Joint pain

Joints - General

Joints are more or less flexible connections between at least two Bone surfaces.
One differentiates between different ones Joint typeswho are in their structure and their Range of motion can distinguish. From an anatomical point of view, it can be roughly expressed in "real" and "fake“Subdivide joints in which subspecies can be separated from each other.

  • Real joints"Are so-called diarthroses, which have the following characteristics:
    • at least two bone parts
    • Joint space between the bones
    • Joint capsule with the so-called synovial membrane, which rests on the inside
    • Articular cartilage
    • In addition, you can Menisci, Tapes and e.g. Band washers contain.
    Belong to the real joints Ball joints as the Shoulder joint or that hip joint, Saddle joints as the Saddle thumb joint or egg joints like the first head joint. Overall, they have greater freedom of movement than fake joints.
  • As "fake joints"Is the name given to the synarthrosis, which is also called"Be liable" is called. It refers to bony connectionsthat do not have the typical components of a real joint (so.) but can be moved against each other.
    They're usually pretty tight through cartilage (Synchondroses), Tapes (Syndesmoses) or bone (Synostoses) connected with each other.
    Fake joints can be found in the cartilaginous connection of the Ribs with the Sternum or the tight connection between Cubit and spoke.

Joint pain - general

In principle, joint pain can occur in different joints. Not infrequently in the knee joint as well.

Joint pain can have many different causes. In general, it is often Signs of wearwhich mainly occur in old age.
But also Injuries, Fractures, Incorrect loads and inflammatory diseases can cause joint pain. They can occur in any age group, although older people are often more affected.
There are different Therapeutic approaches for the treatment of joint pain, which depends on the specific causes and the exact symptoms of the complaints. Such therapies often include various components such as Painkiller, sporting exercises, Physiotherapies up to surgical interventions. The following article looks at the most common causes of joint pain and their therapies. It serves more than a kind of overview and orientation and does not claim to be complete.

Type of joint pain

Joint pain can differ in its type and course.
First, let's be rough three groups differ from joint pain based on its course.

  • The first group are the acute painthat through a sudden onset are characterized. They kick in within hours.
  • The second group are the chronic pain, which through a creeping and slow onset distinguish. They usually only manifest themselves after weeks to months.
  • The last group are them subacute painthat show up after a few days. The course of the pain can be chronically progressive, i.e. that the Pain progresses over time and always exist, or acutely remitting.
    An acute-remitting course is characterized by pain-free intervals out. Depending on how many joints are affected, a distinction is made between monoarticular (only one joint is affected), oligoarticular (two to four joints are affected) or else polyarticular (more than four joints are affectedJoint pain.

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In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
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Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Localization of the joint pain

Pain in the finger joint

Joint pain in the fingers can have various causes. You can do both degenerative (due to wear and tear) as well as due to a Inflammation (arthritis) occur. A common inflammatory cause of finger joint pain is the Rheumatoid arthritis. Rheumatoid arthritis occurs mainly to the Metacarpal and middle joints as well as on wrist, but not at the finger joints on. Usually many joints on both hands are affected at the same time. The pain kicks in even at rest on and improve through movement. The joints are also stiff, especially in the morning.

In the psoriasis joint pain especially in the Finger and toe end and middle joints as well as in the Spine occur. The pain does not necessarily correlate with the appearance of the rash typical of psoriasis. Often a swelling along an entire finger. This is referred to as "sausage finger" based on the appearance.

The degenerative damage to a joint is made arthrosis called. Osteoarthritis occurs mainly in the fingers. to the Finger joints on. The pain is in contrast to rheumatoid arthritis Movement worse and kick not in peace on. There is no relevant morning stiffness and warmth helps better than cold.

Pain in the knee joint

Acute knee pain is often caused by a trauma triggered. The trauma can cause it to Ligament injuries or meniscus and cartilage damage come. One of the most common sports injuries to the knee is the anterior cruciate ligament tear.

Chronic knee painwho mainly getting worse under stress is often based on one Osteoarthritis of the knee (gonarthrosis). The years of wear and tear on the cartilage not only lead to pain, but also to one Restriction of movement.

The Reactive arthritis occurs up to six weeks after a bacterial infection of the intestine or the urinary tract and heals spontaneously in the majority of cases. If the urethra and conjunctiva are inflamed in addition to the joints of the lower extremities, one speaks of a Reiter syndrome.

Also one Rheumatoid arthritis can larger joints, such as. the knee, concern.

Furthermore, you can also Metabolic diseases as the Iron storage disease (Hemochromatosis), the hemophilia or the Pseudogout express in knee joint pain. Besides, knee joint pain can also be a symptom of one Lyme disease be.

