Swollen Joints (Effusion): Symptoms, Causes, Treatment

Swollen joints (effusion) occur when extra fluid builds up within joints due to injury or inflammation. This causes the areas within and around the joints to become swollen and puffy, which can cause pain and difficulty moving your joints.

While swollen joints commonly result from physical injuries to joints or from osteoarthritis (wear-and-tear arthritis), swollen joints can also result from autoimmune conditions that cause the body to attack its own joints.

This article will discuss the symptoms, causes, and treatments for swollen joints, and when to see a healthcare provider. 

Joint pain

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Symptoms of Swollen Joints

Swollen joints are characterized by increased fluid accumulation within and around joints that causes the areas around the joints to become puffy and look larger than usual. The extra fluid can also make the skin around your joints feel tight and restrict your movement. In addition to these physical changes, swollen joints can also cause other symptoms, such as:

  • Pain
  • Decreased range of motion
  • Joint stiffness
  • Tenderness to the touch
  • Skin redness
  • Warm or hot feeling around the joint
  • Fever

When to Seek Prompt Medical Care

If you experience sudden joint swelling accompanied by significant pain, bruising, redness, and/or difficulty or inability to move your joint through its full range of motion, seek medical attention as soon as possible. These could be signs of an injury, infection, or autoimmune condition.

Causes of Swollen Joints

Swollen joints can result from injuries or conditions that cause joint inflammation.

Common causes of swollen joints include:

  • Injuries: Trauma to your joints, bones, cartilage, tendons, ligaments, and muscles, such as a ligament or meniscus tear, can cause swelling in and around your joints. 
  • Infection (septic arthritis): A bacterial infection can infect joints (usually the knees and hips), leading to septic arthritis that causes joint swelling, pain, fever, and chills.
  • Gout and pseudogout: Gout and pseudogout are both inflammatory conditions that are a common cause of painful, swollen joints, but their causes are different. Gout develops when uric acid causes crystal buildup in the joint. "Pseudogout" refers to the acute attacks of calcium pyrophosphate deposition disease (CPPD), which are caused by calcium crystals in the joints. 

Less common causes of swollen joints include:

  • Rheumatoid arthritis: Rheumatoid arthritis (RA) is an autoimmune condition that causes the body to attack its own joints, causing joint inflammation that results in painful, red, and swollen joints. Rheumatoid arthritis usually affects the same joints on both sides of the body, most commonly in the hands, wrists, and knees. 
  • Psoriatic arthritis: Psoriatic arthritis (PsA) is an autoimmune condition that often develops as a complication of psoriasis, an inflammatory skin condition that causes red, dry, itchy skin patches. Psoriatic arthritis most commonly affects the fingers and toes, resulting in a swollen sausage-like appearance.
  • Ankylosing spondylitis: Ankylosing spondylitis (AS) is an autoimmune condition that causes inflammation of the spine, most often resulting in low back pain and fatigue. Ankylosing spondylitis can also affect the knees, hips, and shoulders, causing joint pain and swelling.
  • Osteoarthritis: Osteoarthritis results from the breakdown of cartilage within joints, causing joints to become stiff, painful, and swollen. Osteoarthritis most commonly affects the neck, back, fingers and hands, knees, and hips.

How to Treat Swollen Joints

Treatment for swollen joints will differ depending on the underlying cause. Applying ice to and elevating the affected area can help decrease swelling.

If your swelling is due to an injury, it will take some time for the swelling to go away and your body to fully heal. The time will vary depending on the severity of your injury. If you injure any of the joints of your lower body, including those in your feet, ankles, and knees, avoid prolonged sitting or standing. Taking breaks to walk and move your joints can help decrease fluid from pooling in your feet and lower legs. 

Other treatments to help control your swelling, especially if you also have a lot of pain, include cortisone injections into your affected joints. Cortisone injections are anti-inflammatory steroid medications that can help decrease inflammation and related pain and swelling.

