Joint Pain: Causes from Arthritis to Autoimmune Diseases

At-a-Glance

• Joint pain affects millions of Americans, with arthritis being the leading cause
• Common causes include osteoarthritis, rheumatoid arthritis, gout, injuries, and overuse
• Location, pattern (single vs. multiple joints), and timing help identify the cause
• Many cases improve with rest, ice, exercise, and over-the-counter pain relievers
• Sudden severe joint pain with fever or redness requires immediate medical evaluation

What It Feels Like

Joint pain can affect one or multiple joints and ranges from mild discomfort to severe, debilitating pain that limits movement.

Common descriptions include:

• Aching or throbbing pain in joints
• Stiffness, especially in the morning or after rest
• Swelling, warmth, or redness around joints
• Reduced range of motion
• Grinding, clicking, or popping sensations
• Weakness or instability
• Pain that worsens with activity or improves with rest
• Symmetrical pain (both knees, both hands)

The pain may be constant or intermittent and can significantly impact daily activities.

Common Causes

Osteoarthritis

Osteoarthritis is the most common form of arthritis, caused by wear and tear of joint cartilage over time.

Signs it might be osteoarthritis:

• Gradual onset, typically after age 50
• Pain worsens with activity, improves with rest
• Morning stiffness lasting less than 30 minutes
• Affects weight-bearing joints (knees, hips, spine) and hands
• Bony enlargements on finger joints
• Grinding or crunching sensation (crepitus)
• Asymmetric (may affect one knee more than the other)

Risk factors:

• Age over 50
• Obesity
• Previous joint injury
• Repetitive stress on joints
• Family history
• Female gender

What helps:

• Weight loss (reduces joint stress)
• Low-impact exercise (swimming, cycling, walking)
• Physical therapy
• NSAIDs or acetaminophen
• Topical pain creams
• Hot/cold therapy
• Assistive devices (cane, brace)
• Corticosteroid or hyaluronic acid injections
• Joint replacement in severe cases

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease causing joint inflammation, typically affecting multiple joints symmetrically.

Signs it might be rheumatoid arthritis:

• Symmetrical joint pain (both wrists, both hands)
• Morning stiffness lasting more than 30 minutes
• Swelling, warmth, and redness
• Fatigue and low-grade fever
• Affects small joints first (hands, wrists, feet)
• Can affect any age, but often starts 30-60
• Symptoms may come and go (flares)

What helps:

• Disease-modifying antirheumatic drugs (DMARDs)
• Biologic medications
• NSAIDs for pain and inflammation
• Corticosteroids for flares
• Physical and occupational therapy
• Rest during flares, exercise during remission
• Early treatment prevents joint damage

Gout

Gout is caused by uric acid crystal deposits in joints, causing sudden, severe pain and swelling.

Signs it might be gout:

• Sudden, severe pain (often at night)
• Intense pain in big toe (most common)
• Joint is red, hot, swollen, and extremely tender
• Pain peaks within 12-24 hours
• Attacks last days to weeks, then resolve
• More common in men
• Triggered by diet, alcohol, dehydration, or medications

What helps:

• NSAIDs or colchicine for acute attacks
• Corticosteroids if NSAIDs contraindicated
• Medications to lower uric acid (allopurinol, febuxostat)
• Dietary changes (limit red meat, seafood, alcohol, sugary drinks)
• Stay hydrated
• Maintain healthy weight
• Avoid trigger foods

Bursitis and Tendinitis

Inflammation of bursae (fluid-filled sacs) or tendons around joints causes localized pain.

Signs it might be bursitis or tendinitis:

• Pain localized to one area near a joint
• Pain worsens with specific movements
• Tenderness when pressing on affected area
• Swelling
• Often related to overuse or repetitive motions
• Common in shoulders, elbows, hips, knees

What helps:

• Rest from aggravating activities
• Ice for acute pain
• NSAIDs
• Physical therapy
• Corticosteroid injections
• Gradual return to activity

Lupus

Systemic lupus erythematosus (SLE) is an autoimmune disease that can cause joint pain along with other symptoms.

Signs it might be lupus:

• Joint pain and swelling (often hands, wrists, knees)
• Fatigue
• Skin rashes (butterfly rash on face)
• Fever
• Hair loss
• Sensitivity to sunlight
• Mouth sores
• More common in women of childbearing age

What helps:

• NSAIDs for joint pain
• Antimalarial drugs (hydroxychloroquine)
• Corticosteroids
• Immunosuppressants
• Sun protection
• Regular medical monitoring

Fibromyalgia

Fibromyalgia causes widespread musculoskeletal pain, including joint pain, along with fatigue and sleep problems.