In children, knee pain is often due to a problem with the hip that is projected onto the knee. But adults who suffer from hip osteoarthritis can also be noticed primarily by knee pain.

Pain in the shoulder joint

Shoulder pain is often not due to a disease of the joint, such as an osteoarthritis but can also be a sign of an Calcification of the tendons, one Bursitis or one Tendon tear be.

A Osteoarthritis of the shoulder typically shows through pain when Working above head level or when throwing. The pain is often localized in the armpit. In the case of osteoarthritis of the shoulder joint, on the other hand, the pain is mainly found on the shoulder roof.

A common cause of shoulder pain is one Bottleneck Syndrome (= Impingement). Be at this Muscle tendons pinched painfully within the shoulder joint. A narrowing of the joint can be caused by various factors, such as Bursitis or by one Bone spur, come. The entrapment leads to pain-related Restrictions on movement and to Pain when lying down on the affected side.

Also one Calcification of muscle tendons the shoulder can lead to progressive pain. If the calcareous deposits break into the shoulder joint or into the bursa, the pain will worsen drastically.

In older people there is one Rupture of the rotator cuff muscles the shoulder is a common cause of pain during exercise and at rest. This rupture is usually degenerative due to wear and tear, but it can also occur in younger people as part of an accident.

  • Tendinitis in the upper arm
  • Rotator cuff tear

Pain in the elbow joint

Elbow joint pain can be a inflammatory cause have, under Injuries occur or through wrong or excessive load be evoked.

Inflammatory causes include one Rheumatoid arthritis, one Inflammation of the bursae at the Joint or tendonitis.

Relatively often, however, the pain occurs as part of a Tennis or golfer arms (= Epicondylitis humeri radialis or ulnaris) on. This is a chronic stress of the muscle tendons attached to the elbow. This leads to a painful inflammation. An irritation of the extensor tendons of the forearm or hand is called tennis elbow. In this case, the pressure pain is mainly Localized on the outer elbow or stretching the hand leads to pain. The golfer's arm, on the other hand, mainly affects the flexor tendons and accordingly leads to pain on the inside of the elbow, where the tendons of the flexor muscles start. The tennis and golfer arms owe their names to the fact that the overexertion described above often occurs in these sports. she but can also occur in non-athletes. The overexertion of the tendons, which e.g. also through Bad posture when using a computer mouse can arise.

  • Bandage for a tennis elbow
  • Therapy of the golfer's elbow

Thumb joint pain

Joint pain in the area of ​​the thumb that is associated with a swelling are often associated with one Rhizarthrosis traced back. The rhizarthrosis affects that Saddle thumb joint at the base of the thumb between the metacarpal and carpal bones. This joint is essential for that Holding and gripping function of the thumb / hand.

Rhizarthrosis occurs in 10% of women and 1% of men in old age and is therefore a very common one Wear and tear. Familiar accumulations often occur.

Rhizarthrosis can be treated either conservatively Rest and take anti-inflammatory pain relievers or surgically Removal of the adjacent carpal bone and replacement with a tendon plastic. Also the Stiffening of the joint is an option.

  • Thumb joint pain
  • Surgery for a thumb saddle joint osteoarthritis
  • Test thumb saddle arthrosis

Everywhere - what can it be?

If joint pain occurs in a wide variety of joints throughout the body, this does not indicate degenerative wear and tear on the joints, but leaves one flammable origin accept. Often the joint pain also goes with one in this case Swelling, overheating and redness hand in hand.

Joint pain all over the body is often associated with a disease from the Rheumatic form circle. The Rheumatoid arthritis usually concerns mainly the little finger joints, but often also larger joints, such as the knee. Another rheumatic inflammatory disease is the ankylosing spondylitis. This typically concerns mainly the Joints of the spine, but can also show up in all other joints in the body.

Also one arthritis as part of a psoriasis or one Systemic lupus erythematosus can cause joint pain all over the body.

If no inflammatory or degenerative correlates can be found in the affected joints, the symptoms may be based on on one functional pain syndrome (Fibromyalgia). This diagnosis is made based on clinical signs after organic causes have been excluded.

