Joint Pain Causes and Treatment Options

Joint pain has many causes. It can be hard to find out what's causing it. And treatments vary depending on the cause.

Joint pain can be from a type of arthritis (joint inflammation). Or there may be no damage or inflammation, as with fibromyalgia and hypothyroidism.

This article walks you through many common causes of joint pain and how they're diagnosed and treated.

What causes joint pain?
 Illustration by Alexandra Gordon, Verywell

Arthritis-Related Causes

In arthritis, inflammation and/or joint damage is responsible for the pain. Arthritis comes in many forms with many causes.

Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis. It results from the breakdown of cartilage. This is often due to aging. Trauma can cause it, too.

Cartilage provides a cushion between the bones of a joint. That helps bones glide past each other. When the cartilage wears away, bones don't glide, they grind.

OA tends to affect the:

  • Knees
  • Hips
  • Neck
  • Lower back
  • Fingers

The pain of OA gets worse with movement and better with rest. It often starts with sharp, intermittent pain then grows into a constant ache.

Joint stiffness and a limited range of motion are common.

Classic OA is considered non-inflammatory. But an aggressive subtype of OA, erosive osteoarthritis, is inflammatory.

Erosive OA is most common in postmenopausal women. It causes a gradual onset of joint aches, stiffness, and swelling in multiple finger joints.

Gout

Gout is a type of inflammatory arthritis. It strikes people with high levels of uric acid in their blood.

Uric acid can build up and form crystals inside your joints. The immune system then tries to destroy them. That leads to inflammation and pain.

Common joints for gout are:

  • The big toe
  • Ankle
  • Knee

A classic gout attack involves sudden, severe, often burning joint pain. It usually strikes just one joint.

Along with being sore, joints may be:

  • Red
  • Warm
  • Swollen

Without treatment, an acute flare may last up to two weeks.

Pseudogout

Pseudogout is a type of inflammatory arthritis. It's caused by calcium crystals building up in the joints. The most common joints are the:

  • Knees
  • Wrists
  • Shoulders
  • Ankles
  • Feet
  • Elbows

Pseudogout feels much like gout. But pseudogout attacks may last longer.

Recap

Osteoarthritis, gout, and pseudogout are common joint pain causes. Osteoarthritis is from joint cartilage wearing away. Gout and pseudogout pain is from crystals in the joint and the immune system's inflammatory response to them.

Septic Arthritis

With septic arthritis, a joint becomes infected. It's most often due to bacteria. In rare cases, it may be a fungus (like Candida) or mycobacteria (like tuberculosis).

Septic arthritis tends to affect a single joint. It's usually a:

  • Knee
  • Ankle
  • Wrist
  • Hip

The affected joint gets swollen, warm, and stiff. You'll also have a fever.

The infection usually starts in the blood, then moves into the joint. Less often, joint surgery or something like a tick bite may be the culprit.

Viral Arthritis

Several viruses may cause viral 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.

ARTHRITIS TYPE COMMON JOINTS CHRONIC OR ACUTE DISTINGUISHING FEATURES
Osteoarthritis Knees Hips Neck Low back Fingers Chronic Worse with movement Better with rest
Erosive osteoarthritis Fingers Chronic Aggressive Gradual onset
Gout Big toe Ankle Knee Chronic, acute flares Uric acid crystals Sudden, severe pain One joint
Pseudogout Knee Wrist Shoulder Ankle Foot Elbow Chronic, acute flares Calcium crystals Sudden, severe pain One joint
Septic arthritis Knee Ankle Wrist Hip Acute Joint infection Fever
Viral arthritis Usually 5 or more joints Acute Pain may linger after the infection is gone
Rheumatoid arthritis Wrists Elbows Hips Neck Chronic, acute flares Better with movement Worse with rest
Ankylosing spondylitis Back Neck SI joints  Chronic, acute flares Better with movement Worse with rest
Psoriatic arthritis Fingers Toes Chronic, acute flares Psoriasis plaques Nail symptoms
Reactive arthritis Knees Ankles Feet Acute Follows infections
IBD Associated Knees Hips Chronic, acute flares More active during IBD flare 
Lupus Knees Wrists Finger joints Chronic, acute flares Moves from one joint to another
Polymyalgia rheumatica Shoulders Neck Hips Chronic, acute flares Never affects feet, ankles

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease. It develops gradually. RA predominantly affects the joints. But early symptoms may include:

  • Fatigue
  • Muscle pain
  • Low-grade fever
  • Weight loss
  • Numbness and tingling in the hands

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. Then other joints follow. The likely ones are:

  • Wrists
  • Elbows
  • Hips
  • Neck

The joint(s) also tend to be stiff, warm, red, and swollen. Unlike OA, RA pain tends to be worst in the morning and lasts for more than an hour. It improves with movement.

