Joint pain

Joints form the connections between bones. They provide support and help you move. Any damage to the joints from disease or injury can interfere with your movement and cause a lot of pain.

Many different conditions can lead to painful joints, including osteoarthritis, rheumatoidarthritis, bursitis, gout, strains, sprains and other injuries. Joint pain is extremely common, with millions of sufferers in the UK. Among the most common conditions are knee pain, along with shoulder and hip pain, but joint pain can affect any part of your body, from your ankles to your shoulders. As you get older, painful joints become increasingly more common.

Joint pain can range from mildly irritating to debilitating. It may go away after a few weeks (acute), or last for several weeks or months (chronic). Even short-term pain and swelling in the joints can affect your quality of life. Whatever the cause of joint pain, you can usually manage it with medication, physiotherapy, or alternative treatments. 

Your doctor will first try to diagnose and treat the condition that is causing your joint pain. The goal is to reduce pain and inflammation, and preserve joint function. Treatment options include:

Medications

For moderate-to-severe joint pain with swelling, an over-the-counter or prescription nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, or naproxen sodium, can provide relief. A newer generation of NSAIDs known as COX-2 inhibitors is also good for pain relief. NSAIDs also can have side effects, potentially increasing your risk for gastrointestinal bleeding.

If you have milder pain without any swelling, paracetamol can be effective. Be careful when taking this medicine though, especially if you drink alcohol, because high doses may cause liver damage. Because of the risks, you should take any of these pain medications with caution.

If your pain is so severe that NSAIDs and COX-2 medicines aren't effective enough, your doctor may prescribe a stronger opioid medication. Because opioid drugs can cause drowsiness, you should only use them under a doctor's care. They also can cause constipation, which you can relieve by taking laxatives.

Other drugs that may help relieve pain include:

• Muscle relaxants to treat muscle spasms (may be used together with NSAIDs to increase the effect)
• Tricyclic antidepressants and antiepileptic drugs (which both interfere with pain signals)

Topical agents

Capsaicin -- a substance found in chilli peppers -- may relieve joint pain from arthritis and other conditions. Capsaicin blocks substance P, which helps transmit pain signals, and it triggers the release of chemicals in the body called endorphins, which block pain. Side effects of capsaicin cream include burning or stinging in the area where it is applied. Another topical option is an arthritis cream containing the ingredient methyl salicylate.

Injections

For people who don't find joint pain relief from oral or topical medications, the doctor can inject a steroid medication (which may be combined with a local anaesthetic) directly into the joint. Steroid injections are most commonly used in patients with arthritis, joint disease or inflammation. Research still has not confirmed whether this procedure is effective, and it can have side effects; if steroid injections mask an injury, you could overuse the joint and damage it even further.  

Other injection options include:

• Removing fluid from the joint (this only relieves pain temporarily because the fluid eventually builds up again)
• Injections of hyaluronan, a synthetic version of the natural joint fluid