Joint Pain

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One of the most well-known, and likely the most frequent cause of joint-related problems is osteoarthritis, which leads to joint pain, stiffness, and limited range of motion. However, joint problems are common in a number of other conditions as well. For example, autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus (or lupus) can lead to the development of considerable joint problems, including inflammation, pain, and deformation. A condition known as gout occurs when uric acid builds up in the blood and causes inflammation of the joints, in particular those of the big toe and ankle. Sometimes, joint problems can arise following various infections, including hepatitis, influenza, measles, rubella, and mumps. Bone fractures can also result in both temporary and permanent joint problems, including decreased range of motion and pain.

Fibromyalgia patients are not spared from joint problems either, and are often plagued with unrelenting pain, stiffness, and decreased mobility. A common manifestation of joint-related problems in fibromyalgia patients is the presence of morning stiffness, which affects roughly 70% to 90% of all patients. Patients who experience morning stiffness experience tightened muscles, decreased range of motion, and stiff joints. As a result, it often takes excess time for their bodies to “loosen up” upon awakening, which can interfere with normal everyday tasks.

Fibromyalgia patients who suffer from joint problems can benefit from detailed tracking of their joint-related symptoms. Making note of the following aspects of joint pain/stiffness can help to better pinpoint triggers and exacerbating factors:

  • Note the joint(s) that hurts/is stiff and if the pain/stiffness is located on one side or both sides of the body
  • Record how long the pain/stiffness has persisted
  • Note if the pain/stiffness came on suddenly or gradually evolved
  • Note if the pain/stiffness is constant or fleeting
  • Note any current or prior history of injury, strain, or sprain to the joint(s)
  • Note if the pain/stiffness improves or worsens with rest or movement
  • Note if any medications or treatments have been helpful
  • Note any numbness or tingling in the area
  • Note the presence and duration of morning stiffness, if applicable

Treatment for Joint Problems

Due to the widespread prevalence of joint problems across a number of conditions, adequate treatment for pain, stiffness, and decreased range of motion is a top priority for those who suffer from any of the conditions listed above, including fibromyalgia. On a basic level, some home-care efforts can be utilized in order to relieve joint problems, or to supplement medicinal or physical therapy. These include rest and exercise (for non-arthritis joint pain), as well as warm baths, massage, and stretching exercises. A large body of scientific evidence exists to support the use of low- to moderate-intensity exercise for the purposes of improving pain and increasing range of motion and flexibility. Although the particular type of exercise that is most effective remains a source of debate, most researchers agree that a combination of strength training and aerobic exercise are the best approach for most individuals with joint and muscle pain. In particular, water-based exercises may be of added benefit (and easier to adhere to) for individuals with moderate to severe joint pain and stiffness.

Anti-inflammatory medications, such as ibuprofen or naproxen, can be useful to alleviate pain and reducing inflammation. Occasionally, narcotic pain medications may be required for severe joint pain, and some patients may benefit from injections of corticosteroids (such as prednisone or cortisone), although long-term use of such medicines can have severe side effects and result in further damage to the joint.

A number of natural medicines have been investigated for their use in treating joint pain and inflammation. Capsicum, ginger, cat’s claw, and Devil’s claw have all proven to be somewhat effective in treating the pain and/or inflammation associated with osteoarthritis, although studies have at times produced conflicting findings. In addition, researchers have also focused on the ability of glucosamine sulfate to repair joint damage and promote growth of new cartilage. Although a considerable amount of research has shown promising findings for glucosamine, some studies have failed to show that it is of any significant benefit. In terms of natural therapies for rheumatoid arthritis, cat’s claw, fish oil, glucosamine sulfate and several others have demonstrated possible effectiveness at improving rheumatoid arthritis-related symptoms.

Finally, limited research has been devoted to joint problems in fibromyalgia patients from a purely treatment-related aspect. One study found that the drug interferon-alpha (IFN-alpha) was helpful at improving morning stiffness in fibromyalgia patients, but little additional evidence has been reported in the scientific literature (Russell et al., 1999). One small study also found evidence to suggest that supplementation with melatonin may help to decrease the number of painful joints in fibromyalgia patients (Citera et al., 2000).

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References

1.        Joint Pain. Medline Plus. U.S. National Library of Medicine; National Institutes of Health.  Last updated 5/4/2010; Accessed July 10, 2012.

2.        Russell IJ, Michalek JE, Kang YK, Richards AB. Reduction of morning stiffness and improvement in physical function in fibromyalgia syndrome patients treated sublingually with low doses of human interferon-alpha. J Interferon Cytokine Res. 1999;19(8):961-968.

3.        Citera G, Arias MA, Maldonado-Cocco JA, et al. The effect of melatonin in patients with fibromyalgia: a pilot study. Clin Rheumatol. 2000;19:9-13.

4. Natural Medicines in the Clinical Management of Osteoarthritis. Natural Medicines Comprehensive Database. Accessed July 11, 2012.

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