (unbearable, maximum pain).

Joint pain: Joints that are particularly frequently affected

Which joints are most frequently affected by joint pain depends crucially on the cause of the pain. Some examples:

Wear and tear (osteoarthritis) is the main cause of joint pain. It mainly affects those joints that are heavily loaded throughout life. These are the knee, hip and ankle joints. Osteoarthritis can also occur in all other joints.

Rheumatoid arthritis is another common cause of joint pain. The painful joint inflammation is mainly found in the hand and finger joints. Knee, elbow and shoulder pain as well as pain in the metatarsophalangeal joints are also common in rheumatoid arthritis.

In an acute attack of gout , the joints in the legs usually hurt, mainly in the metatarsophalangeal joint. However, ankle and knee joints can also be affected.

Inflammation of the bursa ( bursitis ) can cause hip, elbow, knee and shoulder pain in particular.

Joint pain: causes and symptoms

Joint pain can have very different causes. The most important are:

Joint wear (osteoarthritis of the joints)

Osteoarthritis is the most common joint disease. In principle, it can occur in all joints. The cartilage layer on the joint surfaces is increasingly destroyed – the adjacent bone areas change and the affected joint becomes less mobile. It becomes inflamed, swollen and painful.

Excessive joint wear usually occurs when the affected joints have been overloaded for a long time. Sometimes arthrosis is also the result of an accident, ligament damage or a congenital weakness or malformation of joints. Most wrist, hip and knee pain is caused by osteoarthritis.

Inflammation of the bursa (bursitis)

Bursae are found between bone and tissue in places that are particularly exposed to stress (eg, in the joints). They act as a kind of organic insulating material – they absorb pressure and thus protect the bones. Bursae consist of a cavity filled with synovial fluid. Inflammatory or mechanical irritation (e.g. in sports injuries) can inflame the bursa and cause pain in the region concerned.

Elbow pain is often caused by inflamed bursa in the elbow joint. Shoulder pain is often based on inflamed or calcified bursae in the shoulder region. Knee pain often originates from inflamed bursae in the knee joint and hip pain from inflamed bursae at the greater trochanter (bony prominence on the upper outer side of the thigh).

Bacterial joint inflammation (bacterial arthritis)

Bacterial joint inflammation primarily affects the knee and hip joints. The bacteria either enter the joint through the blood or infect the joint directly (either through injury or surgery to the joint, or through diagnostic injections into the joint). Possible signs of bacterial joint inflammation are intense knee or hip pain and fever. In addition, the joint area is swollen, reddened and locally overheated.

Borreliosis (Lyme arthritis)

The joint pain in Lyme disease is also based on bacterial joint inflammation. This is triggered by certain bacteria (Borrelia burgdorferi) that are transmitted to humans by ticks. About four weeks later, the typical symptoms such as tiredness , fever , reddened skin and joint pain appear.

Accompanying joint inflammation with and after infections

Inflammatory joint pain can also occur during and after general infectious diseases, such as hepatitis (inflammation of the liver), rubella, mumps, chickenpox, scarlet fever, tuberculosis, flu and chronic inflammatory bowel diseases (Crohn’s disease, ulcerative colitis). The large joints (hip, knee and ankle joints) are mainly affected. The symptoms subside spontaneously.

Joint inflammation in reactive arthritis

Reactive arthritis, also known as Reiter’s disease in the past, is a rare rheumatic disease. Symptoms include painful joint inflammation as well as urethritis and conjunctivitis.

Joint inflammation in psoriasis (psoriatic arthritis)

Psoriasis can be accompanied by joint pain caused by inflammation. Sometimes the joint pain also precedes the skin disease: the joint pain appears first and the scaly lesions develop later. Especially when finger and toe joints and/or the spine hurt, psoriatic arthritis can be the cause.

Joint inflammation in Bechterew’s disease

Morbus Bechterew is a chronic rheumatic inflammation. It primarily affects the spine, but can also spread to the large joints. Bechterew’s disease can therefore be the cause of knee, hip and heel pain and/or pain in the ankle joint.

Gout or acute gout attack

In gout, the concentration of uric acid in the blood is increased. The excess uric acid crystals are deposited in the joints, among other things – this leads to an acute attack of gout with severe joint pain, swollen and reddened joints. The metatarsophalangeal joint of the big toe is usually affected. But knee and wrist pain as well as pain in the finger joints or in the upper ankle can also be the underlying cause of an acute gout attack.

