Joint stiffness & pain

We are asked by many patients each day why their joints are stiff. The underlying idea that they have is that their stiff joint must be the cause of their joint pain. Is this always true?

What is a stiff joint?

Joint stiffness can be described as limited or difficult motion of a joint. The joint may move through its full range of motion but may require more force than usual to do so. The joint stiffness is not necessarily caused by pain or due to weakness of surrounding muscles.

Joint pain is known as arthralgia, the joint may simply be painful or it may also be inflamed (arthritis). The joint pain may occur only when the joint is moved but also when the joint is at rest. Structures outside of the joint such as ligaments, tendons or muscles may be responsible for the joint pain e.g. a ligament sprain, tendonitis, muscle strain or bursitis.

Do You Get Joint Pain when You Have Joint Stiffness?

Although it might seem common sense to think that joint pain and joint stiffness always go together it is important to realise that one can have joint stiffness without joint pain. Children born with generalized hypomobility of the joints, because of increased collagen cross-linking in their connective tissue, can experience significant joint stiffness (even having gait abnormalities) without always having pain [1] . Congenital fusions of neck, thoracic and less commonly lumbar vertebrae may be asymptomatic with the anomaly causing a decrease in total range of motion due to complete stiffness (but no joint pain) at the affected vertebral level from birth [2] .

In fact, in a recent study it was found that there is increased passive stiffness in your dominant hand’s wrist compared to the non-dominant wrist [3] . This increased wrist stiffness could be as high as 40% in right-handed females and was attributed to biomechanical adaptations caused by repetitive asymmetric activities such as writing, teeth brushing or sports like tennis, basketball and squash.

Does Ageing Affect Stiffness?

Another recent study comparing 22 young participants (below 25) and 16 middleaged/elderly (50-65 years old) found that aging alone brings on tightening and thickening ofthe coracohumeral ligament and the capsule decreasing the ability of the joint to glide,however pain was not even a parameter in the study [4]

We have had the opportunity of helping people with painful joints, and stiff joints, and joints that are sometimes both painful and stiff. Let us help you.

References

1. Engelbert, R.H., et al., Pediatric generalized joint hypomobility and musculoskeletal
complaints: a new entity? Clinical, biochemical, and osseal characteristics. Pediatrics, 2004.
113(4): p. 714-9.
2. Mardani, M., B. Mohammad Javad Saeedi, and E. Esfandiary, Congenital fusion of
cervical vertebrae: a review on embryological etiology. Reviews in Clinical Medicine, 2016.
3(4): p. 148-153.
3. Durand, S., et al., Passive wrist stiffness: The influence of handedness. IEEE Trans
Biomed Eng, 2018.
4. Tsai, M.S. and A.T. Hsu, The aging effects on the glenohumeral joint stiffness in
association with anteroposterior glide mobilization: in vivo robotic testing. Physiotherapy,
2015. 101: p. e594.

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