What joint pain is and how it varies
A joint is where bones meet: the knee, shoulder, elbow, wrist, hip, foot. The pain can come from the joint itself, the cartilage, the ligaments, the bursa around the joint or the muscles nearby. It can be dull, sharp or aching, show up with movement or at rest, and come with stiffness, swelling or clicking. A diagnosis cannot be made from a text, because wear, inflammation and overload feel alike. But how the pain starts and what goes with it show how urgent a visit is.
Joint pain in the morning and stiffness
If a joint loosens up within a few minutes and the pain fades with movement, wear of the cartilage (osteoarthritis) is the more common cause. If stiffness lasts longer than half an hour, affects several joints, especially the small joints of the hands and feet, and returns every morning, a doctor will think of an inflammatory joint disease such as rheumatoid arthritis. Book a visit within days rather than putting up with it for months: early treatment of inflammatory arthritis matters.
Pain in several joints at once
Pain in several joints can follow a viral infection, come with an inflammatory disease or gout, or reflect general overload. If a fever, rash, weakness or weight loss joins it, do not put off a visit. For these, see Fever and Fatigue.
Joint pain after an injury
Pain that begins after a fall, a blow or a sudden twist may mean a sprain or torn ligament, a bruise, a dislocation or a fracture. If you cannot put weight on the leg, the joint looks deformed, your fingers are numb or the pain is severe, you need urgent care. A traumatologist treats injuries and ligament damage, and an orthopedist deals with lasting problems of the musculoskeletal system. For one common case, see Knee pain.
A hot, red, swollen joint
Hot, red, very painful skin over a swollen joint, especially with a fever or chills, can mean an infection in the joint. It needs to be seen the same day. Sudden severe pain and swelling at the base of the big toe is more often gout, but it also should be seen by a doctor.
Joint pain with movement and "in the weather"
Pain that builds up in the evening after activity and eases at rest is typical of worn joints, extra weight, and long hours on your feet or at a desk. Many people say their joints ache with a change in the weather. It is a common observation, but it has no solid explanation, so it does not replace a check-up if the pain gets in the way of daily life. Back pain is sometimes mistaken for joint pain: see Back pain.
What you can do before the visit
- Rest the joint, but do not immobilize it for long: complete rest weakens the muscles.
- Apply ice wrapped in a cloth for about 20 minutes several times a day if the joint is swollen after activity or an injury.
- If you are overweight, losing weight takes load off the knees and hips.
- Do not heat or rub a joint that is hot, red and swollen.
- Discuss the choice of a painkiller with a doctor or pharmacist, especially if you have stomach, kidney or heart problems.
- Write down when and how the pain began, which joints hurt and how long the morning stiffness lasts.
How a doctor looks for the cause
The doctor asks how the pain began, about injuries, morning stiffness and other symptoms, examines the joints and checks the range of movement. Blood tests, an X-ray and a joint ultrasound may follow, and if needed an MRI or a sample of joint fluid. Treatment depends on the cause: from exercises and physiotherapy to medicine and, rarely, surgery.