Rheumatoid arthritis

Rheumatoid arthritis is the most common inflammatory joint disease. It usually progresses chronically and gradually destroys the joints. Typical of this disease are painful, stiff fingers and wrists in the morning, joint swelling and the inability to make a fist.

Rheumatic fever

This inflammatory disease is caused by certain bacteria (streptococci) days to weeks after an untreated nasopharynx infection. Children are particularly often affected. In addition to joint pain, possible symptoms include skin symptoms, heart inflammation (carditis) and sudden, involuntary and uncontrolled movements (chorea minor).

Joint inflammation with sarcoidosis (Löfgren’s syndrome)

Sarcoidosis is a rare inflammatory disease of unknown cause that can affect the entire body. A special form of the disease is Löfgren’s syndrome (acute sarcoid). It mainly affects younger women. Symptoms include joint pain (especially around the ankles), acute inflammation of the subcutaneous fatty tissue (erythema nodosum), swelling of the lymph nodes in the lungs (bihilar lymphadenopathy) and weight loss .

Systemic lupus erythematosus (SLE, butterfly lichen)

This rare autoimmune disease develops primarily in women. It often triggers joint pain and inflammation. Many other symptoms can also occur, such as a butterfly-shaped rash on the face, inflammation of the pleura, pericardium, kidneys or brain, as well as loss of appetite and weight loss. Lupus erythematosus is therefore also called the “chameleon” of medicine.

Joint bleeding in coagulation disorders

People with the rare bleeding disorder (hemophilia) tend to have uncontrollable bleeding – both after injury and spontaneously without an external cause. The bleeding occurs particularly in the muscles and joints. Bleeding in the joints can cause pain and, if left untreated, can cause lasting damage to the joint.

In addition to hemophilia, other coagulation disorders can also lead to joint bleeding and pain. This can happen, for example, if someone takes an overdose of anticoagulants.

A disease or a pathological tissue change is not always responsible for joint pain. Doctors then speak of “joint sensitivity”.

Joint Pain: When Should You See a Doctor?

Joint pain sometimes goes away on its own or can be alleviated with simple home remedies. However, you should be careful if you have the following symptoms:

  • Joint pain that limits mobility of the joint
  • Fever
  • red skin over the painful joint
  • swollen joint

If these symptoms last longer than three days, worsen or spread to other joints, you should definitely consult a doctor!

Joint pain: what does the doctor do?

First, the doctor will ask you about your medical history (anamnesis). This involves, for example, when and where the joint pain occurs and whether you suffer from other symptoms (such as fever or joint swelling).

Accurate description of the joint pain

The more precisely you can describe your joint pain, the better the doctor can narrow down the possible causes. An acute attack of gout, for example, is an obvious cause of pain if the joint pain only occurs in one joint. In the case of rheumatoid arthritis, on the other hand, the joint pain manifests itself in several joints.

The location (location) of the joint pain is also revealing: If you have wrist pain or pain in the metatarsophalangeal and medial joints of your fingers, you probably have rheumatoid arthritis. If, on the other hand, the joint pain affects the metacarpophalangeal joint and the end joints of the fingers, arthrosis is more likely to be assumed.

palpation

It doesn’t matter where the joint pain occurs – the doctor has to clarify whether the pain really comes from the joints, from areas close to the joint or from the neighboring bones. He can sometimes find this out by palpating the painful region. However, further examinations such as X-rays or ultrasound are often necessary.

Further investigations into joint pain

  • Orthopedic examination: If there is a suspicion that the joint pain is caused by wear and tear (arthrosis), bursitis, rheumatic fever or an acute attack of gout, an orthopedic examination can bring certainty.
  • Dermatological examination: Skin examinations help to identify psoriatic arthritis or sarcoid as a possible cause of the joint pain.
  • Blood tests: Various triggers can be detected on the basis of blood samples, for example bacterial joint inflammation or Lyme disease. The doctor can also recognize a disturbed blood coagulation in the blood count. The rheumatoid factor and other signs of inflammation in the blood provide information about a possible existing rheumatoid arthritis. If gout is suspected, the focus is on the uric acid level in the blood.
  • Ultrasound scan: This is helpful when bursitis, gout, or systemic lupus erythematosus could be causing the joint pain.
  • X- ray: X-rays show evidence of joint wear and tear (arthrosis), rheumatoid arthritis and Bechterew’s disease.
  • Joint puncture: If the doctor suspects bacterial joint inflammation, he takes a sample of the synovial fluid (joint puncture) and uses it to create a bacterial culture: If bacteria can be cultivated from this, this indicates bacterial joint inflammation.