Recap

Septic and viral arthritis are due to infection. They're short-term illnesses. Rheumatoid arthritis is a chronic inflammatory and autoimmune disease.

Spondyloarthritis

Spondyloarthritis is a family of inflammatory rheumatic diseases. It includes four conditions.

Ankylosing Spondylitis (AS)

Ankylosing spondylitis is an axial spondyloarthropathy. That means it mainly affects the:

The joint pain of AS tends to begin before age 45. It comes on gradually.

Symptoms tend to improve with activity (similar to RA). Morning stiffness that lasts longer than 30 minutes is also common in AS.

Psoriatic Arthritis

Psoriasis is an autoimmune skin disease. It causes patches of thick skin covered in silvery scales.

Up to 30% of people with psoriasis develop psoriatic arthritis. It most commonly affects the end joints of the fingers and toes. It causes:

  • Throbbing pain
  • Stiffness
  • Swelling
  • Nail problems like pitted nail beds

In about 15% of people, joint pain shows up before psoriasis appears.

Reactive Arthritis

Reactive arthritis shows up within six weeks after an infection in the urinary tract, genitals, or intestines. It causes joint pain and swelling.

Bacteria linked to reactive arthritis include:

Typical joints are the knee, ankle, and foot.

Arthritis Associated With Inflammatory Bowel Disease (IBD)

Some people with inflammatory bowel disease (IBD) develop a type of arthritis. It tends to be more active when bowel symptoms flare.

IBD includes Crohn's disease and ulcerative colitis.

Arthritis associated with IBD causes throbbing joint pain and swelling. It's more common in larger joints like the knees and hips.

Recap

Spondylitis is a subgroup of arthritis including four conditions. Ankylosing spondylitis typically affects the spine. Psoriatic arthritis involves throbbing joints and skin plaques.

Reactive arthritis is tied to certain bacteria. Arthritis associated with IBD affects people with Crohn's disease or ulcerative colitis.

Systemic Lupus Erythematosus

Joint inflammation is common in systemic lupus erythematosus (lupus or SLE). That's a chronic autoimmune disease. It can affect nearly every organ in the body.

Lupus especially hits the:

  • Knees
  • Wrists
  • Finger joints

Like RA, joints on the same side of the body tend to be affected. Unlike RA, the morning stiffness doesn't last as long (minutes for SLE versus an hour for RA).

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:

  • Significant muscle and joint aches
  • Stiffness in the shoulders, neck, and hips
  • Sometimes, mild swelling and tenderness in the wrists and fingers

The feet and ankles are never affected. And the disease almost exclusively affects people over 50.

PMR is associated with another condition called giant cell (temporal) arteritis. That's an inflammatory blood vessel disease. It causes inflammation in the arteries of the head and scalp.

Other Systemic Rheumatic Diseases

Other systemic (whole-body) conditions may cause arthritis, too. They include:

  • Systemic sclerosis: Involves the abnormal growth of connective tissues.
  • Sarcoidosis: Produces lumps of cells (granulomas) in organs and tissues, especially the lungs.
  • Familial Mediterranea fever: Rare genetic disorder that causes recurrent bouts of fever, abdominal pain, lung inflammation, and swollen joints.

Recap

Lupus is an autoimmune disease that affects organs and causes joint pain. Polymyalgia rheumatica affects the muscles and joints of people over 50. Other systemic rheumatic diseases can cause arthritis, as well.

Non-Arthritis Causes

Many other conditions cause joint pain that's not related to joint disease or inflammation.

Fibromyalgia

Fibromyalgia is a chronic pain condition. The pain comes from nervous system dysfunction and hypersensitive nerves.

Fibromyalgia pain usually 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 tests don't generally find any serious inflammation or joint damage.

