Causes Of Joint Stiffness And Its Treatment
Joint stiffness occurs when there is difficulty in moving a particular joint or joints across the required number range of motions. Most times, joint stiffness does not occur isolated, it is often accompanied by painful joint symptoms or swelling of the affected joint. And depending on the specific etiology of the stiffness, such individuals can experience redness of the joint, tenderness on examination of the joint, numbness and at times, tingling sensation in the affected joint (1).
There are numerous causes of joint stiffness, it can occur as a result of a disease entity like cancer, or it can result from an inflammatory process or even an injury. Interestingly, injury to surrounding structures of a joint, such as the bursae can result in severe pain one of its manifestations can be stiffness of the affected joint, and also restricted movement (2).
Most times, joint stiffness also occurs with age in quite a several patients, in which no specific injury or disease is causing it but just a result of overuse of the joint and surrounding muscles (3).
Possible Causes Of Joint Stiffness
The following are the causes of joint stiffness:
- 1. Rheumatoid arthritis
Generally, arthritis account for the highest percentage of the causes of joint stiffness in young adults and the elderly, studies have revealed that close to 15 million patients with arthritis are suffering from joint stiffness and pain (3).
Rheumatoid arthritis is a progressive chronic joint inflammatory disease that arises as a result of a disorder affecting the immune system causing the immune system to affect normal body cells, hence, called an autoimmune disorder.
Rheumatoid arthritis can manifest as joint stiffness hand, although it spares the distal interphalangeal joints, causing pain, stiffness, and nodule-like swelling on the affected joints, and when not corrected early, deformity occurs in long term.
Common clinical manifestations of rheumatoid arthritis are pains in the joint, stiffness, and edema in the affected joint. Although rheumatoid arthritis has no definitive treatment, it has management plans that can help relieve the symptoms, and the earlier the treatment the better to prevent complications from arising (3).
- 2. Osteoarthritis
Joint stiffness knee most times occurs as a result of osteoarthritis, which usually occurs as a result of wear and tear of the joint when overuse of the joint occurs. In osteoarthritis, most times the affected structure is the cartilage, when this happens, it leads to bone friction and sometimes bone particles can fall off. This results in stiffness, pain, and swelling of the affected joint (4).
As the treatment for the condition becomes effective, the joint stiffness and other associated symptoms also reduce and get better. Depending on the severity of the symptoms, lifestyle management can help a lot, such as frequent exercises as medically prescribed in other to reduce the body weight being carried by the joint.
Medications to reduce pain and inflammation can also be used such as acetaminophen and other non-steroidal anti-inflammatory drugs such as ibuprofen and diclofenac. Surgery, such as joint replacement, is the last resort in chronic cases not responding to medical treatment (3).
- 3. Circadian rhythm
Studies have revealed that joint stiffness is severe in the morning compared to other times of the day. People with rheumatoid arthritis experience severe treatment in the morning after waking up from sleep which can go as far as thirty minutes in cases with poor prognosis. Studies have also revealed that patients who have inadequate sleep experience joint pain and weakness at night and very early in the morning as in the case of arthritis (5).
- 4. Obesity
Obesity is clinically described as an elevated BMI greater than 30kg/meter square, and when the BMI is greater than 40, it is called severe obesity. In obese patient, their joints are weakened due to the extra load of weight they are carrying at the time, they are also at risk of joint inflammation because fat adipocytes result in the secretion of certain proteins that predisposes the such patient to inflammation.
In obesity, joint stiffness knee joint disease is a common clinical manifestations. Obesity has also been identified as one of the components of metabolic syndrome that can affect tissues and organs of the body, all of which the bone is not an exclusion (5).
- 5. Lupus
Lupus, a popular short form of systemic lupus erythematosus is an autoimmune inflammatory disease common in premenopausal women and commonly known for its effects on the body’s joints and muscles. Commonly lupus affects both small and large joints of the body which can produce joint stiffness fingers and painful joint symptoms
Common clinical manifestations of lupus when it affects joint stiffness and swelling, overall generalized body pain, and weakness which also affects the joints. Due to the complexity of the disease, lupus has no definitive treatment and complications often arise as the disease progresses (2).
- 6. Psoriatic arthritis
Psoriatic arthritis is a joint inflammation that is often associated with a psoriatic skin disorder, and in most cases, patients with psoriatic arthritis have a family history of the disease. Joint stiffness fingers commonly occur in this disorder and patients manifest pain and swelling, and the nails start to pit.
There is also associated stiffness of the joints in the affected joints of the body such as the hands, the finger, and the knee, and it could be symmetrical or asymmetrical (4).
- 7. Bursitis
Bursitis refers to inflammation of the bursae in the joints of the body. Bursaries are cushions in joints that contain fluids and their major function on the joints is to help prevent friction on the joints.
When bursitis occurs, there is swelling of the bursae and this often manifests in stiffness and pain in the joints. Although any joint of the body can be affected, it also commonly affects the large joints more.
Popularly affected joints are the elbow, shoulder, and hip joints. Joint stiffness knee that results in bursitis is due to the affectation of the knee joints. Other joints affected are the ankle and the big toes. Often time bursitis is not a chronic disease, it presents as acute and temporary, and doctors commonly advise patients to rest the affected joint for a week for healing to take place.
Physical exercises can also e done to prevent stiffness or to heal the joint stiffness if there is one already, but this is based on the recommendation by the physical therapist. Non-steroidal anti-inflammatory drugs can also be used to relieve pain, and examples of such include ibuprofen, and diclofenac (2).
