The Basics of Joint Pain

 

Knee painJoint pain is a feeling of soreness or discomfort in one or more joints of the body. A joint is a space where two bones meet together, such as the knee, hip, shoulder, ankle, and elbow.

Joint pain occurs with or without movement, and severe joint pain related to arthritis can limit mobility. Many arthritic joints become inflamed, which leads to burning, soreness, stiffness, and pain.

Joints are made of cartilage, tendons, ligaments, and fluid-filled sacs called bursas. The bursas cushion the joint and the synovial membrane secretes a fluid and lines the entire joint capsule.

If any of these joint structures is injured, irritated, or inflamed, the joint will be painful. This can result from a variety of injuries and conditions. Short-term joint pain (acute) last just a few days or weeks, and can be a symptom of a sprain or dislocation. Chronic joint pain (long-term) lasts or persists for more than three months, and can be a symptom of osteoarthritis, rheumatoid arthritis, or bone cancer.

Symptoms that occur with Joint Pain

Joint pain often occurs along with certain symptoms, which vary depending on the main condition or disease. These symptoms include:

  • Joint swelling
  • Skin redness
  • Fever
  • Joint stiffness
  • Crepitus (crunching or popping noise)
  • Reduced mobility
  • Joint deformity

Common Causes of Joint Pain

  • Traumatic injuries, such as dislocations, separation, ligament tears, and contusionsknee injection
  • Infections, such as septic arthritis, Lyme disease, and rheumatic fever
  • Autoimmune diseases, such as Sjogren’s syndrome and Lupus
  • Chronic degenerative disorders, such as arthritis, gout, bursitis, and ankylosing spondylitis
  • Malignancy, such as Paget’s disease, leukemia, and bone cancer

Potential Complications of Joint Pain

The complications of joint pain are often progressive and depend on the underlying cause. Joint pain could be related to a serious disease, so it should be evaluated by a doctor. The complications include:

  • Loss of mobility
  • Joint deformity
  • Permanent joint damage and immobility
  • Joint instability
  • Physical disability
  • Spread of infection

Treatment Options for Joint Pain

The treatment of joint pain will depend on the cause. For arthritis and bursitis, common injections that are used include:

  • Steroid injection – A corticosteroid is injected into the joint space to decrease swelling and eliminate pain. A long-acting steroid can provide pain relief for several weeks. Commonly used agents include methylprednisolone and triamcinolone, which are formulated to stay in the joint. The procedure sometimes involves aspiration (removal) of the synovial fluid for laboratory analysis, which is done to treat a joint effusion (accumulation of fluid on the joint).

 

  • Hyaluronic acid injection – One substance used for the joint is hyaluronic acid, which lubricates and cushions the joint. This substance is similar to synovial fluid, so the injection replaces lost joint fluid, thus alleviated pain. These injections offer up to 6 months of pain relief. Commonly used viscosupplement agents include Orthovisc, Hyalgan, and Synvisc.

 

  • Regenerative Medicine Injections – Pain doctors may inject stem cells into painful joints, which can be great at repairing damaged cartilage and soft tissue. This may include bone marrow or amniotic derived injections, or possibly platelet rich plasma therapy too.

 

Resources

 

Bijlsma JW, Berenbaum F, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011 Jun 18;377(9783):2115-26.

 

Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology: 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2012;4:465-474.