Painful joints can make everyday movement difficult. From knees that ache nonstop to stiffness in fingers, joint pain affects millions of people.
In fact, according to the Centers for Disease Control (CDC), more than 58 million people in the U.S. have arthritis. And about 25 million must limit their usual activities because of arthritis joint pain. (Arthritis is a leading cause of joint pain, though not all joint pain is arthritis.)
At UPMC Orthopaedic Care, our providers see thousands of people each year for joint pain and associated conditions.
What Causes Joint Pain?
Your joints can hurt from overuse, injury, chronic conditions, or virus-related infections. Some joint pain is mild, whereas other pain may be debilitating.
Arthritis is the most common cause of joint pain, but there are more than 100 types of arthritis. The most frequent type is osteoarthritis, or “wear and tear” arthritis. Osteoarthritis (OA) develops over time. Age and joint overuse are two of the biggest risk factors.
OA often affects the knees, hips, and hands, but it can affect other joints as well. With OA, your cartilage — your joint’s cushioning system — gradually wears away. Your bones rub against each other, which can cause severe pain.
Rheumatoid arthritis (RA) also causes joint pain, but unlike OA, RA is an autoimmune disorder. This means your body mistakenly attacks healthy cells. In the case of RA, your body attacks the lining of your joints, causing pain and swelling.
Lupus, another autoimmune disorder, may also affect your joints. Lupus isn’t the same as RA, though the conditions do have some things in common, including joint pain.
You may also experience joint pain due to:
- Injuries, such as broken bones, muscle strains, or ligament sprains.
- Tendonitis, an inflammation of the tendons that attach muscle to bone.
- Bursitis, an inflammation of the fluid-filled sacs that cushion the bones around your joints.
- Bone infections, usually because an infection has spread from skin into bones.
- Gout, another type of arthritis that commonly affects the big toe.
When Should I Go to the Doctor for Joint Pain?
When it comes to joint pain, it’s never too early to talk to your doctor. Even if you are only seeing your primary care provider (PCP) for a yearly exam, mention any joint pain you have. Your doctor may then refer you to a rheumatologist or an orthopaedic specialist.
Joint pain can be hard to quantify for people, but the CDC has some helpful definitions.
Persistent joint pain: Having joint pain on most or all days over the last three months. This can be joint pain of any severity. Half of adults with arthritis report having persistent pain.
Severe joint paint: Having pain that you rate as a seven or higher (10 being the highest) right now. In other words, it does not need to be persistent but severe enough to be debilitating. About 15 million people report having severe joint pain.
If you have either persistent or severe joint pain, make an appointment with your doctor. The sooner you seek help, the more you may be able to reduce pain. Getting care early can also help you maintain joint mobility.
Other reasons to seek joint pain care immediately:
- You also have a fever that isn’t related to another illness, like flu or Covid-19.
- You have appetite loss, unexplained weight loss, or sweat at night soaking your sheets.
- You have any type of severe joint pain with other unexplained symptoms.
What Are Joint Pain Treatments?
First, your doctor will assess what is causing your joints to hurt. They will likely order tests, including blood tests, x-rays, or other imaging.
If an infection is causing your joint pain, your doctor will treat the infection. But infections aren’t at the root of most joint pain. As we know, arthritis is the leading cause of joint pain.
Treatment depends on your type of arthritis. Rheumatologists take care of people with RA. For people with RA, there are medications and self-management strategies.
Orthopaedic and sports medicine specialists can treat those with OA. Because OA is progressive, treatment depends on much pain you’re in, how much joint mobility you have, and your goals.
Lifestyle changes
Your doctor may first suggest making modifications to your lifestyle. For example, you may need to swap out some of your high-impact workouts for lower-impact workouts. This can be challenging for athletes, but a sports medicine specialist can help you create modifications that work for you.
For some people, modifications at work can also help.
Home-based pain management
Some people can manage joint pain with home care. This includes heat/ice and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. But long-term use of NSAIDs can have side effects for some people.
Medical pain management
Your doctor may suggest giving an injection of corticosteroids directly into the joint. Corticosteroids are powerful anti-inflammatories that can provide relief when you have a flare-up of arthritis pain.
These shots can be effective for some people but don’t work for everyone.
In addition, the shots can cause dangerous changes to blood sugar levels in people with diabetes. If your doctor recommends a steroidal injection, be sure to tell them you have diabetes. You’ll need to have a plan in place for how to manage your blood sugar in the days after the shot.
There are also other types of injections such as viscosupplementation injections that lubricate the joint and can be an option for some patients based on evaluation by an orthopaedic specialist.
Physical therapy
Physical therapy can also help reduce joint pain by helping you strengthen the joint, as well as the muscles around the joint. PT may be very helpful early on for people with OA (it can help people with RA, too).
Joint replacement
For people with severe joint damage that hasn’t responded to nonsurgical treatment, joint replacement may ultimately be the best long term option.
While joint replacement is not a first-line intervention, sometimes it’s the only one that alleviates persistent and debilitating pain. Many people with joint replacement remark that they wish they would have had surgery sooner. Joint replacement can be life-changing for people who are in severe pain every day and can allow patients to return to their desired activities and lifestyle without pain.
Have more questions about joint pain diagnosis and treatment? Learn how UPMC Orthopaedic Care can help.