Joint pain: common causes and when to see a doctor

Joint pain is pain in or around a joint, most often caused by overuse, injury, osteoarthritis or an inflammatory disease. In most cases it is managed without surgery. Pain or stiffness that lasts longer than a week and does not ease on its own is reason enough to see a doctor.

What causes joint pain

A joint is made of several parts: the ends of the bones covered with cartilage, the joint capsule, ligaments, tendons and muscles. Pain can come from any of them, and finding the source is the first step of treatment.

Cause	Typical picture
Overuse	Pain appears after new or increased activity and eases with rest
Injury	Pain starts at a specific moment: a fall, a twist, a blow; often with swelling
Osteoarthritis	Pain builds gradually over years and gets worse with load
Inflammatory arthritis	Several joints at once, long morning stiffness, swelling even at rest
Tendon inflammation or bursitis	Pain in one spot, brought on by a specific movement
Referred pain	Pain is felt in the joint, but its source is elsewhere

Overuse is the most common and the most harmless cause. A new workout, a long walk, gardening or kneeling for a long time puts a load on the joint and its tendons that they are not used to. Pain of this kind usually settles on its own within a few days.

Bursitis is inflammation of a bursa, a small fluid-filled cushion that reduces friction between a tendon and a bone. Its pain is often felt as joint pain, even though the joint itself is healthy.

Osteoarthritis or arthritis: how to tell them apart

The two words sound alike, but they are different diseases. Osteoarthritis is the gradual wear of cartilage that develops over years. Arthritis is inflammation of the joint, often driven by the immune system.

The simplest guide is morning stiffness:

Sign	Osteoarthritis	Inflammatory arthritis
Morning stiffness	Short, usually eases within 30 minutes	More than 30 minutes, often 1 hour or longer
When it hurts	With load, at the end of the day	At rest and at night too
How many joints	Often one or two weight-bearing joints	Often several at once
Swelling	Moderate	Marked, the joint is often warm

This is a guide, not a diagnosis. If an inflammatory disease is suspected, I refer you to a rheumatologist, because its treatment belongs to another specialty. More on both conditions: osteoarthritis or arthritis.

Pain that comes from somewhere else

Not all pain starts where it is felt. This is called referred pain, and it is common in orthopaedics:

• knee pain whose source is the hip joint: my knee hurts, but the problem is in the hip;
• shoulder and arm pain that comes from the neck;
• thigh and leg pain that spreads from the lower back: lower back pain or the hip joint.

That is why the examination is not limited to the place that hurts. A knee X-ray can be normal while the problem sits higher up, in the hip joint.

What you can do yourself in the first few days

If the pain started after overuse or a minor injury and none of the urgent signs listed below are present, the first days can usually be managed at home:

• Cut back on the movement that causes pain, but do not stop moving altogether. Long periods of inactivity weaken muscle and increase stiffness.
• A cold pack in the first days after an injury reduces swelling. Do not put ice directly on the skin: wrap it in a cloth.
• A warm pack is often more comfortable than a cold one for long-standing stiffness.
• A painkiller can help for a short time, but it masks pain and does not treat its cause. If you take other medicines or have stomach, kidney or heart disease, ask a doctor first.

When to see an orthopaedic trauma surgeon

The general rule is simple: pain or stiffness that lasts longer than a week and does not ease on its own is reason enough to see a doctor. It is also worth booking a planned consultation if:

• the pain wakes you at night (night pain is a topic of its own);
• the joint no longer bends or straightens fully;
• your gait has changed or you are limping;
• the joint seems to lock or give way;
• you have pain in several joints at once rather than one;
• time has passed since an injury, but function has not fully come back.

People get used to pain easily. The price is that a problem that would have been simple to manage early gradually becomes harder: the body changes the way it moves, muscles weaken, and load falls on structures that were not designed for it.

When you should not wait

In these situations do not wait for a planned visit, seek urgent care:

• a joint has suddenly swollen, turned red and feels hot, especially with a fever: this may be a joint infection;
• after an injury you cannot put weight on the limb, or it looks deformed;
• the limb has gone numb, weak or changed colour;
• the pain is sudden, very severe and nothing relieves it.

If shoulder or arm pain comes with chest pain, shortness of breath or a cold sweat, call emergency services (112 in Georgia): a heart attack sometimes starts exactly this way.

What happens at a consultation

A consultation starts the same way for every joint: I listen, examine, and order investigations only when they answer a specific question. At the end you have a treatment plan: what to do now and when we meet again. What non-surgical treatment involves is described here: treatment options.

For non-surgical care I see patients with any joint. I have written about each area separately:

• shoulder pain
• knee pain
• lower back and neck pain
• scoliosis
• hand and wrist pain
• foot and ankle pain

I operate only on the hip joint. If another joint needs surgery, I refer you to a specialist in that area. I explain this boundary in detail here: seeing an orthopaedic trauma surgeon.

Key points

• The most common cause of joint pain is overuse, and it usually settles within a few days.
• Pain or stiffness lasting more than a week is reason enough to see a doctor.
• Long morning stiffness and several swollen joints point to an inflammatory disease.
• Pain sometimes comes from another place, so the examination is broad.
• A hot, red joint that swells suddenly is an emergency.

If you are not sure whether you need to see a doctor, booking a consultation is there to answer exactly that question.