Joint pain can feel different depending on the cause.
It might feel like a sudden, sharp pain.
You might notice stiffness, burning, or a dull ache.
Illustration by Alexandra Gordon, Verywell
With so many causes, the reason for your joint pain can be hard to diagnose.
And until you know the cause, you won’t know the best way to treat it.
A major feature that determines the treatment is whether your joint pain involves inflammation.
What Is Arthritis?
Arthritis literally means “joint inflammation.”
Arthro = joint, itis = inflammation.
Arthritis-Related Causes
In arthritis, inflammation and/or joint damage is responsible for the pain.
Arthritis comes in many forms with different causes.
When the cartilage wears away, the bones start grinding against each other, causing pain.
Classic OA is considered non-inflammatory because the damage isn’t because of inflammation.
However, inflammation may be a symptom of OA.
But an aggressive subtype of OAcallederosive osteoarthritisis inflammatory.
Erosive OA is most common in people who’ve gone through menopause.
Uric acid can build up and form crystals inside your joints.
When the immune system tries to destroy them, it leads to inflammation and pain.
(Inflammationis a normal and necessary part of the immune response.)
Common joints for gout are:
A classic gout attack involves sudden, severe, often burning joint pain.
It’s usually in just one joint.
Joints may be:
Without treatment, an acute flare may last up to two weeks.
Pseudogout
Pseudogoutis a pop in of inflammatory arthritis.
In rare cases, it may be a fungus (likeCandida)ormycobacteria(liketuberculosis).
Septic arthritis tends to affect a single joint.
It’s usually a:
The affected joint gets swollen, warm, and stiff.
You’ll also have a fever.
Viral Arthritis
Several viruses may causeviral arthritis.
The most common ones include:
Viral arthritis lasts for a short time.
Then most people are symptom-free.
But some viruses leave behind pain that lingers for months or years.
Rheumatoid Arthritis
Rheumatoid arthritis (RA)is a chronic autoimmune disease that develops gradually.
RA predominantly affects the joints.
Early symptoms may include:
What Is Autoimmune Disease?
Autoimmune disease is the immune system attacking healthy parts of your body as if they were harmful.
This causes inflammation, pain, and other symptoms that vary by disease.
It’s unknown why this happens.
RA then progresses to the joints.
It most often starts in the fingers and toes on one side of the body.
Unlike OA, RA pain tends to improve with movement.
It’s often worse in the morning and the heightened pain lasts for more than an hour.
Spondyloarthritis
Spondyloarthritisis a family of inflammatory rheumatic diseases.
It includes four conditions.
Ankylosing Spondylitis (AS)
Ankylosingspondylitisis an axialspondyloarthropathy.
That means it mainly affects the axial skeleton (the spine and other bones of the central core).
Psoriatic Arthritis
Psoriasisis an autoimmune skin disease.
It causes patches of thick skin covered in silvery scales.
It causes:
In about 15% of people, joint pain shows up before psoriasis appears.
Bacteria linked to reactive arthritis include:
Typical joints are the knee, ankle, and foot.
It tends to be more active when bowel symptoms flare.
IBD includesCrohn’s diseaseandulcerative colitis.
Arthritis associated with IBD causes throbbing joint pain and swelling.
It’s more common in larger joints like the knees and hips.
Systemic Lupus Erythematosus
Joint inflammation is common insystemic lupuserythematosus(lupus or SLE).
That’s a chronic autoimmune disease that can affect nearly every organ in the body.
Lupus especially hits the:
It tends to affect joints on the same side of the body.
Mornings often bring stiffness but it generally lasts for just a few minutes.
Joint pain also tends to be short-lived.
It may move from one joint to another throughout the day.
Polymyalgia Rheumatica
Polymyalgia rheumatica(PMR)is an inflammatory joint disease.
It causes:
The feet and ankles are never affected.
And the disease almost exclusively affects people over 50.
PMR is associated with an inflammatory blood-vessel disease calledgiant cell (temporal) arteritis.
It causes inflammation in the arteries of the head and scalp.
Other Systemic Rheumatic Diseases
Other systemic (whole-body) conditions may cause arthritis, too.
Fibromyalgia
Fibromyalgiais a chronic pain condition involving nervous system dysfunction and hypersensitive nerves.
Fibromyalgia painusually moves around the body.
It can affect joints, muscles, and connective tissues.
Nerves may cause shooting, zinging, or tingling pain.
Other symptoms include crippling fatigue and cognitive dysfunction (“fibro fog”).
Some people with this illness have joint aches and minor swelling.
However,exams and testsdon’t generally find any serious inflammation or joint damage.
