What Is Joint Pain?

Joint pain explained by San Antonio, Austin, Houston, Dallas Texas top pain doctors

Joint pain involves pain in the areas where bones meet up with one another, such as in the knees or shoulders. The malady is prevalent in the general population, affecting the young and old. In the last month, 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.

Joint pain manifestations are diverse. The condition can involve joints large and small. The symptoms can wax and wane for short periods of time in some, and long periods of time in others. Swelling and inflexibility may accompany joint pain. The affect of joint pain on quality of life can be minor to debilitating.

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 

Joint PainManaging 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.

Conclusion

Joint pain is common and can lead to decreased enjoyment of life. The causes of joint paint are many. Management of joint pain requires a multidisciplinary approach. Modalities can include conservative and not so conservative measures. Any plan of treatment for joint pain should be supervised by a competent medical professional to ensure maximum results.

At Texas Pain our goal is to relieve your pain and improve function to increase your quality of life.
Give us a call today at 713-458-4530.

References

  1. Arend WP, Lawry GV. Approach to the patient with rheumatic disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th Philadelphia, PA: Saunders Elsevier; 2011:chap 264.
  2. Ayral X. Injections in the treatment of osteoarthritis. Best Pract Res Clin Rheumatol. 2001;15(4):609-26.
  3. QuickStats: Percentage of adults reporting joint pain or stiffness. National Health Interview Survey. 2006: United States.
  4. Martin TJ, Eisenach JC. Pharmacology of opioid and non-opioid analgesics in chronic pain states. J Pharmacol Exp Ther. 2001;299(3):811-7.
  5. Schaible HG, Eberseberger A, Von Banchet GS. Mechanisms of pain in arthritis. Ann NY Acad Sci. 2002;966:343-54.
  6. Sluka KA. Pain mechanisms involved in musculoskeletal disorders. J Orthop Sports Phys Ther. 1996;24(4):240-54.