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Joint pain

Definition

Joint pain can affect one or more joints.

Alternative Names

Stiffness in a joint; Pain - joints; Arthralgia; Arthritis

Causes

Joint pain can be caused by many types of injuries or conditions. It may be linked to arthritis, bursitis, and muscle pain. No matter what causes it, joint pain can be very bothersome. Some things that can cause joint pain are:

• Autoimmune diseases such as rheumatoid arthritis and lupus
• Bursitis
• Chondromalacia patellae
• Crystals in the joint -- gout (especially found in the big toe) and CPPD arthritis (pseudogout)
• Infections caused by a virus
• Injury, such as a fracture
• Osteoarthritis
• Osteomyelitis (bone infection)
• Septic arthritis (joint infection)
• Tendinitis
• Unusual exertion or overuse, including strains or sprains

Signs of joint inflammation include:

• Swelling
• Warmth
• Tenderness
• Redness
• Pain with movement

Home Care

Follow your health care provider's advice for treating the cause of your pain.

For non-arthritic joint pain, both rest and exercise are important. Warm baths, massage, and stretching exercises should be used as often as possible.

Acetaminophen (Tylenol) may help the soreness feel better.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may help relieve pain and swelling. Talk to your provider before giving aspirin or NSAIDs such as ibuprofen to children.

When to Contact a Medical Professional

Contact your provider if:

• You have fever that is not associated with flu symptoms.
• You have lost 10 pounds (4.5 kilograms) or more without trying (unintended weight loss).
• Your joint pain lasts for more than several days.
• You have severe, unexplained joint pain and swelling, particularly if you have other unexplained symptoms.

What to Expect at Your Office Visit

Your provider will ask you questions about your medical history and symptoms, including:

• Which joint hurts? Is the pain on one side or both sides?
• What started the pain and how often have you had it? Have you had it before?
• Did this pain begin suddenly and severely, or slowly and mildly?
• Is the pain constant or does it come and go? Has the pain become more severe?
• Have you injured your joint?
• Have you had an illness, rash, or fever?
• Does resting or moving make the pain better or worse? Are certain positions more or less comfortable? Does keeping the joint elevated help?
• Do medicines, massage, or applying heat reduce the pain?
• What other symptoms do you have?
• Is there any numbness?
• Can you bend and straighten the joint? Does the joint feel stiff?
• Are your joints stiff in the morning? If so, for how long does the stiffness last?
• What makes the stiffness better?

A physical exam will be done to look for signs of joint abnormality including:

• Swelling
• Tenderness
• Warmth
• Pain with motion
• Abnormal motion such as limitation, loosening of the joint, grating sensation

Tests that may be done include:

• Complete blood count (CBC) or blood differential
• C-reactive protein
• Sedimentation rate
• Blood tests specific to various autoimmune disorders
• Joint aspiration to obtain joint fluid for culture, white cell count and examination for crystals
• Joint x-ray

Treatments may include:

• Medicines such as NSAIDs including ibuprofen, naproxen, or indomethacin
• Injection of a corticosteroid medicine into the joint
• Antibiotics and often surgical drainage, in case of infection (usually requires hospitalization)
• Physical therapy for muscle and joint rehabilitation

References

Bykerk VP, Crow MK. Approach to the patient with rheumatic disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 236.

Davis JM, Moder KG, Hunder GG. History and physical examination of the musculoskeletal system. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 43.

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