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15 causes of joint pains, other than arthritis

The causes of joint pain are several, and arthritis is just one of them.

Written by Dr Anitha Anchan |Updated : May 27, 2016 10:02 AM IST

A joint is a site at which bones connect. The connection between bones provides support and movement to the body. A joint comprises of bones separated by the cushioning cartilage. Ligaments, the fibrous tissue in and around the joint, connect the bones. Tendons attach muscles to bones. A bursa is a small fluid-filled sac which acts as lubricated cushion between a bone and its surrounding soft tissues at the joints. It helps reduce friction. Joint pain or arthralgia can affect you at any age but become increasingly more common as you age. It can affect one or more joints from your head to toe. It can be mild to severe and may last for few days to few weeks to several months. The causes of pain in the joints are several and arthritis i.e. inflammation of joint is just one of them. An injury or disease of the joint or its adjacent tissues can cause joint pain. Here is a list of some of the causes:

1. Sprains and strains A sprain is an injury to the ligaments and a strain refers to muscle injury. Your ankle joints are most commonly prone to sprain whereas the hamstring muscle is most commonly strained. Sprains and strains can be very painful and are the most common causes of pain in a single joint.

2. Inflammation of tendons (tendinitis/tendonitis) Excessive use of the tendons can cause their inflammation or irritation and lead to tendinitis which causes pain just outside the joint. The tendons in the shoulders, elbows, wrists and heels are most commonly affected. Tennis elbow, swimmer s shoulder, golfer s elbow, etc. are some of the common names for various types of tendinitis.

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3. Bursitis Bursitis is inflammation of the fluid-filled bursa of the joint most often caused by frequent repetitive motions. It is associated with pain especially when movement occurs and can be disabling causing immobility of the joint.

4. Traumatic injury The primary symptom of an injury to the joint is the pain. The injury may be in the form of bone dislocation or fracture. A physical injury to the joint may come back years later to haunt you as post-traumatic osteoarthritis [1] which is characterized by severe pain, discomfort and swelling and may even cause a restriction in joint movements.

5. Infections Infections cause one or more of classic symptoms like fatigue, fever, rashes, loss of appetite, chills or body aches. But some bacterial or viral infections may also cause joint pains. Gonorrhea, staphylococcus infection, strep throat, pneumonia, tuberculosis, etc. are some of the bacterial infections which can get into the joints and cause swelling and significant pain. Viral infections like hepatitis, rubella, chikungunya, HIV, etc. cause inflammation and pain in the joints along with symptoms of a fever. Chikungunya, characterized by an abrupt onset of fever, is frequently accompanied by severe muscle and joint pains.

6. Hypothyroidism Thyroid hormones affect proliferation and differentiation of bone and cartilage at the cellular level. Hence decreased thyroid function or hypothyroidism can induce abnormalities in these tissues and cause muscle and joint aches.[2]

7. LupusLupus is a chronic inflammatory autoimmune disease with the most distinct feature of a facial rash on the cheek that appears as unfolding of the wings of the butterfly. The condition can affect different body systems including the joints causing severe pain.

8. Fibromyalgia Chronic pain in the joints, muscles and tendons and extreme fatigue are the two key characteristic features of fibromyalgia. The pain, usually not associated with any other cause, may be accompanied by other symptoms like sleep, memory and mood issues.

9. Bone cancerBone cancer, most commonly seen in the long bones of the arms and legs, attacks within the first 20 years of life when maximum musculoskeletal growth takes place. Painful bones and joints are the first sign of bone cancer in children but it can easily be mistaken for minor sporting injury or growth spurt pain.

10. Sarcoidosis Sarcoidosis is the inflammation of tissues of the body commonly affecting the lungs and skin (lymph nodes). In some people, it can cause muscle pain, joint pain and joint inflammation which may lead to the diagnosis of the disease [3].

11. Osteonecrosis (Avascular necrosis) Loss of blood to the bone can cause the bone to die. The condition, termed avascular necrosis or osteonecrosis, initially is asymptomatic. But as it progresses, the affected bone and surrounding joint surface collapse which causes pain severe enough to interfere with the movement of the joint.

12. Polymyalgia rheumatic Polymyalgia rheumatica is an inflammatory condition of the muscles and joints. It is characterized by sudden onset of widespread pain and stiffness in the muscles and joints mostly in the neck, shoulders and hips.

13. Scleroderma In scleroderma, an autoimmune disorder, there is an overproduction of collagen (a structural protein found in the bones, muscles, skin and tendons). It mostly affects the skin on the hands and face causing hardening of the skin. In systemic sclerosis, the sclerosis (hardening) occurs in the internal organs of the body like gastrointestinal tract, lungs, kidneys, heart, blood vessels, muscles and even the joints. The involvement of joint tissues causes it to become fibrous and hard which makes them stiff and less functional.

14. Hypertrophic pulmonary osteoarthropathy Hypertrophic pulmonary osteoarthropathy is a condition characterized by deformity of the nails (clubbing), painful, inflammation of the connective tissue surrounding the bone (periostitis), increased bone deposition on long bones, excessive proliferation of skin and painful, swollen joints. Joint pain may range from mild to severe.

15. Side effects of medications Some medications can cause joint pain as a side effect. Pain in the joints is a common and debilitating side effect experienced by breast cancer patients taking aromatase inhibitors (AIs) [4]. Mirtazapine, an antidepressant, has arthralgia (joint pain) as a possible adverse drug reaction [5]. Anticholesterol drug statin may cause tingling sensation in the fingers or toes, muscle ache and sometimes joint pain too [6]. Steroid-induced osteonecrosis [7], commonly affecting the femoral bone, may cause pain in the joint.

References

1. Lieberthal J, Sambamurthy N, Scanzello CR. Inflammation in joint injury and post-traumatic osteoarthritis. Osteoarthritis Cartilage. 2015 Nov;23(11):1825-34. doi: 10.1016/j.joca.2015.08.015. Review. PubMed PMID: 26521728; PubMed Central PMCID: PMC4630675.

2. McLean RM, Podell DN. Bone and joint manifestations of hypothyroidism. Semin Arthritis Rheum. 1995 Feb;24(4):282-90. Review. PubMed PMID: 7740308.

3. Abril A, Cohen MD. Rheumatologic manifestations of sarcoidosis. Curr Opin Rheumatol. 2004 Jan;16(1):51-5. Review. PubMed PMID: 14673389.

4. Crew KD, Greenlee H, Capodice J, Raptis G, Brafman L, Fuentes D, Sierra A, Hershman DL. Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer. J Clin Oncol. 2007 Sep 1;25(25):3877-83. PubMed PMID: 17761973.

5. Passier A, van Puijenbroek E. Mirtazapine-induced arthralgia. British Journal of Clinical Pharmacology. 2005;60(5):570-572. doi:10.1111/j.1365-2125.2005.02481.x.

6. Pasternak RC, Smith SC Jr, Bairey-Merz CN, Grundy SM, Cleeman JI, Lenfant C; American College of Cardiology; American Heart Association; National Heart, Lung and Blood Institute. ACC/AHA/NHLBI Clinical Advisory on the Use and Safety of Statins. Circulation. 2002 Aug 20;106(8):1024-8. PubMed PMID: 12186811.

7. Gebhard KL, Maibach HI. Relationship between systemic corticosteroids and osteonecrosis. Am J Clin Dermatol. 2001;2(6):377-88. Review. PubMed PMID: 11770392.

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