What could cause joint pain and swelling?

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Over time, your joints can take a beating from a variety of things - from running too much, or from weighing too much, or from playing too many contact sports. And as you age, the shock-absorbing cartilage and synovial fluid thin and you gradually lose their protective cushioning - just as an old pair of running shoes loses its ability to absorb shock and pounding.

Like most things, your body balances the wear and tear by putting new fluid in and getting rid of the old fluid. But if a joint becomes injured or inflamed from wear and tear, you can produce too much synovial fluid, which leads to painful swelling. Over time, and as we age, we produce less synovial fluid and our cartilage breaks down. The breakdown of cartilage and loss of synovial fluid can lead to painful bone on bone grinding because of the loss of your shock absorbers.

Muscle weakness is another major cause of joint pain. Muscles suspend the bones in joints, so the bones don't touch each other and there's less pressure on the joint. When muscles get weak, joints deteriorate and bones lose their ability to slide smoothly, so they end up rubbing against each other like stick on stick. When you have pain, you start hobbling and your muscles immediately get weaker, so when you start moving around again, guess what? The ability of your muscles to suspend your bones is lost and you feel bone hit bone with only the thin Teflon cartilage in between. That process triggers painful inflammation, which can make even walking tough.
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Aaron Nelson
Sports Medicine
Joint pain and swelling can be caused by several factors. In acute cases, direct blows to a joint(knee to knee, knee to object, kicking an object, etc.), twisting(foot planted and over rotating internally or externally), damaging/tearing meniscus or medical issues(bug bites near a joint or infections) can all cause pain and swelling to a joint. Chronic issues such as arthrits, OCD(osteochondral defects) or debris(loose bodies) in the joint can also cause pain and swelling.

In addition to acute trauma and medical conditions, chronic joint pain can be caused from muscle imbalances around the affected joint. Muscles surround a majority of the joints in the body and move our bones as they are signaled from the central nervous system to do so. When the muscles around a joint are balanced, that means that all the muscles are equally "active" in their ability to produce force at the right time, in the right direction, with the right amount of force. 

Muscles can become imbalanced with poor postural habits, overuse, or repetitive occupational or athletic stress (i.e. carpal tunnel syndrome from typing or rotator cuff strain from excessive overhead activity such as painting). When this occurs, certain muscles around the joint become overused, overactive, or over-tight and others become underused, underactive, and over-lengthened. When this happens, excessive, unequal stress is placed on parts of the joint, the body senses this as an injury, and begins the inflammation process in an attempt to heal the joint thereby producing swelling and pain.

If the stimulus for injury and inflammation is not alleviated, pain and swelling will continue, joint tissue will wear down, and chronic pain will follow.

Kathleen Porter
Alternative & Complementary Medicine

With the exception of traumatic injury to a joint, much joint pain and swelling is caused by basic misalignment of the skeleton. This can show up as osteoarthritis (a common condition that contributes to joint pain and swelling), loss of synovial fluid and deterioration of cartilage in the joint capsule, tendonitis and other musculoskeletal complaints. However, the underlying cause of all of these conditions is often the misalignment of the skeleton that puts chronic stress and strain on the joints.

Subject to the same physical laws that govern engineering and architecture, the bones of the skeleton form the underlying structure of support, much like the wall studs and posts behind the walls of a house. When the bones are naturally aligned, the muscles that attach to those bones are able to function in an efficient and balanced way. When those bones don't conform to these physical laws, many problems develop, most commonly at the joints, where bones are "lashed together" with ligaments and other connecting tissue.

Close examination of healthy toddlers and countless people in rural environments throughout the world  (often small women) who successfully carry astonishingly heavy loads on their heads without developing problems, is now revealing that it is those people who never lose what we all discover as healthy toddlers, who are best able to avoid many common "modern" pain problems, beginning with joint pain.

Swelling of joints can result from many different issues. It can be from injury (new or old), rheumatologic disease like rheumatoid arthritis, lupus or psoriatic arthritis, a flare-up of a chronic disease like osteoarthritis or infection. Gout is another common cause of joint swelling and most often starts in the big toe. Swelling of particular joints and whether the swelling is on the right and left side or just one-sided can sometimes give your doctor a good clue of what disease-process may be occurring.
Injury is the main cause of pain in a single joint regardless of age. When several joints begin to hurt at once, it is more likely to be arthritis. Arthritis is the leading cause of joint inflammation and pain aside from injury. Osteoarthritis, a degenerative joint condition, is the most common underlying cause of joint problems related to arthritis. Osteoarthritis can be inherited or caused by excess weight, trauma to a joint, and aging. Infectious arthritis and gout are also common causes of joint pain.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.