Joint pain is one of the most common diseases in Germany, which can result in a restriction in everyday life and thus reduce the quality of life. More than one in two Germans report suffering from pain in at least one joint during the course of a year. The knee, shoulder, hip or fingers are frequently affected. The pain can be triggered by a variety of diseases. This article provides a brief overview of the main causes, such as osteoarthritis or rheumatism, and highlights possible treatments.
What causes pain in the joint?
To understand the various causes of joint pain, it is worthwhile to first take a look at the anatomy of the joints:
Our joints represent the junction between bones. They allow us the greatest possible freedom of movement and absorb pressure shocks and tensile forces. To prevent the free bone ends from constantly rubbing against each other, they are lined with a thin layer of hyaline cartilage. Between the cartilage layers is the joint space, through which the joint fluid supplies the cartilage with nutrients. This is fundamentally important because cartilage does not have its own blood vessels, through which metabolic products are normally exchanged. Nor does cartilage possess any pain receptors. Pain only occurs when surrounding structures, such as the bone, muscles or tendons, are damaged.
Which joints can be affected?
In principle, all joints can cause pain. The most commonly affected are:
- Knee
- Shoulder
- Hip
- Ankles
- Wrists
- Elbows
- Thumb
At the same time, there are further subdivisions. For example, three joints are found on the thumb:
- The thumb saddle joint, which connects the base of the thumb with the carpus.
- The thumb metacarpophalangeal joint, which is located at the transition from the palm to the thumb
- The thumb end joint, which is the uppermost joint on the thumb
The remaining fingers also have a finger middle joint, which is located between the base and end joints. Finger joints – iStock.com/VectorMine
Depending on the underlying cause, the joint pain that occurs may have a typical pattern of involvement. For example, the finger end joints and the thumb saddle joint are affected in so-called Heberden’s arthritis, while the finger base and middle joints are more likely to be painfully altered in rheumatoid arthritis. Another example is gout. For the first time, this disease usually makes itself felt in the base joint of the big toe.
What are the symptoms of joint pain?
Since articular cartilage does not have pain receptors, other factors trigger pain at the joint. Most commonly, joint inflammation causes acute pain. This can cause joint swelling, which is sometimes visible, as part of the inflammatory process. Another symptom may be reddened, overheated skin over the joint. Lack of exercise is widespread in society and also contributes to the development of painful joints. With prolonged lack of exercise, the joint fluid can no longer circulate sufficiently in the joint space and supply the cartilage. In addition, the surrounding ligaments and muscles shorten, which can lead to nonspecific muscle pain that radiates into the joint.
What diseases can be the trigger?
Joint pain can be a symptom of a variety of different diseases. Among the most important are:
- Osteoarthritis
- Rheumatic diseases, such as rheumatoid arthritis
- Gout
- Lyme disease
- Ankylosing spondylitis
- Sarcoidosis
- Bursitis (inflammation of the bursa), often at the elbow joint.
- Estrogen deficiency, for example, during menopause.
- Infectious causes, such as bacterial arthritis (often in the knee joint) or postinfectious arthritis.
Joint pain can also occur as a side effect of medication, for example, when taking tamoxifen or fluoroquinolones, such as moxifloxacin. In addition, physical causes, such as weight gain (including during pregnancy) or axis misalignment of the joints can cause pain.
Osteoarthritis – degenerative destruction of articular cartilage.
Osteoarthritis is the most common cause of joint pain in Germany.Over the course of years, the joint cartilage is destroyed, which initially leads to minor restrictions. Classically, those affected complain in the early stages of a “start-up pain” that occurs in the morning when the joint is first moved, but then disappears again. Osteoarthritis can occur throughout the body, but most commonly affects the large joints, such as the knee and hip, or the fingers. As a result, alternating joint pain is possible. Unlike rheumatoid arthritis, sufferers with osteoarthritis complain of an increase in discomfort in cold weather. Also, some report “weather sensitivity.” That is, depending on the temperature, the joint pain varies.
Rheumatoid arthritis – an inflammatory autoimmune disease with a variable course.
At first glance, rheumatoid arthritis and osteoarthritis are similar in terms of symptoms. These two diseases are not always easy to tell apart. In rheumatoid arthritis, episodic inflammation occurs in the body for reasons that have not yet been explained, affecting the joints in particular. But other organs, such as the lungs or the eyes, can also be affected. Joint pain can also occur in the context of other autoimmune diseases, such as Hashimoto’s thyroiditis, in which the thyroid gland is destroyed. The exact causes of this are not yet fully understood.
