Orthopedic Aches and Pains

Whether it's your shoulder, ankle, or some other joint, pain in or around joints has similar origins and treatments no matter what part of the body it affects. Joint pain and limited mobility are usually caused by an injury to muscles, ligaments, or connective tissue. Knowing what happened before the pain started gives you an important clue to the problem. The following are common sources of muscle and joint pain.

Accidents

A fall, bump, blow, or sudden twist can cause bruising of soft tissues; bone fractures; joint dislocations; or torn muscles, tendons (fibers connecting muscle to bone), or ligaments (bands that hold joints together and connect bone to bone).

Repetitive Motions or Prolonged Overuse

All good things require moderation, including work and play. Even an athlete in top shape can strain a muscle while training. Too much of any activity—such as pitching too many games of softball or working long hours at a computer—can cause inflammation and pain in the joint and surrounding tissues.

Overdoing It

If you've been indoors and inactive for months, a 10-mile bike ride or a day digging in the garden can cause some muscle soreness. Injuries from overdoing it occur most often when people are out of shape and do moderate or strenuous activities. You need to slowly build the strength and endurance needed for any demanding physical activity.

Muscle Imbalance

When muscles on one side of the body are much stronger than those on the other side, they put added stress on weaker muscles, often causing injury. For example, a weight lifter who overdevelops the arm and chest muscles but neglects the muscles that support the upper back and shoulder blades may wind up with a back or neck injury. The reason: The chest muscles overpower the back, causing constant tightness and muscle or joint pain.

Referred Pain

Sometimes pain felt in one area of the body originates in a different area. For example, pain in the left shoulder or arm may be a sign of a heart attack. Likewise, knee pain may be caused by a hip or foot problem. Whenever pain appears suddenly without an apparent cause such as accident or injury, call your health care provider. If you are over 35 years of age and feel sudden left-arm pain, chest tightness, shortness of breath, or pain in the jaw with no apparent cause, call 911 immediately.

Self-Care Steps for Aches and Pains in Muscles and Joints

The RICE Method

With a few exceptions, the RICE (Rest, Ice, Compress, Elevate) method explained below will reduce pain and help speed recovery of joint and muscle injuries.

Rest

For most injuries, rest the area until the pain stops. For simple sore muscles, however, gentle stretching will reduce stiffness sooner. Hold the stretch for 30 to 60 seconds, then rest and repeat 5 to 10 times. Do not bounce. Do this several times a day.

Ice

Ice is the most effective way to reduce inflammation, pain, and swelling of injured muscles, joints, and connective tissues (such as tendons, ligaments, and bursas). The cold helps keep blood and fluid from building up in the injured area, reducing pain and swelling. Apply ice as soon as possible after injury, even if you are going straight to your health care provider.

To speed recovery and ease pain, raise the injured area and apply ice for 20 minutes (10 to 15 minutes for children) every 2 to 3 hours while awake. For best results, use crushed ice in a moist towel as an ice pack. Use an elastic bandage to hold the ice pack in place. During the first 48 to 72 hours, or as long as there is any swelling, do not apply heat to an injury. Heat increases blood flow to the affected area, which makes swelling and pain worse.

Compress

Between icings, wrap the injured area with an elastic bandage to help control swelling and provide support. Begin wrapping at the point farthest from the body and wrap toward the heart. For example, to wrap an ankle you would begin at the toes and wrap to the mid-calf. Don't sleep with the wrap on, unless your health care provider tells you to do so. And don't wrap too tightly! If the wrap begins to cause pain or numbness, or if toes are cool or white, remove the elastic bandage and wrap it more loosely.

Elevate

Raising the injured area above your heart will allow gravity to help reduce swelling by draining excess fluid. At night, place a pillow under the area to support and raise it.

In addition to RICE, there are several other things you can do to promote healing and relieve pain of most muscle and joint injuries. These are the basics to remember, but see the topic later in this section that addresses the joint where you are having pain.

Pain Relievers

If you need to, take acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen sodium, and aspirin. Acetaminophen, aspirin, and NSAIDs often reduce the discomfort of muscle and joint injuries effectively. Aspirin and NSAIDs may work best because they also reduce inflammation. Acetaminophen does not reduce inflammation.

Aspirin and other NSAIDs are more irritating to the stomach and bowel. Acetaminophen is better for patients with ulcers or other digestive problems or for those who suffer stomach problems when they take NSAIDs. When using aspirin, choose buffered aspirin or enteric-coated aspirin, which is easier on the stomach. All aspirin and NSAIDs should be taken with food. If NSAIDs cause minor stomach upset after 7 to 10 days of use, stop medication, take antacids, and call your health care provider. Acetaminophen should not be taken in higher than recommended doses or in conjunction with alcohol as it has the potential to damage the liver.

Children and teenagers with muscle or joint injuries can be given most NSAIDS or acetaminophen but not aspirin, unless your child's health care provider says otherwise. Aspirin should not be used in children or teens due to the risk of Reye's syndrome.

Slowly Strengthen the Injured Area

Slow strengthening of the injured area after it has healed is advisable for keeping most injuries from occurring again. Your health care provider or a physical therapist can recommend specific exercises, including range-of-motion exercises, muscle stretches, and specific weight training.

Warm Up Before You Exercise

You are less likely to injure muscles that have been gradually eased into activity. Before you launch into any strenuous activity, try jogging in place, quick walking, or other activities that will get you moving and eliminate stiffness.

Heat Before, Ice After

Once the swelling has subsided—which often takes weeks—and you are working to strengthen the recovering area, you may apply heat before exercise to prepare the muscles, joint, and connective tissues for the workout. Apply ice soon after your workout to prevent inflammation and swelling.

Special Concerns for Muscle and Joint Pains in Children

• Muscle and joint pains in children are treated much the same way as they are in adults. Children and teenagers, however, can be given NSAIDS or acetaminophen to relieve pain. Do not give them aspirin, due to the risk of Reye's syndrome. If the child cannot move the joint or if pain increases with movement, call your child's health care provider. Inability to bend a joint can be a sign of a fractured bone or infection in the joint-both serious conditions.

• Before a child reaches maturity, the long bones in the body (arms and legs) have growth plates, called epiphyses. The epiphysis allows the bone to grow or lengthen. A fracture or dislocation can damage the epiphysis. This may slow or stop bone growth or make a bone grow crooked. Although common sense tells you that any suspected broken bone should be seen by your child's health care provider, this is particularly important if the child complains of pain around a joint. A fracture to the epiphysis can occur without trauma, often through overuse (pitching too many fastballs or lifting heavy weights).

• Broken bones and other injuries aside, it is common for children having growth spurts to have vague aches and pains for no apparent reason.