Pain Conditions
      Back to home
      1. VCT Resource Library
      2. Pain Conditions

      Chronic Joint Pain

      Brief Overview: Chronic joint pain is persistent pain, stiffness, or discomfort in one or more joints lasting >3 months. It may result from degenerative changes, autoimmune conditions, past injuries, or overuse. It is highly prevalent in seniors and often contributes to reduced mobility, functional decline, and lower quality of life.

      Prevalence:

      • Among adults over 60, 30–50% report chronic joint pain.
      • Knee, hip, shoulder, and hand joints are the most commonly affected.

      Etiology:

      • Degenerative: osteoarthritis (cartilage breakdown).
      • Inflammatory: rheumatoid arthritis, gout, pseudogout, lupus.
      • Post-traumatic: prior joint injury, surgery.
      • Mechanical/overuse: repetitive strain, obesity-related stress on joints.

      Risk Factors:

      • Advanced age.
      • Female sex (higher risk for osteoarthritis and autoimmune diseases).
      • Obesity (increases load on joints).
      • Previous joint injury or surgery.
      • Occupations/hobbies with repetitive joint use.
      • Family history of arthritis.
      • Sedentary lifestyle leading to deconditioning.

      Commonly Associated Conditions:

      • Osteoarthritis, rheumatoid arthritis, gout, pseudogout.
      • Diabetes and metabolic syndrome.
      • Depression, anxiety, sleep disturbance.
      • Sarcopenia (muscle loss) and frailty in seniors.

      Common Medications:

      • NSAIDs, Tylenol
      • Corticosteroids
      • Antidepressants, sleep aids
      • Topicals: diclofenac gel, etc.
      • Opioids

      Common Labs, Imaging, and Tests:

      • Labs:
        • ESR, CRP (inflammation)
        • Rheumatoid factor, anti-CCP (if RA suspected)
        • Uric acid (if gout suspected)
      • Imaging:
        • X-rays (joint space narrowing, osteophytes in OA)
        • MRI/ultrasound (soft tissue, early arthritis, effusions)
      • Joint aspiration: if infection, gout, or pseudogout suspected.

      Common Symptoms:

      • Persistent pain (dull, aching, or sharp).
      • Stiffness, especially in the morning or after inactivity.
      • Swelling or tenderness around the joint.
      • Reduced range of motion.
      • Crepitus (grinding sound with movement).
      • Functional limitations (difficulty walking, climbing stairs, gripping).

      Common Treatments:

      • Heat/ice therapy
      • Exercise – discuss with your healthcare provider first to determine what the best exercise regimen for you is
      • Weight management
      • Dietary supplements – ask your healthcare provider if any are safe/recommended for you to try
      • Supportive aids – brace, cane, orthotics
      • Physical, occupational therapy

      Physical Findings:

      • Joint tenderness, swelling, warmth (in inflammatory causes).
      • Bony enlargement and deformity (OA, RA).
      • Decreased range of motion.
      • Muscle weakness around affected joint.
      • Limping or altered gait in hip/knee pain.

      Potential Complications and Contraindications:

      • Complications:
        • Functional decline, falls, immobility.
        • Depression, isolation, decreased quality of life.
        • Secondary weight gain and cardiovascular risks due to inactivity.
        • Joint deformity and disability if inflammatory arthritis untreated.
      • Contraindications:
        • NSAIDs: avoid in GI bleed history, kidney disease, uncontrolled hypertension, heart failure.
        • Corticosteroid injections: limit frequency (risk of cartilage/tendon damage).
        • Opioids: avoid long-term use unless severe refractory pain and under specialist care.

      General Health and Lifestyle Guidance:

      • Encourage low-impact exercise (walking, swimming, stationary cycling). Ask your healthcare provider what exercises are safe and recommended for you.
      • Stretching and strengthening exercises daily.
      • Maintain healthy weight to reduce joint strain.
      • Practice joint protection strategies (proper footwear, assistive devices).
      • Heat/ice therapy for flare-ups.
      • Good sleep hygiene — chronic pain worsens with poor sleep.

      Suggested Questions to Ask Patients:

      • Which joints are painful? When did the pain start?
      • What makes the pain better or worse?
      • Do you notice stiffness in the morning or after rest?
      • How does pain affect your daily activities (walking, dressing, cooking)?
      • Do you use pain medications? How often? Do they help?
      • Have you tried physical therapy, exercise, or joint supports?
      • Have you had any falls or near-falls due to joint pain?

      Suggested Talking Points:

      • Chronic joint pain is common as we age, but there are many ways to help manage it.
      • Gentle daily activity and strengthening exercises can help protect your joints.
      • Excess weight puts more strain on joints — even small weight loss can make a difference.
      • Using a cane, brace, or walker is not a weakness — it’s a way to stay safe and active.

      Sources:

      This content was created with the assistance of AI. Any AI-generated content was reviewed by a Nurse Practitioner.