- 8. Gout
Unlike the other aetiologies of joint stiffness that are often progressive and chronic, gout is an acute disease of the joint which occurs as a result of excess accumulation of uric acid in the body, hyperuricemia. It may start during sleep causing a sudden stiffness of the joint in the morning, and it is characterized by the sudden pain and tenderness of the affected joint. In most cases, the big toe of the body is commonly affected by gout, and gout can affect any joint of the body
Some studies explain that a gout is a form of arthritis and that it has a sexual predilection for men more than women, especially post-menopausal women. Unlike in lupus where it has no definitive treatment, joint stiffness in gout is treatable with the use of drug therapy, although recurrence is also possible (2).
- 9. Bone cancer
Although it is unlikely, this can occasionally result in joint discomfort and stiffness. Joint pain and bone pain are potential side effects of bone malignancy. The most common manifestation of a bone malignancy is the swelling around the bone, and not all patients present with pain, which explains why the malignancy may have become advanced before its diagnosis.
Bone cancer is usually treatable but the treatment approach is often dependent on the cancer staging, the size and the location of the tumor, and of course, the type of cancer is also important in determining the management therapy. Common bone malignancy treatments include the use of radiotherapy, surgery, and the use of chemotherapy as well.
Recently, immunotherapy has been indicated and this includes the use of managing drugs such as pembrolizumab, to stimulate the action of the immune system against the cancer cells (2).
- 10. Fibromyalgia
Joint and muscle discomfort, as well as issues with sleep, emotions, and cognition, are all symptoms of this chronic illness. According to researchers, the brain amplifies natural pain impulses. They don’t understand what causes it, but disease, surgery, or periods of extreme stress frequently precede it. However, it doesn’t harm the affected joints the way osteoarthritis does. Joint stiffness knee and painful joint symptoms are manifestations of fibromyalgia (4).
- 11. Diet
Consuming dairy and meat products may contribute to the development of diseases like gout or osteoarthritis, which can cause joint stiffness. Humans are possibly more prone to joint stiffness if they consume greater amounts of these meals and fewer organic diets. According to research, adopting a vegetarian or Diet plan may aid with stiffness reduction. It may be advantageous to consume more fiber, cereals, and fruits. Others are vegetables, healthy fats, and herbs (5).
- 12. Sleeping position
How individuals sleep during the night is frequently a factor in joint stiffness. Whenever a patient does not sleep with a good neck position and their spine aligned, they may awaken experiencing joint stiffness or soreness. For individuals who are already experiencing joint pain or stiffness in certain parts of their body, it is normally best advised if they avoid sleeping on the same body side when they go to bed at night (4).
- 13. Injury to the joints
Patients who suffer from ligament injuries frequently feel excruciating agony. The femur, tibia, and fibula are the three bones that are connected by ligaments in a joint. They contribute to the knee joint’s stability.
The anterior, posterior, and medial cruciate ligaments, which are the three ligaments in the knee, are frequently injured in sports-related injuries. Ligamentous injuries can also occur in car accidents with strong forces.
The following characteristic is frequently seen in patients who have ligament injuries:
- – Joint pain is always really severe.
- – Painful joint symptoms causing discomfort when moving.
- – There is a crepitus-like noise inside the building.
- – Movement instability or difficulty.
- – Joint edema in the afflicted area.
- – The inside of the joint, such as the knee, is sore, producing joint stiffness knee (6).
- 14. Fracture
Joint fractures happen when any of the bony parts of the joint experience a discontinuity, and this can make the damaged joint stiff and immobile.
After the fracture has been fixed or healed, stiffness often persists, and in some cases, physical treatment is necessary to relieve it.
Depending on the joint site affected, the stiffness of the joint can occur in different sites of the body, for example, joint stiffness hand will occur in a fracture to the bones of the hands, joint stiffness knee will occur in a knee fracture, and they all have their associated painful joint symptoms.
Therefore, it is always recommended for patients recuperating from fractures to keep all of their scheduled physiotherapy appointments to aid with the stiffness and accompanying swelling.
Treatment For Joint Pain And Stiffness
Before thinking of what to use to relieve joint stiffness, it is best to see a doctor to determine the specific cause of the stiffness and to treat it accordingly. The doctor may diagnose the etiology and recommend the appropriate treatment plan, such as physical therapy that may tackle the cause. The following are the available treatment options for joint stiffness:
- A. Medications: Medications such as over-the-counter pain relievers can be used especially when there are associated pains, and the doctor can also prescribe specific NSAIDs depending on the severity of the pain.
- B. Cold or hot compress: Following the RICE principle, which requires that patient should rest the affected limb, apply ice, compression, and elevation, when cold compress is applied, it helps to reduce the edema around the stiff joints while hot compress causes relaxation of the muscles and soft tissues.
- C. Steroids: Depending on the severity of the joint issue causing the stiffness, the doctor can also prescribe steroids to help with inflammation, but this should be taken with caution because of the possible side effects.
- D. Exercise: When necessary, exercise will be prescribed at the right time by the doctor or the physical therapist as exercise can also help to relieve stiffness.
- E. Supplements: The use of supplements such as glucosamine and fish oil has been proven to help with joint stiffness (7).
References:
- 1.https://www.medicinenet.com/joint_stiffness/symptoms.htmhttps://www.medicoverhospitals.in/symptoms/joint-stiffness
- 2. https://www.medicoverhospitals.in/symptoms/joint-stiffness
- 3. https://www.healthline.com/health/stiff-joints#traditional-treatment
- 4. https://www.webmd.com/rheumatoid-arthritis/ss/slideshow-stiff-joints
- 5. https://www.medicalnewstoday.com/articles/321588#causes