joint pain relief surprise: what may help your sore joint

What can you do for the soreness today?

Try easy movement, then check the soreness later that day and after waking tomorrow. A warm shower may loosen stiffness, while a covered cold pack may calm swelling after activity. Don't place a cold pack on bare skin or leave it there too long.

Short walks and simple strength work keep the muscles around the joint working. For the first try, do less than you did before that bad day. If soreness hasn't returned to its usual level by morning, do less next time.

Creams and pills may help, but some can harm the stomach, kidneys, or heart. Blood thinners and medicines that cause dizziness can also change which choice is safe. Have your doctor or pharmacist check every medicine and supplement before you add another one.

When is it time to have the joint checked?

Book a visit when soreness repeatedly cuts short sleep, walking, dressing, or chores. An exam can find weakness, lost motion, swelling, or pain traveling from the neck or back. Your doctor may decide an X-ray would help choose your care.

Get help sooner if the joint turns hot, swells badly, or becomes hard to move. Fever, feeling badly ill, or a fresh injury makes the need more urgent. Seek urgent care for chest discomfort, trouble breathing, sudden calf swelling, or a leg you can't stand on.

Without those warning signs, book a regular visit and continue the gentle home care that helps. A doctor can review your medicines and may suggest physical therapy or another procedure. The best choice depends on the sore joint, your other health problems, and the task you miss.

Sources

1. OARSI's 2019 guideline is the only major osteoarthritis guideline that grades treatments separately for people with disease in MULTIPLE joints. Its Core Treatments for polyarticular OA are arthritis education and structured land-based exercise. Critically, intra-articular corticosteroid and intra-articular hyaluronic acid were Level 1B/2 options for knee OA only and were NOT recommended for hip or polyarticular OA; oral NSAIDs were not recommended at all for people with cardiovascular comorbidity or frailty; and paracetamol/acetaminophen was conditionally not recommended.

   Bannuru RR, Osani MC, Vaysbrot EE, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.. Osteoarthritis and Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

2. A network meta-analysis of 192 randomised trials in 102,829 patients with knee or hip osteoarthritis found that five oral preparations - diclofenac 150 mg/day, etoricoxib 60 and 90 mg/day, and rofecoxib 25 and 50 mg/day - had a 99% or greater probability of exceeding the minimal clinically important reduction in pain. Topical diclofenac (70-81 and 140-160 mg/day) had a 92.3% or greater probability. Every opioid studied had a 53% or LOWER probability of exceeding that threshold.

   da Costa BR, Pereira TV, Saadat P, et al. — Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis.. BMJ, 2021. DOI: 10.1136/bmj.n2321.

3. CDC's 2022 clinical practice guideline for prescribing opioids covers acute (under 1 month), subacute (1-3 months) and chronic (over 3 months) pain in outpatients aged 18 and over, built on GRADE. It addresses whether to initiate opioids at all, opioid selection and dosage, duration and follow-up, and assessing risk and harms - and states that people with pain should receive appropriate pain treatment with careful consideration of the benefits and risks of ALL treatment options in the context of the patient's circumstances.

   Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R — CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.. MMWR Recommendations and Reports, 2022. DOI: 10.15585/mmwr.rr7103a1.

4. A Cochrane overview of 21 systematic reviews (381 studies, 37,143 participants) covering rheumatoid arthritis, osteoarthritis, fibromyalgia, low back pain, neck disorder and other chronic pain conditions concluded that physical activity and exercise are interventions with few adverse events that may improve pain severity and physical function - but that the quality of the evidence is low, effects on pain were inconsistent across reviews, and physical function improved significantly in 14 reviews with only small-to-moderate effect sizes. The commonest reported adverse event was increased muscle soreness that settled within weeks.

   Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH — Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.. Cochrane Database of Systematic Reviews, 2017. DOI: 10.1002/14651858.CD011279.pub3.