Joint Pain

Joint pain involves pain in the areas where bones meet up with one another, such as in the knees or shoulders.  The human body contains over 300 joints; in fact, each hand has 29 major joints, each hand has 29 major joints. The Centers for Disease Control (CDC) surveyed a national incidence of 33% with regard to joint pain in adults. Advancing age is a risk factor for the development of joint pain.

Many different conditions can lead to painful joints, including osteoarthritis, rheumatoid arthritis, bursitis, gout, strains, sprains, and other injuries. Joint pain is extremely common. In one national survey, about one-third of adults reported having joint pain within the past 30 days. Knee pain was the most common complaint, followed by shoulder and hip pain, but joint pain can affect any part of your body, from your ankles and feet to your shoulders and hands. As you get older, painful joints become increasingly more common.

Joint pain can range from mildly irritating to debilitating. It may go away after a few weeks (acute), or last for several weeks or months (chronic). Even short-term pain and swelling in the joints can affect your quality of life.

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Causes of Joint Pain

Joint pain can be rooted in a multitude of circumstances.

Osteoarthritis, the most prevalent type of arthritis, can cause joint pain as a consequence of years of overuse or injuries. Inflammation in the joints leads to the disintegration of cartilaginous surfaces, and ultimately joint pain. On X-rays, the visualization of bone grinding on bone marks the tail end of disease. This event may spur an evaluation for a joint replacement.

Autoimmune diseases, like systemic lupus erythematosus and rheumatoid arthritis, cause joint pain as a consequence of a defective immune system invading and destroying one’s own joints. Rheumatoid arthritis is more common in women and can lead to joint erosions and deformities. Systemic lupus erythematosus tends to be relapsing with exacerbations that range from mild to life-threatening. In the U. S., approximately 1.5 million are afflicted with systemic lupus erythematosus.

Bursitis is another cause of joint pain that involves inflammation of small sacs of fluid, or bursa, in the vicinity of joints. Joint pain can involve large joints, including the knee, shoulder, elbow, and hip. Trauma, infection, and overburdened joints can be the culprits of this disease.

Gout, or podagra, can also cause joint pain. The disease is ancient and has been traced as far back as Greek civilization. It was once hailed a “disease of kings.” The cause is excessive amounts of uric acid in the blood, forming crystals that are irritating to joints. The joints of the first toe are most commonly affected. Joint pain is accompanied by redness, tenderness, and warmth in the afflicted joint.

Tendinitis involves inflammation of fibrous connective tissue attaching muscle to bone, or tendons. Many activities can be causative in the development of tendinitis, including gardening, skiing, golfing, and tennis. These activities usually involve repetitive motion or minor to major impact on the affected joint. Limiting force and repetition can be used in the management and prevention of this disease. Tendinitis can occur in large and small joints of the upper and lower extremities.

Infections can also cause joint pain. Some examples are:

  • Gonorrhea
  • Lyme disease
  • Hepatitis
  • Tuberculosis (TB)

Alarming symptoms that can be associated with joint pain include fever, significant unintentional weight loss, duration of pain greater than three days, and severe pain with unfamiliar symptoms.

Treatments For Joint Pain

Managing joint pain encompasses pain relief, restoration of function, and prevention of permanent damage. Pharmacological interventions include acetaminophen (Tylenol) for mild symptoms. Capsaicin is a topical agent also helpful with mild joint pain. Aspirin, a salicylate, is another agent that can be utilized for mild joint pain.

For moderate to severe joint pain, anti-inflammatory agents are indicated. Over-the-counter preparations utilized are ibuprofen (Motrin or Advil) and naproxen (Aleve). Prescription non-steroidal anti-inflammatory drugs include oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril). Side effects of this group of medications include stomach pain, diarrhea, nausea, and vomiting. Serious side effects can be liver problems, kidney problems, anemia, heart attack, and stroke.

Prednisone, an oral corticosteroid, can also be utilized to treat severe joint pain. It drastically reduces inflammation. Oral corticosteroids are not indicated for long-term treatment of joint pain. Hydrocodone and oxycodone with or without acetaminophen (Tylenol) can also be used in the management of severe joint pain. Their main target is pain. Oral narcotics should be used with caution as long-term use can lead to abuse and addiction.

Joint injections with corticosteroids and hyaluronan (Synvisc) can also be used for joint pain. Injection corticosteroids mainly target inflammation. Hyaluronan mimics biological synovial fluid found in joints. No greater than three injections per year should be given with these agents.

Chondroitin and glucosamine have provided relief for some with joint pain. These are over-the-counter supplements and are considered alternative therapies. They are components of natural cartilage. They are available in a variety of forms and have no adverse effects.

Non-drug treatment of joint pain can include physical therapy (PT). PT modalities include ultrasound, cryotherapy, heat therapy, and nerve stimulation. Joint stability, power, and flexibility can be re-established with physical therapy. Weight loss can be achieved with low-impact exercise, which can relieve stress on overburdened joints.

Lastly, those with joint pain as a result of end-stage osteoarthritis are candidates for joint replacement. Shoulders, knees, and hips are commonly replaced. Surgery on these joints can relieve pain and restore function.