True joint pain (arthralgia) may or may not be accompanied by inflammation of the joint (arthritis). Pain is the most frequent symptom of joint inflammation. Swollen joints may also be hot and swollen, and less often, the skin that covers them may be red. Pain can occur only with joint movement or also be present at rest. Other symptoms, such as skin rash, fever, eye pain or sores in the mouth, may be present depending on the cause of the joint pain.
When several joints are affected, some disorders more often affect the same joint on both sides of the body than others. This is called symmetric arthritis. Also, in some disorders, an acute arthritis crisis remains in the same joints throughout the duration of the outbreak. In other cases, arthritis moves from one joint to another (migratory arthritis).
In most cases, the cause of polyarticular pain is arthritis. The disorders that cause arthritis may differ from each other in certain characteristics, such as:
How many and which joints are usually involved?
• If it affects the axial skeleton, such as the spine or pelvis.
• If arthritis is sudden or long-term.
Acute arthritis that affects multiple joints occurs more frequently due to:
• Viral infections
• Start of a joint disorder or an outbreak of a pre-existing chronic joint disease.
Less common causes of acute polyarticular arthritis include Lyme disease, gonorrhea and bacterial streptococcal infections, reactive arthritis, and gout.
Chronic arthritis that affects multiple joints occurs more frequently due to:
• Inflammatory disorders such as rheumatoid arthritis, psoriatic arthritis, or systemic lupus erythematosus
• Osteoarthritis (in adults)
• Juvenile idiopathic arthritis (in children)
Other causes of chronic polyarticular arthritis are autoimmune disorders affecting the joints, for example, systemic lupus erythematosus, psoriatic arthritis, ankylosing spondylitis and vasculitis.
The most common disorders outside the joints that cause joint pain are:
• Rheumatic Polymyalgia
• Bursitis or tendonitis
Bursitis and tendonitis are usually the results of trauma, and usually, affect only one joint. However, some diseases can cause bursitis or tendonitis in several joints.
The underlying disorder is treated. For example, patients with an autoimmune disease may need a medication that inhibits the immune system. Patients with a joint infection with gonorrhea need antibiotics.
Symptoms can usually be relieved before knowing the diagnosis. The inflammation can generally be treated with non-steroidal anti-inflammatory drugs. Pain without inflammation is usually treated more safely with paracetamol. Immobilizing the joint with a splint or a sling can sometimes relieve pain. The application of heat can reduce the pain caused by spasm of the periarticular muscles.
The application of cold can help relieve pain caused by joint inflammation. Heat or cold should be applied for at least 15 minutes each time to allow deep penetration. The skin should be protected from extreme heat or cold. For example, ice should be placed in a plastic bag and wrapped in a towel.
After the acute pain and inflammation have subsided, physiotherapy can be helpful in regaining or maintaining range of motion and strengthening the surrounding muscles. In patients with chronic arthritis, it is important to maintain physical activity to avoid permanent joint stiffness (joint contractures) and loss of muscle mass (atrophy).