Pain in a joint may be caused by a wide variety of
conditions. Below are fifteen of the more common causes of pain in or
around a joint.
- Capsulitis
One of the most common (yet underdiagnosed)
causes of acute pain in a joint is capsulitis. Joint capsule is the
covering that extends around a joint, so capsulitis is an inflammation of
that joint covering. Capsulitis is usually caused by small but
repetitive trauma, like that caused from running or walking, but it can be
caused by sudden, larger traumas like having something fall on the
joint. In cases caused by small, repetitive trauma, there is often a
structural abnormality associated with those joints, such as a
hammertoe,
or if there is abnormal or excessive flattening of the feet, or pronation.
- Synovitis Synovitis
is an inflammation of the cells within the joint
fluid (the synovium).
Closely tied to the joint capsule, the synovium is actually produced by the joint capsule. Some believe that
if you have capsulitis, you also have synovitis.
- Ligament damage
Ligaments
holding the bones together are directly adjacent to the joint, and they may
become strained or torn, giving the patient pain at the level of the
joint. Capsule may be considered as a specialized type of
ligament.
- Joint dislocation
In cases where the ligaments and/or capsule
is compromised enough, the bones that comprise the joint may actually tear through the capsule,
causing a dislocation of the joint.
- Arthritis
Arthritis
may develop in the joints in the area, frequently causing joint pain.
Some forms of arthritis tend to predispose particular joints in the
body. There are dozens of forms of arthritis, with the most common
types being:
- Osteoarthritis, the "wear and tear"
arthritis that may come from sudden, severe trauma or minor, low-grade
repetitive trauma. Affecting nearly 2 million Canadians,
osteoarthritis is more common than all the other types of arthritis put
together.
- Rheumatoid Arthritis, or "RA" for
short, is caused by an auto-immune response (where the body's defense
system starts attacking the body, itself). RA affects
approximately 225,000 Canadians.
- Gouty Arthritis is caused by too much uric
acid in the body, which can form crystals which get stuck in various
joints and other tissues. Gouty arthritis affects over 100,000
Canadians.
- Ankylosing Spondylitis seems to have a
genetic predisposition. Primarily affecting the spine, Ankylosing
Spondylitis affects approximately 40,000 Canadians.
- Juvenile Arthritis affects 25,000 children in
Canada, despite the generally wide-held belief that arthritis primarily
affects the elderly.
- Psoriatic Arthritis, a complication of
psoriasis, affects approximately 20,000 Canadians.
- Systemic Lupus Erythematosus (Lupus), a
systemic disease, affects the joints in approximately 15,000
Canadians.
- Bone bruise The
bones on the adjacent sides of the joint may become bruised. Terms
such as "metatarsalgia" (which literally means pain in the
metatarsal bones) is an example of one form of bone
bruise.
- Periostitis Periosteum
is the thin, soft-tissue sheath surrounding the bones.
Periosteum may be thought of as a thinner version of joint capsule, and it
may become inflamed. Because of periosteum's close proximity to the
bone itself, It may be difficult to differentiate periostitis from a bruise
of the bone.
- Stress Fractures One
step beyond metatarsalgia,
stress
fractures are small cracks in the metatarsals or toe bones that develop
over time as a result of excessive strain or stress.
- Foreign body A
foreign body (splinter, fragment of glass, etc) may cause severe pain in or
around a joint. This seems to be most common in patients with
neuropathy,
such as those with diabetes.
- Neoplasms There
are several types of benign and malignant bone
tumours, joint or
soft
tissue growths that may cause discomfort in
the region of a joint.
- Avascular necrosis This
is a degenerative condition where the constant stress to the metatarsal
bones gets severe enough that a portion of the bone actually begins to die.
-
Tendinitis There
are a lot more tendons in the area of the classic neuroma location than you
might think, any one of which may develop
tendinitis.
Tendons to the Flexor Digitorum Longus, Flexor Digitorum Brevis, Extensor
Digitorum Longus, Extensor Digitorum Brevis, the 3rd Dorsal Interosseus, the
2nd Plantar Interosseus and the 3rd Lumbrical muscles all attach in the area
immediately adjacent to the classic neuroma location.
- Crystal Deposition Disease In
addition to gout mentioned above, several other
crystal
deposition disorders may cause joint pain,
including pseudogout, hydroxyapatite deposition disease, steroid crystal
inflammation, and others.
- Neuroma
Neuromas are basically pinched nerves. The classic location is in the
ball of the foot, between the third and fourth toes, something called a Morton's
Neuroma.
- Infection Infections
may create pain in the area of a joint. An infection may affect the
soft tissues (the non-bony tissues), the bone itself, (a condition known as
"osteomyeltis"),
or the actual joint, (a condition known as "septic
arthritis").
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