Joint pain is discomfort that arises from any joint. Joint pain is sometimes called arthralgia. There are many different causes of joint pain.
Most causes of joint pain are harmless and resolve without any long-term problems. However, some causes of joint pain require treatment for a long time and cause long-term joint problems.
Note: some causes of joint pain require urgent treatment. For example:
- If you have an infection in a joint (septic arthritis) then you will need to be seen in hospital as an emergency.
- If you are thought to have rheumatoid arthritis then you will need an urgent appointment with a specialist because starting treatment early will reduce the risk of long-term problems.
What is joint pain?
Joint pain is discomfort that arises from any joint. Joint pain is sometimes called arthralgia. Arthritis means inflammation of the joint, which usually causes pain and sometimes swelling of the joint.
Joint pain may affect just one joint or it may affect many different joints. The pattern of the joint pain in terms of how many and which joints are affected will depend on the underlying cause.
What are the causes of joint pain?
There are many causes of joint pain. The possible causes will partly depend on your age. The possible causes for joint pain in children are different to the possible causes for adults.
The cause of joint pain may be obvious, such as following a sports injury. At other times it may need investigations and a referral for you to see a specialist to find the diagnosis.
Joint pain may also be caused by different structures in or around the joint. The underlying cause may therefore be a problem with:
- The lining of the joint.
- The surrounding bone.
- The tendons, ligaments or muscles around the joint.
Joint pain may also be caused by pain felt along the course of a nerve. This is called 'referred pain'. For example, a problem in your hip may cause you to also feel pain in your knee. Nerve pain also occurs when a 'slipped disc' in your back causes pain in your leg (called sciatica).
The following is a list of the most common causes of joint pain. There are many more less common causes that your doctor may need to consider. See the links for more information about each condition that can cause joint pain.
The list separates conditions usually affecting one joint from conditions affecting more than one joint for each age group. However sometimes conditions usually affecting one joint may affect a few different joints. Conditions usually affecting many joints may sometimes cause pain in just one joint, especially at the beginning of any underlying illness.
Causes of joint pain in adults
Pain affecting more than one joint
- Any general body infection: joint pains may be caused by any general body infection, especially a flu-like illness with high temperature (fever).
- Osteoarthritis (OA): the most common form of arthritis in the UK. OA mainly affects the joint cartilage and the bone tissue next to the cartilage. See separate leaflet called Osteoarthritis.
- Rheumatoid arthritis (RA): causes inflammation, pain, and swelling of joints. Persistent inflammation over time can damage affected joints. The severity can vary from mild to severe. See separate leaflet called Rheumatoid Arthritis.
- Psoriatic arthritis: causes inflammation, pain, and swelling of joints in some people who have psoriasis. See separate leaflet called Psoriatic Arthritis.
- Reactive arthritis: caused when a joint reacts to an infection elsewhere in the body. The infection which triggers reactive arthritis is not actually in the joint but is usually in the gut or the bladder outlet (urethra). See separate leaflet called Reactive Arthritis.
- Gout: causes attacks of painful inflammation in one or more joints. The pain of a gout attack can be severe. See separate leaflet called Gout.
- Fibromyalgia: causes pains and tenderness in many areas of the body, as well as tiredness and other symptoms. See separate leaflet called Fibromyalgia.
- Ankylosing spondylitis: this is a form of arthritis. It mainly affects the lower back but other joints and other parts of the body are sometimes affected. See separate leaflet called Ankylosing Spondylitis.
- Connective tissue diseases - for example, systemic lupus erythematosus and scleroderma: connective tissue diseases affect tissues throughout the body, including tendons, ligaments, skin, eyes, cartilage, bone and blood vessels. See separate leaflets called Systemic Lupus Erythematosus and Scleroderma - Systemic Sclerosis.
Pain affecting one joint
- Joint, bone or soft tissue injuries: injury to the joint (for example, joint dislocation), bone (fracture) or surrounding muscles, tendons or ligaments (soft tissue injury).
- Problems with other tissues around the joint - these include:
- Knee: see separate leaflets called Knee Pain (Patellofemoral Pain), Housemaid's Knee (Prepatellar Bursitis), Knee Cartilage Injuries (including Meniscal Tears) and Knee Ligament Injuries.
- Elbow: see separate leaflets called Student's Elbow (Olecranon Bursitis) and Tennis Elbow (lateral epicondylitis).