NAME OF CONDITION COMMON JOINTS CHRONIC OR ACUTE  DISTINGUISHING FEATURES 
Fibromyalgia Any Chronic, acute flares Moves around the body
Fatigue
Fibro fog
Hemoarthrosis Any Acute Bleeding into a joint
May resolve without treatment
Hypothyroidism Any Chronic Fatigue
Weight gain
Cold intolerance
Lyme disease Knee
Shoulder
Ankle
Elbow
Jaw
Wrist
Hip
Acute, can become chronic Bacteria transmitted through tick bites
Depression Any Either Loss of interest
Sleep problems
Feeling hopeless

Hemarthrosis

Hemarthrosis occurs when you have bleeding into a joint. It may be due to a number of reasons, including:

  • Trauma
  • A bleeding disorder like hemophilia
  • A postsurgical complication
  • Tumor growth like a synovial (joint lining) hemangioma

Blood can damage the cartilage inside your joints. Symptoms include:

  • Joint pain and stiffness
  • Swelling
  • Bruising
  • Redness and warmth

It can take weeks or months to go away on its own. Treatment helps prevent pain and disability.

Hypothyroidism

Hypothyroidism involves an underactive thyroid gland. The most common cause is Hashimoto's thyroiditis. That's 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:

  • Joint aches
  • Stiffness
  • Fatigue
  • Weight gain
  • Constipation
  • Cold intolerance

Lyme Disease

Lyme disease is 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. Common sites include:

  • Knee
  • Shoulder
  • Ankle
  • Elbow
  • Jaw
  • Wrist
  • Hip

Depression

It may seem odd, but unexplained joint pain is a primary physical symptom of depression. Other common symptoms include:

  • A loss of interest in pleasurable activities
  • Appetite changes
  • Sleep disturbances
  • Difficulty concentrating
  • Feelings of hopelessness and/or guilt

Recap

Some non-inflammatory conditions can cause joint pain. In fibromyalgia, pain comes from hypersensitive nerves. In hemoarthritis, it comes from blood in the joints.

Hypothyroidism involves low thyroid activity. Lyme disease comes from bacteria spread by ticks. And joint pain is common in depression.

When to See a Healthcare Provider

New joint pain is a reason to see your healthcare provider. Also, make an appointment if you have a pain condition but:

  • Have pain in a new area
  • A markedly different type of pain
  • New symptoms along with the pain

Many people with one pain condition go on to develop another. For example, it's common for someone with RA or lupus to eventually develop secondary fibromyalgia.

Emergency Symptoms

Get urgent medical care if your joint pain is severe or you have:

  • Fever
  • Unexplained weight loss
  • Inability to function due to joint pain
  • A hot or significantly swollen joint
  • Sudden numbness with burning and/or muscle weakness

Diagnosis

Healthcare providers have myriad tools for diagnosing the cause of your back joint pain. They include:

  • A thorough medical history
  • A comprehensive physical examination
  • Blood tests
  • Imaging tests
  • A joint aspiration procedure
  • In rare cases, a biopsy (tissue sample)

The specific tests you get depend on your symptoms.

Medical History

The first step in the diagnostic process is a medical history. That includes the details of your joint pain, such as:

  • Where does it hurt?
  • How intense is it?
  • Is it worse at certain times of day? After rest or certain activities?
  • What makes it better and worse?

Your healthcare provider will also ask whether you have a family history of joint pain. That's because some conditions (like psoriatic arthritis) tend to run in families.

Be sure to tell your healthcare provider if any of the following apply to you:

  • Recent fever
  • Unusual symptoms, like fatigue or unexplained weight loss
  • Recent trauma
  • Recent surgery
  • Recent viral infection

Before your appointment, think about all of these things so you can provide helpful information.

How Symptoms Help

Details about your pain can help narrow down possible diagnoses. For example, if sudden, severe pain hits one joint at a time, it may be:

  • Gout
  • Pseudogout
  • Bacterial infection

Mild, achy pain that comes on gradually and affects more than one joint? It could be:

  • Rheumatoid arthritis
  • A type of spondylitis
  • Lupus

Joint pain of osteoarthritis improves with rest and worsens with activity. Arthritis due to RA is worse with rest and improves with activity.

Being thorough at that first appointment can help you get to the right tests, and the right treatments, faster.