If your swollen joints are related to an autoimmune condition (such as RA, PsA, or AS), your healthcare provider may also recommend taking certain types of medications such as disease-modifying antirheumatic drugs (DMARDs) or biologics. These medications can help decrease the autoimmune response to treat joint inflammation and swelling and are typically administered via an injection or IV fusion.

Other medications, such as Mitigare or Colcrys (colchicine) or Aloprim (allopurinol) to treat gout or antibiotics to treat an infection, may be needed to reduce your swollen joints.

Complications and Risk Factors Associated With Swollen Joints

Swollen joints typically indicate some type of inflammation within your body, whether it’s from an injury, autoimmune disorder, or another condition. If left untreated, these conditions can progress and lead to serious and sometimes permanent joint damage and disability.

Scheduling an appointment with your healthcare provider to determine the underlying cause of your swollen joints is important for protecting your joints and maintaining their ability to move and support your body parts. 

Autoimmune conditions that cause swollen joints also affect and cause inflammation throughout the entire body and can damage multiple organ systems. Early diagnosis and consistent treatment are key for managing autoimmune conditions to prevent them from getting worse. 

Are There Tests to Diagnose the Cause of Swollen Joints?

Swollen joints are initially assessed through a physical examination to observe the appearance of your joints and their ability to move. Imaging tests like X-rays, ultrasound, magnetic resonance imaging (MRI) can be used to examine your bones and structures in and around your joints to check for damage from an injury or arthritis. 

Blood work may also be performed if your healthcare provider suspects that gout or an autoimmune condition is causing your swollen joints. Y

Your healthcare provider may perform a procedure called a joint aspiration (arthrocentesis) in which fluid is removed, or aspirated, from your swollen joint. This procedure helps assess the cause of swelling and helps to decrease it. A joint aspiration also provides a sample of fluid that can be tested for markers of infection, gout, or autoimmune conditions.

When to See a Healthcare Provider

You should schedule a visit with your healthcare provider if you experience a sudden onset of pain and swelling within a joint to check for signs of injury or infection. You should also see your healthcare provider if you have been experiencing swelling within your joints for several weeks or months to determine the underlying cause and receive appropriate treatment.

If you have swollen joints that become red, hot, and very painful, seek immediate medical attention. These are signs that you may have a serious infection or flare up of an autoimmune attack. 

Summary 

Swollen joints result from excess fluid accumulation within and around joints. Swollen joints can result quickly from an injury, over time with arthritis, or change in severity and include gout or autoimmune conditions such as RA, PsA, or AS.

Ice and elevation to the affected joints can help decrease swelling, while pain medications and cortisone injections may be needed to treat swelling that also causes pain. Swollen joints from autoimmune conditions often require special medications given via injection or IV infusions to help control chronic joint swelling and inflammation. 

A Word From Verywell 

Swollen joints can indicate injury or inflammation to the body. While mild swelling from arthritis or a minor injury typically resolves with time, rest, and icing, swelling that lasts for a long time or that occurs with significant pain is a cause for concern. Contact your healthcare provider to help determine the underlying cause of your swollen joints and initiate appropriate treatment to prevent permanent damage to your joints.

Frequently Asked Questions

  • What causes swollen joints?

    Swollen joints are caused by injuries or conditions that cause joint inflammation like gout, osteoarthritis, or autoimmune forms of arthritis, such as RA, PsA, and AS.

  • Can arthritis cause swollen joints?

    Arthritis can cause swollen joints by causing joint inflammation from the breakdown of cartilage. Inflammatory autoimmune forms of arthritis can also cause swollen joints when the body produces an autoimmune response and attacks its own joints, causing joint pain, inflammation, and swelling.

  • How can I get rid of swollen joints?

    You can help treat swollen joints by applying ice, resting painful joints from aggravating movements, and talking to your healthcare provider about different medication options that can treat the underlying cause.

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By Kristen Gasnick, PT, DPT
Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.