Signs it might be fibromyalgia:

• Widespread pain affecting multiple areas
• Tender points on body
• Fatigue
• Sleep disturbances
• Cognitive difficulties ("fibro fog")
• Headaches
• More common in women
• No visible joint swelling or inflammation

What helps:

• Regular exercise (start slowly)
• Stress management
• Adequate sleep
• Medications (duloxetine, pregabalin, gabapentin)
• Physical therapy
• Cognitive behavioral therapy
• Warm baths, massage

Viral Infections

Many viral infections can cause temporary joint pain.

Common viruses:

• Influenza (flu)
• COVID-19
• Parvovirus B19
• Hepatitis B and C
• Epstein-Barr virus

Signs it's viral:

• Joint pain with fever, fatigue, other viral symptoms
• Multiple joints affected
• Resolves as infection clears
• Recent illness or exposure

What helps:

• Rest and fluids
• NSAIDs or acetaminophen
• Treat underlying infection
• Symptoms typically resolve in days to weeks

Lyme Disease

Tick-borne infection can cause joint pain, especially in knees.

Signs it might be Lyme disease:

• Joint pain weeks to months after tick bite
• Large joints affected (especially knees)
• May have had bull's-eye rash earlier
• Fatigue, fever, headache
• Exposure to ticks (hiking, camping in endemic areas)

What helps:

• Antibiotics (doxycycline, amoxicillin)
• NSAIDs for pain
• Early treatment prevents complications

Serious Causes Requiring Immediate Attention

Septic Arthritis (Infected Joint)

Bacterial infection in a joint is a medical emergency.

Warning signs:

• Severe pain in one joint
• Joint is hot, red, and swollen
• Fever and chills
• Inability to move joint
• Feeling ill

Action: Seek emergency care immediately. Requires antibiotics and joint drainage.

Fracture

Broken bone near a joint can cause severe pain and swelling.

Warning signs:

• Severe pain after injury
• Visible deformity
• Inability to move joint or bear weight
• Rapid swelling
• Bruising

Action: Seek emergency care for X-rays and treatment.

When to See a Doctor

Schedule a doctor's appointment if:

• Joint pain persists for more than a few days
• Swelling, redness, or warmth around joints
• Morning stiffness lasting more than 30 minutes
• Joint pain interferes with daily activities
• Multiple joints are affected
• You have other symptoms (rash, fever, weight loss)

Diagnosis

Your doctor may perform:

• Medical history: Onset, pattern, affected joints, family history
• Physical examination: Check for swelling, warmth, range of motion
• Blood tests:
  • Rheumatoid factor and anti-CCP (rheumatoid arthritis)
  • Uric acid level (gout)
  • ESR and CRP (inflammation markers)
  • ANA (lupus and other autoimmune diseases)
  • Lyme disease antibodies
• Joint fluid analysis: Check for crystals, infection, inflammation
• X-rays: Detect arthritis, fractures, bone abnormalities
• MRI or ultrasound: Visualize soft tissues, inflammation

Treatment and Management

Treatment depends on the underlying cause:

For Osteoarthritis

• Weight management
• Exercise and physical therapy
• NSAIDs or acetaminophen
• Topical creams
• Injections
• Joint replacement if severe

For Rheumatoid Arthritis

• DMARDs and biologics
• NSAIDs and corticosteroids
• Physical therapy
• Early aggressive treatment

For Gout

• Medications for acute attacks
• Uric acid-lowering drugs
• Dietary modifications
• Hydration

General Strategies

Exercise:

• Low-impact activities (swimming, cycling, walking)
• Strengthening exercises
• Flexibility and range-of-motion exercises
• Balance training

Weight Management:

• Lose excess weight to reduce joint stress
• Every pound lost reduces 4 pounds of pressure on knees

Hot and Cold Therapy:

• Heat for stiffness (warm shower, heating pad)
• Ice for acute pain and swelling

Medications:

• NSAIDs (ibuprofen, naproxen)
• Acetaminophen
• Topical pain creams
• Prescription medications for specific conditions

Lifestyle Modifications:

• Protect joints (use assistive devices, avoid repetitive stress)
• Maintain good posture
• Pace activities
• Adequate rest

Frequently Asked Questions

The Bottom Line

Joint pain is extremely common, affecting people of all ages. While osteoarthritis is the most common cause in older adults, many other conditions—rheumatoid arthritis, gout, injuries, infections—can cause joint pain.

The pattern of joint involvement provides important clues: osteoarthritis typically affects weight-bearing joints asymmetrically, while rheumatoid arthritis causes symmetrical pain in small joints. Sudden, severe pain in one joint may indicate gout or infection.

Most joint pain responds well to conservative treatment: weight management, appropriate exercise, medications, and physical therapy. Early diagnosis and treatment of inflammatory arthritis like rheumatoid arthritis can prevent permanent joint damage.

Don't accept joint pain as an inevitable part of aging or ignore symptoms hoping they'll resolve on their own. Many effective treatments are available, and early intervention provides the best outcomes.

Remember: This information is educational and doesn't replace professional medical advice. If you're experiencing persistent or severe joint pain, consult a healthcare provider for proper evaluation and treatment.