Once the cause of the joint pain has been found, the doctor can initiate appropriate treatment. Rheumatoid arthritis, for example, is treated with various drugs. Medication can also alleviate the symptoms of joint wear and tear (arthrosis). In advanced cases, an operation can also be useful (insertion of an artificial joint).

Joint pain: you can do it yourself

General tips for joint pain

  • Lose excess weight . Every excess kilo puts additional strain on the joints – they wear out faster, which inevitably leads to joint pain.
  • Do endurance training regularly to strengthen muscles and joint cartilage. Swimming and cycling, for example, are particularly easy on the joints .
  • Regular strength training (such as weight lifting and jumping rope) is also recommended. Let an experienced trainer or sports doctor develop a balanced training program that strengthens all muscles equally.
  • Take enough breaks when exercising .
  • Avoid one-sided loads such as carrying heavy shoulder bags.
  • Reduce mental stress – mental stress can also manifest itself in the form of joint pain. Therefore, ensure a balance , for example through autogenic training or progressive muscle relaxation according to Jacobson.
  • Get acupuncture treatment for aching joints .

These and subsequent measures can supplement conventional medical treatment at best, but cannot replace it. Talk to your doctor about how you can best support the therapy yourself.

Tips for joint wear and tear (arthrosis)

How you help yourself with osteoarthritis depends in part on whether you’re having an inflammatory flare-up (activated arthritis) or not (non-activated arthritis).

Tips for activated arthrosis

“Activated arthrosis” is what doctors mean by current severe joint inflammation with joint pain, swelling and redness. In this case, you should immobilize the affected joint (bed rest). Position it so that the associated muscles are relaxed. Moist and cooling compresses (e.g. quark wraps or quark compresses) can also relieve joint pain.

You can support the effect of the anti-inflammatory and pain-relieving medication that you receive from the doctor with the help of medicinal plants. Arnica, for example, is well suited (as a tea for compresses or as an ointment or gel for rubbing into the joints). There are also anti-inflammatory and analgesic ready-made preparations based on willow bark and combination preparations with oils from rosemary and eucalyptus leaves . In addition, cooling peppermint oil can have a pain-relieving effect.

Note that medicinal plants can also lead to side effects or drug interactions. It is therefore essential to find out beforehand from your doctor or pharmacist about possible side effects and interactions of the medicinal plant.

Tips for non-activated arthrosis

When pain, redness and swelling have subsided, this is referred to as non-activated arthrosis. Then it is a matter of preventing a renewed activation of the joint problems. Sufficient sleep on an orthopedic mattress helps here, as the muscles relax and the spine and joints are relieved.

A tea made from devil’s claw root is also recommended for non-activated arthrosis: Pour two cups of boiling water over a tablespoon of the powdered root and let the tea steep for eight hours. Briefly boil the drink before drinking and then strain it. You drink the tea for three days at a time. After about three weeks, it unfolds its effect.

In the case of non-activated arthrosis, you can also prepare a tea mixture of currant leaves, willow bark, nettle herb, field horsetail and meadowsweet blossoms (20 g each). Take two teaspoons of this mixture and pour over one cup of boiling water. Boil for half an hour, then strain. Drink five to six cups of this tea throughout the day. It has an anti-inflammatory effect and relieves joint pain.

