Joint Pain

Joint pain can be due to any number of causes, from injuries, to medical conditions. Generally, joint pain is a dull pain which cannot be pin-pointed to a specific area.Joint pain is most common in the hips and knees. Pain which is localised to one joint is usually a specific condition or injury at the joint in question. Multiple joint pain should be investigated for more systemic (whole body) conditions.

Here are some of the more common causes of joint pain:

Arthritis

Rheumatoid arthritis

This is one of the most common forms of arthritis and affects around 1 in every 100 people. Rheumatoid arthritis is caused by a reaction of the nervous system, to a non-existent stimulus. That is, the immune system starts attacking the joints and other parts of the body, although no threat is present.

This form of arthritis results in inflammation of the tendons, synovial sheaths and bursae (sacks of fluid which allow smooth movement of muscles/tendons over bone). Flare-ups usually occur, where the symptoms are exacerbated for a period of time. During a flare-up, joints will become stiff, swollen, red and painful. The small joints of your fingers, hands, wrists, feet and ankles are most commonly affected.

 

Osteoarthritis

Osteoarthritis is the most common form of arthritis. It affects the cartilage and adjacent bone surfaces within a joint. It is sometimes referred to as 'wear and tear' arthritis.

The cartilage in weight bearing joints (most often the knee and hip) becomes damaged and worn away. The exact reason for this is unknown, although there are some predisposing factors such as age, weight and previous injuries:

The symptoms of OA include pain, stiffness and reduced movement at the joint. It is usually worse in the morning and improves within an hour or so. Inflammation and swelling sometimes also occur.

Gout

Gout is a form of arthritis caused by a build up of uric acid within the body. Uric acid is a waste product of metabolism (breaking down food to make energy) which is usually excreted by the kidneys. Problems with the function of the kidneys, or high production of uric acid may mean that crystals develop within the joints which cause pain and inflammation.

Gout most commonly presents in the big toe, but also the heels, ankles, knees, elbows, wrists or fingers.

Injuries

Injury to any of the structures in the joint may cause pain, although often the pain is quite local and can be pinpointed to roughly the location of the structure (for example on the inside of the knee for a medial ligament injury). However, some injuries, generally those to deeper structures, can cause a more widespread joint pain.

For the knee, these include:

For the hip, these may include:

Medical Conditions

Osteomyelitis

Osteomyelitis is an infection inside a bone. It's usually a bacterial infection but can also be a fungal infection.

There are three main types of osteomyelitis. The condition can be classed as acute, sub-acute or chronic depending on the time frame between the initial infection or injury and the bone infection developing. This can be two months or more in chronic cases.

Osteomyelitis can be successfully treated using antibiotics or, when appropriate, anti-fungal medicines. More severe cases, may require surgery to remove diseased bone and tissue.

Osteochondritis dissecans

Osteochondritis dissecans is a joint condition where part of the bone and attached cartilage loses its blood supply and becomes unattached from the rest of the bone. Common symptoms include pain and locking at the joint, making it difficult to move the joint in its full range of motion. Most commonly the knees and elbows are affected. Depending on the extent of the symptoms, arthroscopic knee surgery may be offered.

Paget's disease

Paget's disease is a chronic condition which results in enlarged, deformed, weakened bones. This is caused by a breakdown and re-growth of bone tissue. This causes bone pain, joint pain, arthritis, deformities, cartilage damage and fractures.

Paget’s disease most commonly affects the leg bones, pelvis, vertebrae, clavicle (collarbone), and humerus (upper arm bone). Pain is most frequent in the hip joint due to problems with the pelvis and leg bones.

The condition is thought to be caused by a slowly progressive infection. This infection may be present for many years before any symptoms appear.

Whilst there is no cure for the condition, treatment is aimed at slowing the disease progression and reducing symptoms. This is usually achieved with medicines called Biphosphonates.

Ankylosing Spondylitis

Ankylosing Spondylitis is a form of chronic, degenerative arthritis that affects the spine and sacroiliac joints and often other joints of the body.

Symptoms of ankylosing spondylitis may initially be limited to lower back or joint aching, which is often just put down to 'aches and pains' and 'growing pains' in young people. Symptoms come and go and will usually progress to include the following:

  • Stiffness and pain in the morning affecting the sacroiliac joint area and spine
  • Pain radiating down the legs and into the groin
  • Pain is worse during and after rest e.g. in the mornings. Exercise eases the pain and stiffness
  • Aches and pains in the buttocks, neck, shoulders, hips and upper back

Tumors

A tumor near a joint can result in pain at the joint. Tumors can be either bone or soft tissue in nature.