Causes for joint and muscle pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Pain is the primary symptom of most musculoskeletal diseases.

The pain can be mild or severe, local or diffuse, depending on where the injury is. Although pain may be acute and short-lived, as is with most injuries, pain may be chronic, the prime example being arthritis.

Bone pain is usually a deep, penetrating, boring, or dull pain. It commonly results from injury; however, other causes of bone pain include infection and tumors.

While muscle pain is often less intense than that of bone pain, it still can be very uncomfortable. For example, a muscle spasm or cramp in the calf causes an intense pain that is known as a "charley horse." Pain can occur when a muscle is injured as a result of an athletic injury, an autoimmune reaction, loss of blood flow to the muscle, infection, parasite, or tumor.

Because joint pain is so common, doctors usually base a specific diagnosis on the presence of other symptoms and results of laboratory tests. For example, Lyme disease is characterized by joint pain and a peculiar skin rash; blood tests show antibodies to the spirochete that causes Lyme disease. Gout is characterized by a sudden attack of pain and inflammation at the base of the big toe; blood tests generally show elevated levels of uric acid. A similar condition can occur in pseudogout which is due to crystals of calcium pyrophosphate.

Sometimes pain can affect the tendons of the palm; this condition is called tenosynovitis or trigger finger.

Inflammation causes swelling, warmth, redness, and tenderness, along with pain, and reduced physical function. A fever may be present. Inflammation is a very common reaction of joints to a variety of abnormal circumstances, such as infection or autoimmune disease. Sometimes, the location where the tendon meets the bone, the “enthesis” becomes inflamed in conditions such as psoriatic arthritis, Reiter’s disease, or ankylosing spondylitis.

Muscle inflammation (myositis) can result from a number of diseases, including a viral infection. Like any inflammation, muscle inflammation can cause pain and tenderness, swelling, warmth, and impairment of function, occurring as muscle weakness.

Weakness can occur with many conditions affecting the musculoskeletal system. For example, if the muscle cannot contract, weakness occurs. If a nerve leading to the muscle is damaged, it can't stimulate the muscle and the muscle won't move. If a joint is frozen and unable to function normally, the muscle may not be able to cause movement. Even pain prevents normal movement, causing the appearance of weakness. Weakness may be limited to one joint or limb or diffuse, as occurs in widespread neurologic or muscular diseases.

Joint stiffness is common with arthritis. Disorders of joints often interfere with joint movement sufficiently to produce stiffness. Stiffness should be differentiated from pain. While they often co-exist, making the distinction between the two can help diagnostically.

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