Hemarthrosis
Hemarthrosisoccurs when you have bleeding into a joint.
Symptoms include:
It can take weeks or months to go away on its own.
Treatment helps prevent pain and disability.
Hypothyroidism
Hypothyroidisminvolves an underactive thyroid gland.
The most common cause isHashimoto’s thyroiditis, an autoimmune disease in which your body attacks your thyroid gland.
The thyroid is responsible for keeping numerous hormones in balance.
When they’re out of balance, a lot of things can go wrong.
Symptoms of hypothyroidism include:
Lyme Disease
Lyme diseaseis transmitted via tick bites.
Lyme bacteria in your joint tissue causes inflammation and pain known as Lyme arthritis.
The main symptom is swelling of one or more of the joints.
For example, it’s common for someone with RA or lupus to eventually developsecondary fibromyalgia.
They include:
The specific tests you’ll get depend on your symptoms.
Medical History
The first step in the diagnostic process is a medical history.
That’s because some conditions (like psoriatic arthritis) tend to run in families.
How Symptoms Help
Details about your pain can help narrow down possible diagnoses.
Arthritis due to RA is worse with rest and improves with activity.
Physical Examination
During the physical exam, your healthcare provider will press on the painful joints.
They’re looking for:
These are signs of inflammation.
They’ll note whether your pain is symmetrical (in the same joint on both sides) or asymmetrical.
Lastly, they’ll look for various clues such as:
Exam findings may lead to a clear diagnosis.
But much of the time, more work is needed.
They may include:
If they suspect autoimmune disease, your provider may order tests for certain antibodies.
Those are your immune system’s “attack” cells.
If they suspect fibromyalgia, you may be given questionnaires to fill out.
These are measurements of pain, other symptoms, and their impact on you.
Imaging
Imaging tests can help confirm or rule out a diagnosis.
Common ones include:
Procedures
A few procedures can help confirm a diagnosis.
Thefluid is then analyzedunder a microscope.
This involves removing a small tissue sample from the synovium.
The tissue is then examined in the lab.
Differential Diagnoses
Sometimes, what’s perceived as joint pain comes from a non-joint related condition.
These may include:
These causes are typically easy for your health team to rule out.
Treatment
Treatments for joint pain depend on the diagnosis.
Some illnesses, such as gout, may be improved with specific dietary changes.
Be sure to involve your healthcare practitioner in any lifestyle change you make.
Medication
Several different medications can ease joint pain.
The specific throw in depends on your diagnosis.
Some possible medications are:
Medications for autoimmune diseases change how your immune system works.
These include:
Fibromyalgia and depression are often treated with drugs that alter brain chemistry.
These include:
Fibromyalgia is also treated with anti-seizure medications:
Other conditions require specific treatments.
For fibromyalgia, asupervised physical exercise programis especially important.
It can help manage symptoms like muscle and joint, fatigue, and anxiety.
Complementary and Alternative Medicine
Several mind-body therapies can alleviate joint pain.
Surgery
Surgery is generally reserved for advanced cases of joint pain.
This may include knee or hip OA that hasn’t responded to less invasive treatments.
An osteotomy is sometimes a good option.
It involves cutting and reshaping bones to ease pressure on a joint.
That may delay the need for a joint replacement.
Good osteotomy candidates are:
In severe cases, total joint replacement may be necessary.
Summary
Many conditions cause joint pain.
Some are chronic (long-lasting).
Others may be temporary.
They may run their course without treatment or only clear up with the right treatments.
Some joint-pain causes just affect the joints.
Others are systemic conditions with many other symptoms.
Treatment depends on the diagnosis.
Medication, physical therapy, and sometimes surgery are standard.
You may also benefit from lifestyle changes, self-care strategies, and complementary therapies.
A Word From Verywell
Pain is your body’s way of telling you something is wrong.
Joint pain is a clear signal but it can be hard to figure out where it’s coming from.
The diagnostic process can take time and lead to a lot of frustration.
Hang in there, though.
Once the cause is found, you could start on the right treatments.
Frequently Asked Questions
You may have a temporomandibular disorder (TMD).
The temporomandibular joints (TMJ) attach your lower jaw to your skull.
TMD can come from internal problems with the joint, osteoarthritis, and rheumatoid arthritis.
Pain in many joints is sparked by some types of arthritis or other inflammatory disorders.
Multiple-joint pain that comes from elsewhere could be fromtendonitis,bursitis,polymyalgia rheumatica, andfibromyalgia.
That’s because it reduces blood flow to the area.
Heat can relieve chronic joint pain.
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