Joint pain

Joint pain is a very common problem with many possible causes - but it's usually a result of injury or arthritis.

The information and advice on this page should not be used to self-diagnose your condition, but it should give you a better idea of what is causing your pain and what you should do.

It covers:

• pain in just one joint
• pain in many joints

Pain in just one joint

Of all the joints, the knee joint is probably the most frequently damaged and the most susceptible to pain. But knee pain isn't always a joint problem. Learn about the most common causes of knee pain and what you should do.

The most common and more unusual causes of pain in a single joint are described below.

Worsening of osteoarthritis

In older people, joint pain that gets steadily worse is usually a sign of osteoarthritis, which is the most common type of arthritis in the UK. It may affect just one joint, or many. Read more about the symptoms of osteoarthritis.

Osteoarthritis causes pain and stiffness because it damages the protective surface of the bones and cause mild swelling of the tissues in and around the joint.

It can sometimes affect younger people, especially those who are overweight or those who have had serious injuries to the joint in the past.

You should see your GP if you think this is the cause of your joint pain.

Inflammation of the joint lining

If you've injured the joint recently and it suddenly becomes painful again, the cause could be inflammation of the thin layer of tissue lining the joints and tendons - a condition called traumatic synovitis. It usually does not to cause any redness or heat.

You should be able to manage injury-related swelling at home with anti-inflammatories, an icepack and rest.

Gout or pseudogout

If the skin over the joint is hot and red, and the pain comes in repeated attacks, the cause is likely to be gout or pseudogout, which are types of arthritis.

Gout is caused by a build-up of uric acid (a waste product) in the body. Uric acid builds up if the kidneys do not excrete it properly or if too much is produced.

If the level becomes very high, crystals form in the joints. The crystals cause the joints to become inflamed and severely painful. You will barely be able to move the joint and may have a slight fever.

Gout usually affects the joint of the big toe first, before affecting other joints. It's important to correctly diagnose gout, as treatment will prevent future attacks of joint pain and disability.

Pseudogout is a similar condition to gout, in that crystals of calcium are deposited in and around the joint. However, unlike gout, pseudogout can affect the knee joint first.

You should see your GP if you think you have either condition.

Damage to the cartilage at the back of the kneecap

Knee pain that feels worse when going up or down stairs could be a sign of a damaged kneecap – a condition called chondromalacia patellae. This shouldn't cause any redness or heat around the knee.

The cause is not really understood, but it can be linked to overuse of the knee. 

You can treat this problem yourself with anti-inflammatories, an icepack and rest.

Bleeding into the joint space

If you have recently had an injury to the knee joint, such as a torn ligament or knee fracture, it may cause bleeding into the joint spaces. This is known as haemarthrosis.

This is more likely to happen to people on anticoagulants, such as warfarin. 

Signs of haemarthrosis are swelling of the knee, warmth, stiffness and bruising, which occur soon after the injury.

You should go to hospital immediately for treatment if you have a very swollen knee.

Less common causes

Sudden pain in a joint is less commonly caused by:

• a fracture (read about a broken arm or wrist, broken leg, broken ankle or hip fracture)
• reactive arthritis – which usually develops after an infection and tends to affect young adults
• psoriatic arthritis – a type of arthritis that affects up to one in five people with psoriasis 
• rheumatoid arthritis – which can start in just one joint, with the pain coming and going 
• Osgood-Schlatter's disease (swelling and tenderness over the bony bump just below the kneecap) 

Rarely, the cause may be:

• septic arthritis – a serious condition that causes a painful, hot, swollen joint that you won't be able to move (sometimes with fever) – see your GP urgently or go to A&E
• haemophilia – an inherited condition that affects the blood's ability to clot 
• a tropical infection
• cancer
• crumbling of the bone (avascular necrosis) – caused by a lack of blood supply
• Repeated dislocation of the joint

Pain in many joints

Osteoarthritis

In older people, the commonest cause of joint pain is osteoarthritis. This may affect just one joint, or many.

Many people also have rheumatoid arthritis at the same time.

Read about the symptoms of osteoarthritis.

Rheumatoid arthritis

Rheumatoid arthritis is another type of arthritis that causes pain and swelling in the joints – most commonly the hands, feet and wrists.

The pain may come and go in the early phases, with long periods between attacks.

It can leave you feeling generally unwell and tired. Read more about the symptoms of rheumatoid arthritis.

Psoriatic arthritis

Psoriatic arthritis affects up to one in five people with psoriasis. This type of arthritis is unpredictable, but flare-ups can be usually be managed with treatment.  

Like other types of arthritis, it means that one or more of your joints are inflamed and become swollen, stiff, painful and difficult to move.

A viral infection that causes arthritis

Examples are viral hepatitis (liver inflammation caused by a virus) and rubella (a viral infection that used to be common in children), which can both cause pain in the joints and symptoms of a fever.

The links will take you to more information on these conditions.

A disease of the connective tissue

Widespread joint pain is sometimes a sign of a disease that affects almost all the organs of the body, such as:

• lupus – where the immune system mistakenly attacks healthy cells, tissue and organs
• scleroderma – where the immune system attacks connective tissue underneath the skin, causing hard, thickened areas of skin

Less common causes

Widespread joint pain can less commonly be caused by:

• a rarer type of arthritis – such as anklyosing spondylitis, juvenile arthritis or reactive arthritis
• Behçet’s syndrome – a rare and poorly understood condition that causes inflammation of the blood vessels
• Henoch-Schönlein purpura – a rare condition, usually seen in children, that causes blood vessels to become inflamed
• cancer 
• some treatments – including steroid therapy, isoniazid and hydralazine
• hypertrophic pulmonary osteoarthropathy – a rare disorder that causes clubbing of the fingers, seen in people with lung cancer
• sarcoidosis – a rare condition that causes small patches of tissue to develop in the organs

The above links will take you to more information on these conditions.