General tips for osteoarthritis

  • Relaxation : Regular meditative relaxation methods such as progressive muscle relaxation or autogenic training can help if you often suffer from stress-related muscle tension.
  • Sport and exercise : Physical activity helps to supply the articular cartilage with synovial fluid and nutrients. Swimming, cycling and water aerobics are particularly easy on the joints. However, you should avoid jogging on hard asphalt. This is especially true if your knee or hip joints are already damaged by osteoarthritis. If you don’t want to give up running, you should prefer soft forest soil and wear well-cushioned running shoes that absorb shock. Better yet, walk instead of jogging. Avoid sports with sudden changes of direction, such as tennis and squash. These put a lot of strain on the joints and then quickly trigger joint pain.
  • no long standing or sitting : Avoid standing or sitting in an unchanged position for a long time.
  • low in arachidonic acid : Eat a diet low in arachidonic acid. This omega-6 fatty acid can promote osteoarthritis-related joint inflammation. Examples of fatty pork, egg yolk, lard, tuna, liverwurst, beef, and camembert contain arachidonic acid.
  • lots of omega-3 : Consume omega-3 fatty acids regularly . They neutralize the arachidonic acid. Larger amounts are found in fish oil. That’s why fish should be on your menu at least once a week.
  • Sufficient vitamin E : Make sure you have a sufficient supply of vitamin E. It is important for the “joint lubrication” and thanks to its antioxidant effect it helps against inflammation. Vitamin E is found in vegetable oils, especially wheat germ, soy germ and sunflower seed oil.
  • Heat : Arthrosis-related joint pain and other joint complaints can be relieved with heat, for example with the help of fango packs, moor, hay flower and rosemary baths.
  • Kneading : Kneading clay or loam at body temperature can help with arthrosis in the finger joints against joint pain and swelling. Regular finger exercises in warm sand are also highly recommended. This is particularly good for joint stiffness and joint pain in the morning.
  • Essential Oils : Massage in essential oils of eucalyptus, juniper , rosemary, lavender or lemon . This promotes blood circulation and can help fight joint inflammation. However, you must not apply the essential oils directly to the skin, but first dilute them in a carrier oil (e.g. almond oil or jojoba oil).
  • Stimulus therapies : Stimulator therapies that stimulate circulation, such as dry cupping or leech therapy, are said to help with arthrosis. The latter also has an anti-inflammatory effect.

Autologous blood treatments are controversial, especially if the treated fluid is injected into the joint (risk of infection!).

Tips for Rheumatoid Arthritis

Some tips for osteoarthritis can also help with rheumatoid arthritis. The recommendations for nutrition, the external use of arnica and the preparation of devil’s claw root tea apply to both diseases. But there are other tips for rheumatism-related joint pain and other joint problems:

  • Keeping the joint flexible : In the case of minor symptoms (non-activated rheumatoid arthritis), you can keep the joint flexible with physiotherapy and massage.
  • Tea blend for inflammatory flare-ups: During an inflammatory flare-up (activated rheumatoid arthritis), an anti-inflammatory tea blend made from meadowsweet flowers, willow bark, goldenrod herb, currant herb and nettle herb (20 g each) can help. To do this, pour a tablespoon of the mixture into a cup of cold water and let it steep for an hour. Then heat until just before boiling (do not let it boil!) and immediately remove from the stove. Let steep again for five to ten minutes, then strain. Drink three to four cups a day.
  • Bromelain : Protein-degrading enzymes such as bromelain are said to help with acute joint inflammation.
  • Tai Chi and Qi Gong : These holistic Chinese sports are highly recommended for rheumatic diseases such as rheumatoid arthritis. Studies show that they can have a positive effect on mobility, muscle strength, endurance, quality of life and mood of the patient.
  • Cold or heat : Joint pain caused by inflammation can be relieved with cold and heat – just test which one is more comfortable for you. In principle, cold is recommended for acute joint inflammation in order to stop the inflammation. In the case of chronic complaints, however, heat is usually more pleasant. Warming baths (e.g. with hay flowers), fango packs or moor applications are beneficial.
  • Herbal healing powers for rubbing in : Creams and ointments with willow bark, rosemary or eucalyptus oil and peppermint oil also have an anti-inflammatory and pain-relieving effect.
  • Ayurveda : Ayurveda therapists recommend cleansing cures (panchakarma cures) for rheumatic diseases in order to remove waste products (ama) from the body. According to this teaching, Ama accumulations are considered to be the cause of the disease. Indian frankincense (shallaki) and triphala (herb mixture) are used for acute joint inflammation with joint pain. Both have strong anti-inflammatory effects.

Alternative medical methods and home remedies can at best supplement conventional medical treatment, but cannot replace it. Be sure to talk to your doctor beforehand about whether these methods are right for you and whether you can use them safely.

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