Joint pain

Joint pain can arise from a wide variety of causes. Depending on the problem, one or more joints can become inflamed or painful.

The joints in our body are complex structures consisting of bones, muscles, ligaments, tendons and other tissues. Injury or damage to a joint can involve any of these structures and because of this, it is sometimes difficult to be precise as to which of these are the cause of pain. Often, all parts of the joint become inflamed.

Irrespective of what the basic problem is, joint pain can be associated with a number of other symptoms including:

• Stiffness, where movements in the joint become more limited because of pain
• Swelling of the joint
• Loss of function of the joint

A joint that becomes warm to touch suggests a higher degree of inflammation. This may indicate ongoing severe inflammation or infection – conditions which constitute a medical emergency.

Pain in one or more joints can result from a variety of relatively common health conditions. Whilst usually associated with increasing age, joint pain is not exclusive to the elderly. For instance, a sporting injury such as an ankle sprain can result in severe joint pain with swelling in the joint, limitation of movement and the other symptoms described above.

The most common causes of joint pain seen in the general public are:

• Joint injuries
• Osteoarthritis
• Rheumatoid arthritis
• Gout
• Other causes

This is probably the most common cause of joint pain and will have been experienced by the majority of people at some point in their lives.

Injuries to joints can result from sports injuries, falls, other simple accidents such as ‘going over your ankle’ and other similar situations where forces exerted on a joint exceed their design capabilities.

The joint structures most commonly damaged in these injuries are the ligaments holding the bones together. If the injury is severe, more than one ligament may be damaged, ruptured or severely torn. Muscles and associated tendons surrounding the joints may also become injured and inflamed. 

The most common of such joint injuries is the sprained ankle followed by damage to the ligaments of the knee – the classic footballer’s injury.

Osteoarthritis, sometimes also referred to as ‘wear and tear’ arthritis, is probably the second most common cause of joint pain. The problem is seen with older people and usually starts with one or sometimes two joints.

The large, weight bearing joints such as the hips or the knees are typically the first ones to become painful. Osteoarthritis of the bones in the lumbar spine can give rise to lumbago (low back pain) and similar wear and tear of the spinal bones of the neck can, on occasion, give rise to neck pain.

In contrast to osteoarthritis, rheumatoid arthritis is a condition which can give rise to joint pain from a relatively young age. It is a condition doctors describe as an autoimmune illness – where the body’s immune system usually designed to attack invading organisms such as bacteria and viruses, attacks its own cells.

Typically, rheumatoid arthritis causes pain in a number of joints simultaneously. Unlike osteoarthritis, the smaller joints such as those in the hands and feet tend to be involved first.

The symptoms of rheumatoid arthritis can come and go. ‘Flare ups’ of pain, are interspersed with quieter pain-free periods. It is a serious medical condition which should, in the first instance, be managed by a doctor or hospital specialist.

Gout is a metabolic disorder where uric acid crystals precipitate out of the blood and settle in joints and other tissues. Uric acid crystals inside joints will set off an inflammatory reaction, giving rise to swelling and pain.

The joints of the big toes are classically the first ones to be affected. Other joints such as the knees, elbows and fingers can also be involved.

Joint pain can also be the result of a number of rare health conditions. Some of these are:

• Joint infections
• Other infections (eg. Lyme disease, gonorrhoea)
• Bone tumours
• Allergic reactions to medication
• Autoimmune illnesses
• Excessive intake of vitamin A

All of the conditions above are serious and should be managed by a doctor. You should also see your doctor if your joint pain is severe and undiagnosed, or worsening, or if you do not see an improvement after 4 weeks of self-medication.