Joint pain is a prevalent medical condition with several likely causes. However, the condition is often attributed to three primary causes—inflammation, injury and degenerative osteoarthritis. In the elderly, joint pain that consistently gets worse usually signals osteoarthritis.
Whether joint pain is a cause for worry or not will depend on the underlying cause. In essence, joint pain can be the result of any of the following:
Gout
Gout is a form of arthritis that can cause an attack of stiffness, joint swelling, and sudden burning pain. The attacks can occur repetitively unless the condition is treated. Over time, gout can cause harm to the tendons, joints, and other tissues. The condition is far more common in men than in women.
Causes – Gout is primarily attributed to a high level of uric acid in the blood. It can be familial and may occur in the males within a family. When the uric acid level becomes significantly high, the uric acid can form hard crystals in the joints. The chances of developing gout are higher for individuals who drink too much alcohol, those who eat food high in purines (“red” meat), and those who are overweight.
Symptoms – Prevalent symptoms of gout include night-time attacks of tenderness, swelling, sharp pain, and redness in the big toe. Gout attacks can also occur in the knees, ankle, foot, and other joints. Occasionally they may follow intense exercise due to muscle breakdown and release of purines. Attacks can linger for a few days (or weeks) before the pain goes away.
Treatment – To help relieve pain, resting the affected joint is suggested. Taking ibuprofen and other anti-inflammatory drugs like Indomethacin will also help. Probenecid helps the kidneys to excrete crystals in the urine. To prevent future attacks, your doctor will likely prescribe medication that will help minimize the buildup of uric acid in the blood. Colchicine is used in acute attacks, and allopurinol for long-term control.
Rheumatoid Arthritis
Rheumatoid arthritis can cause joints to become stiff, painful, and swollen. The condition is more common in women and often develops between the ages of 40 and 60 years old.
Causes – The exact cause of the condition is not known. However, rheumatoid arthritis is considered an autoimmune disease and affects females more commonly than males, opposite to gout.
Symptoms – Primary symptoms of rheumatoid arthritis include swelling, stiffness, and pain in the joints of the wrists, feet, ankles, neck, knees, and elbows. Gnarled deformities can also occur, especially in the wrists and fingers. The condition often affects both sides of the body.
Treatment – Management of rheumatoid arthritis can include medicine (disease-modifying anti-rheumatic drugs, or DMARD), lifestyle changes, and exercises.
However, if the disability will not respond to conventional treatment interventions, surgery might be an option, especially in removing the florid swelling of the synovial lining of joints or replace damaged joints with artificial prostheses.
Osteoarthritis
Also known as “wear and tear” arthritis and degenerative joint disease, primary osteoarthritis is considered a chronic joint condition. While the condition can develop in any joint, it often occurs in the neck, lower back, knees, hips, big toe, and the small joints of the fingers.
Causes – Factors like genes and excess weight has been known to contribute to the development of the condition. Joint injuries (i.e. ligament tears, fracture, etc.) and repetitive stress-loading have been known to also cause osteoarthritis. Bone and joint disorders and certain metabolic disorders may also lead to the development of osteoarthritis (secondary osteoarthritis).
Symptoms – Osteoarthritis symptoms can vary depending on the joints affected and the severity of the condition. However, stiffness and pain (often more pronounced in the mornings or after resting) are the most prevalent symptoms. Joints affected may also swell especially after doing activities for prolonged periods.
Other common symptoms include:
- Limited motion range
- Cracking or clicking sound when the joint is bent
- Mild swelling (around the affected joint)
- Pain that gets worse after an activity
Treatment – Osteoarthritis is a chronic condition. While there is no cure, there are treatment interventions available that will help manage the symptoms. Management of the condition includes physical activity, stretching, weight management, oral and topical medications (i.e. acetaminophen, opioids, ibuprofen, celecoxib, naproxen, corticosteroids, etc.), occupational and physical therapy, assistive devices like bracing, alternative and natural therapies, and joint replacement surgery.
Reactive Arthritis
Formerly known as Reiter’s syndrome, reactive arthritis is a type of arthritis that affects the urethra, eyes, skin, and joints.
Causes – While the cause of the condition is still unknown, some research suggests that reactive arthritis is partly caused by a genetic predisposition, as approximately 75 per cent of the individuals with reactive arthritis tested positive for the genetic marker HLA-B27. In some cases, people develop symptoms of the condition after an intestinal infection with salmonella, shigella, campylobacter bacteria, and yersinia.
Symptoms – Prevalent symptoms that point to reactive arthritis include:
- Arthritis that usually affects the toes, fingers, ankles, hip and joints of the knee
- Inflammation of the eye
- Back pain (from sacroiliac joint involvement)
- Pain (secondary to inflammation of the tendons and the ligaments)
Treatment – Inflammation of the joint secondary to reactive arthritis is often treated using nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, naproxen, and ibuprofen. Those patients with chronic arthritis may benefit from the expertise of a physical therapist and may be advised to exercise on a regular basis.