Gout – sudden, severe pain in the big toe.
The classic case of a gout attack would look something like this: In the evening, one has still eaten extensively, usually meat and alcohol in abundance, and the next morning very severe joint pain occurs, typically in the big toe. The cause is urate crystals (the salt of uric acid), which are deposited in the joint and lead to local inflammation. Uric acid is a breakdown product that is excreted by the kidneys. If the uric acid level is too high (hyperuricemia), the acid is no longer dissolved in the blood, but crystals are formed from it. Since this usually occurs after eating foods with a high purine content, such as meat, offal or legumes, gout is also counted among the diseases of affluence.
Joint inflammation after gastrointestinal illness or flu.
Joint pain can also occur as a result of joint inflammation after an infection – this is called post-infectious arthritis. The triggers here are processes of the immune system. For example, days to weeks after a gastrointestinal infection, for example caused by bacteria such as Yersinia, a migratory joint inflammation can occur. In this case, the pain occurs successively in different parts of the body. Usually the joints of the legs and feet are affected. Joint pain can also sometimes occur in the course of influenza. However, these are more likely to be due to the general immune response and not to postinfectious arthritis.
What to do about joint pain?
The different causes of joint pain dictate a very wide range of treatment options. They range from conservative, physiotherapeutic measures, to medicinal anti-inflammatory drugs, to surgical procedures. First of all, a distinction should be made as to whether the joint pain is chronic or acute. For the initial diagnosis, the general practitioner is the best point of contact, but especially in the case of more complex clinical pictures, the question quickly arises as to which doctor can help you further. In principle, orthopedists take care of most joint complaints. If a rheumatic disease is the cause, one should see a rheumatologist.
What home remedies help against joint pain?
Home remedies can provide relief, especially for mild joint pain:
- Cabbage wrap: separate the leaves from the hard stalk, wash and dry. Wrap in a cloth and flatten with a rolling pin so that the juice passes into the cloth. If necessary, the cabbage leaves can also be warmed with a hot water bottle. Tie the cloth with the squeezed cabbage leaves around the corresponding joint and leave it on for a few hours. The flavonoids contained in cabbage have a local anti-inflammatory effect. This is a very old method, which is used for osteoarthritis or rheumatism their application.
- Homeopathy and phytotherapy: some methods that fall within the scope of homeopathy or phytotherapy target the inflammation often found in joint pain. For example, the African devil’s claw is said to have anti-inflammatory and analgesic powers.This effect was also confirmed in several studies in which subjects were given preparations containing 50 mg of harpagoside (the anti-inflammatory substance in devil’s claw) compared to placebos.
- Diet: Diet can have an effect on symptoms in several ways. The most obvious effect may be a diet for obesity. This can relieve the joints and improve symptoms. Furthermore, just in rheumatoid arthritis is a zinc deficiency, which can be compensated after consultation with the doctor.
- Less alcohol: Alcohol should be avoided, since this can cause, among other things, a gout attack.
In addition, talk to your doctor about what measures are suitable for the treatment of your joint pain. For example, cooling the affected joint can help with acute joint pain. Also, in many cases – such as osteoarthritis – exercise can help to alleviate the discomfort, as this produces more joint fluid again, which supplies the cartilage with nutrients. In addition, a well-trained muscular system protects the joints from overuse and incorrect loading. Sports that are easy on the joints include cycling, walking, swimming or hiking.
What to do for joint pain during menopause?
The exact causes of joint pain during and after menopause are still the subject of current research. One possible cause is estrogen deficiency. Among other things, estrogen is involved in regulating water stores in the body. If estrogen levels fall, less joint fluid is produced and the cartilage is less well nourished. These processes make the joint more susceptible to inflammation overall. In severe cases, hormone replacement therapy can then provide relief.
Medication and surgery – what helps with joint pain?
If conservative therapies do not work sufficiently, many doctors resort to tablets. Most medications are aimed at reducing pain. Among the most commonly prescribed substances are ibuprofen or diclofenac, which can also be applied as an ointment. For some years, attempts have also been made to combat joint pain with injections. However, these treatments, which include injections of hyaluronic acid, for example, do not bring the hoped-for relief in all patients and can also be associated with considerable costs. If all treatment options have been exhausted, or if the joint is so worn that there is significant impairment in everyday life, an artificial joint may be used as a last resort.
