UNC Health Care
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7 Reasons Your Joints May Ache

If your joints hurt, you probably want to know why and what can be done to alleviate your pain. We talked to UNC Health sports medicine specialist Michael K. Seifert, MD, about the seven most common causes of joint pain and how they are treated.

1. Osteoarthritis

Sometimes called wear-and-tear arthritis, osteoarthritis is the most common culprit in joint pain.

“Osteoarthritis occurs when the lining of the joints—which is called cartilage—is worn down,” Dr. Seifert says.

Although osteoarthritis can damage any joint, it most commonly affects the knees, hands and hips. The primary risk factors for osteoarthritis are obesity, a traumatic injury or a lack of physical activity.

To feel better, it helps to lose weight and to exercise, and physical therapy can make a big difference. Over-the-counter pain medication and anti-inflammatory topical gels and creams can help, as can injections of either the steroid cortisone or platelet-rich plasma (PRP). In the knee, hyaluronic acid injections are also an option.

Using PRP, doctors can extract platelets from the patient’s blood and then inject the platelets into the damaged joint or tendons to bring relief.

2. Tendon Injuries

The second most common cause of joint pain is injury to the tendons, which can range from inflammation and swelling to a partial or full tear.

“Tendons are the extension of muscles that attach on a bone, and a lot of the time these attach around joints, so sometimes you could feel like the pain is in your joint, but it’s really a muscle,” Dr. Seifert says.

For college and professional athletes, a torn tendon may be treated with surgery. For most people, treatment may involve some combination of over-the-counter pain medication, rest, cortisone injections, PRP or physical therapy.

“Using physical therapy, you can strengthen the other muscles around the injured muscle so it doesn’t have to do as much,” Dr. Seifert says.

3. Ligament Injuries

Injured ligaments can cause joint pain, particularly around the knees and ankles. Ligaments are pieces of tissue that attach bones to each other. Trauma, such as a forceful hit, is the primary cause of an injured ligament.

“Just like the tendon, you can partially or fully tear your ligaments,” Dr. Seifert says.

Some ligaments can heal on their own, while others require you to wear a brace. Surgery is necessary to repair large tears, Dr. Seifert says.

4. Gout

A common, painful form of arthritis, gout causes a chemical called uric acid to build up in the blood, which then “leaks into the joints and makes crystals” in the body’s joints, fluids and tissues, Dr. Seifert says.

“The crystals can be very painful and cause lots of swelling, pain and redness in the joints, such as your big toe, hand, wrist or knee,” Dr. Seifert says.

People with gout should avoid alcohol, red meat and shellfish in their diets, because these can make gout worse. If diet modification does not ease your pain, your healthcare provider may prescribe medication to lower the amount of uric acid in your blood.

5. Injured Meniscus

An injury to the meniscus, which is the cartilage in your knee that cushions and stabilizes the knee joint, is a common cause of knee pain. Although the meniscus is usually injured while playing sports, arthritis in the knee can also cause painful tears in the meniscus, Dr. Seifert says.

During some activities—especially contact sports—your knee can twist and tear the cartilage that provides cushioning between your thigh bone and shinbone.

Surgery is sometimes needed, but meniscus injuries also can be treated with physical therapy or cortisone or hyaluronic acid injections.

6. Autoimmune Diseases

Many autoimmune diseases—lupus and rheumatoid arthritis in particular—cause joint pain. People are born with a tendency to develop these conditions, which may be triggered by a viral infection, Dr. Seifert says.

More common in women in their 20s and 30s than in men, these autoimmune disorders usually “cause pain in the small joints—fingers, wrists and toes,” Dr. Seifert says.

Being active can help with the stiffness in the joints caused by lupus and rheumatoid arthritis, but sometimes medication is needed to treat flare-ups.

7. Frozen Shoulder

Also known as adhesive capsulitis, frozen shoulder causes pain and stiffness in the shoulder.

“There is a capsule that connects the two bones of the shoulder and allows the ball and the socket joint to move, and that becomes inflamed and stuck,” Dr. Seifert says. “It’ll hurt a lot in the beginning, and then they’ll start to notice they just can’t move their shoulder.”

A frozen shoulder will usually resolve on its own over time, but a steroid injection can help reduce inflammation. Sometimes, doctors use hydrodilatation, the injection of a large amount of sterile fluid to expand the shoulder joint capsule, which “helps the motion in the shoulder come back more quickly,” Dr. Seifert says. Physical therapy also helps.


Have pain in your joints? Talk to your doctor or find one near you.