Joint pain that won't go away: the causes, and when to worry

Go to a hospital now if

These need the same day, not an appointment next week.

• One joint is suddenly hot, red and swollen and you have a fever or feel shivery and unwell
• A joint is very painful after an injury and looks out of shape, or you cannot put weight on it
• A joint is swollen in someone with sickle cell disease and they have a fever
• Joint pain comes with chest pain, breathlessness, a fit or sudden confusion

What the pattern tells you

Doctors start with the pattern, because it narrows the cause before any test.

• Worse when you use the joint, better with rest, stiffness for less than half an hour: usually osteoarthritis
• Swollen joints, stiffness for more than an hour in the morning, better as the day goes on: inflammatory arthritis
• Sudden, severe attacks in one joint, often at night, that settle in a week or two: often gout
• Pain that moves from joint to joint, with a rash, mouth ulcers or fevers: can be lupus or another autoimmune condition
• Pain all over the body with tiredness and poor sleep, but no swelling: can be fibromyalgia
• Back pain that began before 45, wakes you at night and eases with movement: can be ankylosing spondylitis

Joint pain that comes and goes

Pain that disappears for weeks and returns is not reassurance. Gout behaves like this, and so does early rheumatoid arthritis. Keep a note on your phone each time: which joint, whether it swelled, how long the morning stiffness lasted, and what you took. A rheumatologist can often make the diagnosis from that record and an examination.

Which doctor to see

For swelling, long morning stiffness, pain that moves around, or joint pain with a rash or fevers, see a rheumatologist: on Mezo the first consultation is from ₦100,000. For an injured knee or shoulder, or a joint that locks or gives way, see an orthopaedic surgeon. For wear-and-tear pain with no swelling, physiotherapy is a good first step.

Common questions