- 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 thigh bone and shin bone 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 causes and risks of the condition?
There are many possible causes of joint pain. The causes can be divided into categories:
- 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. Gonorrhea and syphilis, two sexually transmitted infections, can cause joint pain. Lyme disease, an infection that results from a tick bite, and other infections can also cause arthritis.
- autoimmune disorders, in which a person's body produces antibodies against its own tissues. These disorders include rheumatoid arthritis and systemic lupus erythematosus.
- 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 diarrhea or from chlamydia, a sexually transmitted infection.
- bone diseases, such as Paget's disease, which causes inflamed bones and bone tumors or cancer near joints.
- medications, such as penicillin or procainamide
- influenza (the "flu")
Other causes are also possible. In some cases, no cause can be found.
What can be done to prevent the condition?
Prevention is related to the cause of the joint pain. For example, practicing safer sex can reduce, but not eliminate, some joint pain resulting from sexually transmitted infections. Maintaining a normal weight can reduce the risk of joint damage. Avoiding injuries or certain medications can prevent joint pain from these causes. Many cases cannot be prevented.
How is the condition diagnosed?
In some cases, the cause of joint pain is obvious from the medical history and physical exam. In other cases, more tests may be needed, depending on the suspected cause. Blood tests are often used to help diagnose infections, autoimmune disorders, and metabolism problems. Joint X-rays of the affected area may also be helpful.
A joint aspiration can detect abnormal cells or deposits in the joints. 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 lab for further examination and testing. This procedure can be used to help diagnose septic arthritis, gout, pseudogout, and other conditions.
Long Term Effects
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
cancer affecting the bone may cause death. When the cause is injury or overuse, the joint pain may go away with rest 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 infection, is the cause, the infection may be contagious.
What are the treatments for the condition?
Pain medications, such as aspirin, acetaminophen (i.e., Tylenol), or nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen (i.e., Advil, Motrin) can be given to reduce pain. Splints and braces of various types can sometimes be used to help rest the joint. These may be the only treatments needed after an injury. Other treatments are directed at the cause of the joint pain. Infections may be treated with antibiotics.
Gout is often treated with medications such as allopurinol (i.e., Aloprim, Zyloprim) to help improve the metabolism. Autoimmune disorders can be treated with medications that suppress the immune system, such as prednisone. A person with severe osteoarthritis or a bone tumor may need surgery.
What are the side effects of the treatments?
Aspirin and nonsteroidal anti-inflammatory drugs, or NSAIDs, may cause stomach upset, ulcers, or allergic reactions. Because of the risk of Reye syndrome, aspirin should not be given to an individual under age 18 except under the supervision of a healthcare professional. Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic.
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
arthritis 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 healthcare professional. Other monitoring may be needed for the underlying cause of the joint pain. For example, someone who has cancer affecting the bone may need frequent visits to the healthcare professional for X-rays to check for the spread of the cancer.
Harrison's Principles of Internal Medicine, 1998, Fauci et al.