- Shoulder: see separate leaflets called Rotator Cuff Disorders and Frozen Shoulder (adhesive capsulitis).
- Ankle: see separate leaflet called Ankle Injuries.
- Joint and bone infections: infection of the joint (septic arthritis) or infection of the surrounding bone (osteomyelitis). See separate leaflets called Septic Arthritis and Osteomyelitis.
- Other infections: these may also cause joint pain - for example, see separate leaflet called Lyme Disease.
- Bone cancer or leukaemia: see separate leaflets called Primary Bone Cancer and Leukaemia - A General Overview.
- Paget's disease of bone: see separate leaflet called Paget's Disease of Bone.
Causes of joint pain in children and teenagers
Many of the causes of joint pain in adults can also be the cause in children. However, because of developing bones and joints, there are other conditions that can cause joint pain in children and teenagers. These include:
- Juvenile idiopathic arthritis (JIA): a condition in which joint inflammation occurs in children under the age of 16 years. See separate leaflet called Juvenile Idiopathic Arthritis.
- Henoch-Schönlein purpura: a condition that can cause a skin rash, tummy (abdominal) pain and joint pains. Most people who develop Henoch-Schönlein purpura are children. See separate leaflet called Henoch-Schönlein Purpura.
- Growing pains: aches, usually in the legs, which are common in children. It is not known what causes growing pains but, despite the name, they are not due to growing. They are not serious and settle in time of their own accord. See separate leaflet called Growing Pains.
Hip pain in children may be serious and needs urgent assessment by a doctor. The possible causes of hip pain in children include those conditions that can affect any joint, such as septic arthritis.
Conditions specifically affecting the hip joint in children may be harmless, such as irritable hip (transient synovitis) which usually resolves within a few weeks but may recur. See the separate leaflets below for more serious conditions, which include:
- Developmental Dysplasia of the Hip (age 0-3 years).
- Perthes' Disease (usually 4-8 years and mostly affects boys).
- Slipped Capital Femoral Epiphysis (most often occurs in boys aged 10-17 years).
Sinding-Larsen Johansson disease is a painful knee condition that may affect teenagers during periods of rapid growth. The pain occurs at the front of the knee. Resting the knee for several months and treatments with medicines for pain relief and physiotherapy may be needed. The outcome is usually very good but symptoms may persist for at least one year.
When should you see a doctor?
Make an appointment with your doctor if your joint pain is accompanied by:
- Tenderness and warmth around the joint.
See a doctor immediately if your joint pain is caused by an injury and is accompanied by:
- Joint deformity.
- Inability to use the joint.
- Intense pain.
- Sudden swelling.
See a doctor if you have any concerns, especially if:
- You feel unwell.
- The pain persists for more than two weeks.
- The pain is not relieved by simple medicines for pain relief such as paracetamol or ibuprofen.
Will I need any tests (investigations)?
Joint pain often resolves without the need for any tests. Your doctor can help to diagnose the cause of the joint pain. This will involve asking you questions about your symptoms and examining the affected joints. Your doctor may also arrange for you to have blood tests and an X-ray to help find out the reason for your joint pain.
What is the treatment for joint pain?
Many causes of joint pain are harmless and resolve without treatment or just with medicines to help relieve the pain until it resolves.
- Try an over-the-counter medicine to relieve the pain, such as paracetamol or ibuprofen.
- Avoid using your joint in ways that cause or worsen the pain. You may have to avoid sports, driving or long walks, depending on which joint is affected. However, it is very important to stay active so that the muscles around the joints don't become weak.
- Apply an ice pack to your painful joint for up to 20 minutes a few times each day.
Any further treatment will depend on the underlying cause. Some causes of joint pain will require long-term treatment and you may need to see a joint specialist (a rheumatologist or an orthopaedic surgeon). Assessment and treatment from a physiotherapist and an occupational therapist may also be needed.
What is the outcome (prognosis)?
The outcome will depend on the underlying cause of joint pain. Many causes of joint pain resolve completely with no problems later on.
Other causes of joint pain (for example, osteoarthritis or rheumatoid arthritis) may need long-term treatment and continue to cause problems. Long-term problems may include persistent joint discomfort and restrictions with using the affected joint(s).
Dr Colin Tidy
Dr Colin Tidy
Dr Hayley Willacy