What is joint pain?

Who has not had some form of joint ache or pain in their lives? Not many. It is an ‘ache’ that arises from a single or multiple joints. Medically, it is called ‘arthralgia’, which is different to ‘arthritis’ as the latter is inflammation of the joint.  Joint pain can occur with or without inflammation. Please use this article as a guide to your symptoms and seek medical/expert help.

What are the causes of joint pain?

This is a very common problem with many causes, usually due to injury (sports injury or a fall/accident for example) or a type of arthritis and other musculoskeletal disorders. Pain can affect just one joint or many joints.  Looking for a pattern helps to diagnose the underlying cause. Some joint pain may result due to a medical emergency.

Please go to your local Urgent Care Centre or Accident & Emergency for the following issues:

  • Broken bone or fracture
  • Infection in the joint (red, hot, swollen joint/s) – medically called ‘septic arthritis’
  • If you are thought to have an inflammatory arthritis, which includes a condition called ‘Rheumatoid Arthritis’
  • A fall or injury causing sudden severe back pain, especially in the elderly, when there is a risk of compressing or damaging the nerves

Pain in a single joint

Neck pain

  • Can be as a result of osteoarthritis, which is general wear and tear of the joint due to use or over use.

Shoulder pain 

  • Injury including dislocation, or inflammation of the surrounding muscles, tendon, or ligaments.
  • ‘Frozen Shoulder’ or ‘Adhesive Capsulitis’ can occur where the shoulder becomes painful and stiff

Elbow pain

  • A direct injury due to any form of trauma or infection from a wound nearby wound. 
  • Tennis or Golfer’s elbow – due to a repetitive/overuse strain injury causing damage to tendons around the elbow.

Back pain

  • Poor posture.
  • Trauma or injury causing muscle spasm or a prolapsed disc.
  • Osteoporosis (‘thinning of the bones’).
  • Referred pain from the hip or neck for example.

Hip pain

  • Osteoarthritis.
  • Infection.
  • Referred pain from the back. 

Knee pain

  • Probably the most common and frequently damaged large joint in the body.
  • Pain can also be referred from the back, hips, or calves. 
  • It can also be due to infections or inflammation. 
  • Bleeding in to the joint can cause pain, so if you are on medication to thin the blood (Aspirin, Clopidogrel, Warfarin, NOAC/DOAC) and have any injury, please seek help urgently.

Foot and Ankle pain

  • Ankle sprains
  • Inflammation due to gout or pseudogout – these are inflammatory conditions that can cause the skin over the big toe, ankle, knee, elbow, wrist, finger for example, to become red, hot, and possibly swollen. Please seek help if you think you have these conditions.

Pain in multiple joints

General infections in the body 

Flu symptoms with a raised temperature can cause whole body aches. Sexually transmitted infections, like Chlamydia and Gonorrhoea, can also result in a condition called ‘Reactive Arthritis’. More serious tropical infections such as Dengue, Chikungunya, Zika along with others such as Lyme’s disease and Hepatitis, will also cause whole body aches. 

Fibromyalgia

This is pain coming from the muscles, tendons, and ligaments. It is a chronic condition with no obvious known cause and difficult to manage as a result. Usually, a specialist referral to a rheumatologist is required.

Osteoarthritis

This is caused by general ‘wear and tear’ of the joint due to repetitive movements, weight bearing joints like hips and knees. It is the most common type of ‘arthritis’ in the UK and can be well managed through the appropriate treatments.

Rheumatoid Arthritis

Rheumatoid arthritis causes painful, swollen, and stiff smaller joints (fingers, thumbs, wrists, ankles, and toes), which tend to be worse in the mornings. The joints can be destroyed over time, so specialist referral to a rheumatologist is required. 

Psoriatic Arthritis

Similar to Rheumatoid Arthritis but occurs in some people who also have a skin condition called ‘Psoriasis’

Vitamin D deficiency

This has been all the hype over the last few years but as it plays an important role in keeping your bones healthy it can cause joint pain when you are severely deficient. If you’re worried this may be the cause, speak to your GP or have a simple blood test to measure your vitamin D levels.

Connective Tissue Disorders 

This include conditions such as Lupus, Scleroderma, and Ehlers-Danlos Syndrome, which can be extremely debilitating if not managed adequately. 

Rare causes

All of the above can be caused by bone cancers or tumours, Leukaemia, and pain from other infections including Lyme disease. However, this being the cause of your joint paint is very rare.

Joint pain in children and young adults

This can be as simple as ‘growing pains’, which are aches in legs and settle down with time and Osgood-Schlatter disease, which can cause knee pain especially in teenagers who do sport, or more serious conditions like Henoch-Schönlein purpura, which can cause symptoms including a skin rash, abdominal pain, and joint pain in children, and Juvenile idiopathic arthritis, which causes joint inflammation in those under the age of 16 years.

What is the treatment for joint pain?

Treatment is usually down to managing the symptoms and causes. A simple sprain or repetitive strain injury can be self-managed with ‘RICE’ – rest, ice, elevation, and compression.

Over-the-counter pain relief medication like Paracetamol and Ibuprofen can be used.  Ibuprofen or other non-steroidal anti-inflammatory medication can also be used in the form of creams or gels superficially over the joint.  Please check with the pharmacist before using any of these medications.

Steroid joint injections can have a short to medium-term beneficial effect for those patients with Osteoarthritis.

Physiotherapy is a great way to manage simple joint and muscle strains.  Our doctors can provide you with a physiotherapy referral at any of our London Doctors Clinic, or by video appointment.

Other conditions mostly need GP or specialist assessments, investigations, and either medical or surgical interventions, so please seek advice.

How to avoid joint pain or injuries?

Early self-care for simple strains and inflammation of the joints. If you notice any worrying symptoms, please seek help early and follow the advice given by your GP, Physiotherapist, and Specialist.

  • When exercising or doing sport – stretch, warm up and cool down, focus on technique, get good sports gear, rest between training, avoid doing too much too soon, have a balanced training schedule (e.g. cardiovascular and core body training, flexibility, resistance, and nutrition to name a few), hydrate well and stay healthy throughout, avoid training/exercising with pain.
  • Do not forget the mental stress that comes with competitive sports and marathon/ultra-marathon participation.
  • Finally, seek GP and specialist help early.

How can London Doctors Clinic help you?

We are private general practice clinic based in convenient locations within central London providing multiple services. From general practice with walk in clinic same day appointments, through to diagnostics and same-day blood tests with results sent via email. We have access to referring you to local same-day X-ray service and other imaging departments and we can refer you to see a Rheumatologist or Orthopaedic Surgeon as well. Should you be unfortunate enough to have to miss work, university, or school, we can assess you and offer an appropriate Medical Certificate or Sick Note.

Joint pain can be simple or complex it is always best not wait for things to get worse.  Come and see us for an early assessment to make sure 

 

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Article written by Dr Tashiya A Mirando, General Practitioner

Published: November 2018

Review date: November 2021