Physical Examination

During the physical exam, your healthcare provider will press on the painful joints. They're looking for:

  • Warmth
  • Swelling
  • Tenderness

These are signs of inflammation. They'll also move your joints around to check for a limited range of motion or crepitus (popping and grinding).

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.

Labs and Tests

Blood tests are necessary for diagnosing many systemic (body-wide) causes of joint pain. 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.

For example, an X-ray may reveal:

  • Osteophytes (bony growths common in OA)
  • Joint space narrowing (see in OA)
  • Erosions (craters in the bone seen in inflammatory arthritis)

Other imaging tests may provide more information about a joint and its surrounding tissues. Common ones include:

Procedures

A few procedures can help confirm a diagnosis.

Joint Aspiration and Synovial Fluid Analysis

With joint aspiration, a needle is used to remove fluid from inside the synovium (joint lining). The fluid is then analyzed under a microscope. This can help diagnose:

  • Gout
  • Septic arthritis

Synovial Biopsy

If your healthcare provider suspects tuberculosis or fungal infection, they may perform a synovial biopsy.

This involves removing a small tissue sample from the synovium. The tissue is then examined in the lab.

In some cases, you may need to see a specialist (or more than one) to get an official diagnosis.

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.

Recap

See a healthcare provider if you have new joint pain, a new type of pain, or new symptoms occurring with the pain. Diagnosis usually involves a medical history, physical exam, and possibly blood tests, imaging, and other procedures.

Treatment

Treatments for joint pain depend on the diagnosis. Options include:

  • Self-care
  • Medication
  • Physical therapy
  • Complementary and alternative treatments
  • Less often, surgery

Self-Care Strategies

Simple things you can try at home, before or after a diagnosis, include:

  • Ice or heat
  • Topical pain relievers
  • Gentle stretching
  • Rest
  • Supportive wraps

You can take good care of your joint(s) and yourself by:

  • Staying up-to-date on vaccinations and regular check-ups
  • Educating yourself about your diagnosis
  • Doing aerobic and strengthening exercise regularly
  • Eating a nutrient-rich diet
  • Losing extra weight

You may want to try an anti-inflammatory diet. 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 type 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.

  • Hypothyroidism is treated with replacement thyroid hormones.
  • Some drugs help with gout by preventing uric acid crystal formation.
  • For septic arthritis, intravenous (through a vein) antibiotics are typical.

Physical Therapy

Physical therapy for joint pain focuses on:

  • Maintaining (or regaining) joint function and range of motion
  • Strengthening muscles surrounding the joint
  • Minimizing joint stiffness and pain

Depending on your condition, your physical therapist may recommend a walking aid, brace, or splint.

For fibromyalgia, a supervised physical exercise program is 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. They can be used alone (alternative) or along with other treatments (complementary). Some of these include:

Your healthcare provider can help you decide which approaches may be helpful or harmful to you.

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:

  • Young
  • Active
  • Have one-sided knee or hip problems

In severe cases, total joint replacement may be necessary.

Recap

Treatments for joint pain vary by condition. Your regimen may include self-care, medication, physical therapy, complementary and alternative therapies, and surgery. Surgery is usually a last resort.

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.

New joint pain, or a new type of joint pain, are reasons to see a healthcare provider. To diagnose the problem, they'll use your medical history, a physical exam, and possibly blood tests, imaging, and special procedures.

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 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 can start on the right treatments.

And that's what it takes to tackle your pain, quiet your symptoms, and improve your quality of life.

Frequently Asked Questions

  • What is causing pain in my jaw?

    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.

  • What causes pain in more than one joint at a time?

    Pain in many joints is caused by some types of arthritis or other inflammatory disorders. Multiple-joint pain that comes from elsewhere could be from tendonitis, bursitis, polymyalgia rheumatica, and fibromyalgia.

  • When should you see a healthcare provider for joint pain?

    Make an appointment if you have these symptoms for three days in a row or several times in one month:

    • Pain, swelling, or stiffness in one or more joints
    • Redness, warmth, or tenderness in one or more joints
    • Decreased mobility


  • Which is better for joint pain—hot or cold?

    Cold therapy (like an ice pack) is usually most effective for acute (short-term) joint inflammation. That's because it reduces blood flow to the area.

    Heat can relieve chronic joint pain. It does this by opening blood vessels so healing blood, oxygen, and nutrients can get to the joints.

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