Common causes

There are many possible causes of joint pain. It is very difficult to differentiate between all causes. The following is a overview about particularly common causes and their therapies:

arthrosis

So-called osteoarthritis is a sign of wear and tear on the joints, which exceeds the normal age range.
Joints begin to show signs of wear and tear from around the age of 30, depending on the given risk factors such as stress or excess weight.
Osteoarthritis usually manifests itself in pain between around 50 and 60 years of age, so that around 2/3 of those over 65 years of age suffer from osteoarthritis. Causes for this wear and tear are risk factors such as smoking, obesity, improper loading, joint misalignments as a result of injuries and inflammation (e.g. arthritis). But genetic predispositions also play a role in the development of osteoarthritis.
Women are also more often affected than men. As the articular cartilage perishes and the joint surfaces become uneven, the affected joints can crunch and be very painful.
The large joints, such as the knee or the hip joint, are often affected. The freedom of movement is then restricted. As the disease progresses, everyday stress, such as climbing stairs, becomes more and more difficult and the joints hurt even at rest. The affected joints can be red and swollen in the acute episode.
The therapeutic approaches are very diverse and include both conservative and surgical approaches. The goal is extensive freedom from pain and more freedom of movement. Pain reliever and anti-inflammatory drugs can be used. Exercises to strengthen the joints also help. Ultimately, there are surgical approaches that range from arthroscopies and cartilage transplants to joint prostheses.

You might also be interested in: Inflammation of the synovial membrane

gout

With gout it is Uric acid concentration increased in blood. Uric acid is metabolic waste, which, if the concentration is too high, manifests itself in the form of uric acid crystals, especially in the Big toe joint, but also deposited in other joints. There are violent attacks in acute gout attacks Pain, Swelling, Redness and fever.
The acute attack of gout manifests itself mainly after rich, meat-based meals or Alcohol consumption.
Serve for therapy Anti-inflammatory drugs (anti-inflammatory drugs) how Indomethacin, a meat-restricted diet, abstinence from alcohol, and drugs that lower uric acid levels, such as Urikosurika and Allopurinol (the latter not in an acute attack).

arthritis

The term arthritis denotes in general inflammatory joint disease. He's from the arthrosis to delimit, which is joint wear.
Arthritis is usually characterized by the typical Signs of inflammation Swelling, redness, overheating and pain.


A distinction is made between different forms of arthritis, which can be roughly divided into infectious-related and non-infectious-related arthritis:


Infectious arthritis: For purulent-bacterial arthritis (infectious arthritis) it is a very difficult one Damage to the jointwhich is a very acute event. There is usually one surgical treatment with additional Antibiosisto kill the pathogens. Such bacterial joint inflammation usually develops on the floor of a injury, but can also have endogenous causes. The terms pyarthrosis and joint empyema are used as synonyms for purulent arthritis.


Arthritis of non-infectious origin: There are different forms of non-infectious arthritis. The most important are Rheumatoid arthritis, the Psoriatic arthritis and the gout.

Rheumatoid arthritis, which is an autoimmune disease, can manifest itself at a very young age and is diagnosed using blood tests, tissue removal from the joint, and imaging tests such as bone scintigraphy. It is the most common inflammatory joint disease and manifests itself, for example, in joint pain in the fingers, morning stiffness of the fingers and wrists and joint swelling. Psoriatic arthritis occurs as part of psoriasis (psoriasis) and is characterized by an asymmetrical involvement of the joints (joints on one side are affected), as well as so-called radiation involvement. In the case of radiation exposure, for example, all joints of a finger are affected. The joint complaints can occur before the skin complaints of psoriasis, which makes the diagnosis much more difficult. (Gouty arthritis see above).

ankylosing spondylitis

Bechterew's disease is a chronic rheumatic inflammation, which is mainly the Spine and other large joints affected. Lower back, knee, hip and heel pain are typical. The soles of the feet can also be inflamed.

Joint pain in inflammatory bowel disease

These diseases include the Crohn's disease as well as the Ulcerative colitis. What they have in common is that inflammation occurs in various areas of the gastrointestinal tract.
About a quarter of patients suffer from one of these diseases arthritis, about 15% on one Inflammation of the colon and sacrum (Sacroileitis). One speaks here of enteropathic arthropathies. In addition to various digestive tract complaints such as diarrhea or Constipation, those affected then suffer from joint pain. New joint pain in the context of a chronic inflammatory bowel disease suggests an acute one Crohn's disease attack or ulcerative colitis.

Joint pain during and after infections

Lyme disease: Borrelia are the pathogens caused by Ticks transferred to humans. Borreliosis runs in different stages and shows symptoms such as Reddening of the skin, tiredness, fever and also Joint pain. These can occur months after the infection and decrease over time. The knee and elbow joints are particularly affected.


Others: Even after Hepatitis, scarlet fever, mumps, rubella, tuberculosis, flu and other infectious diseases, joint pain can occur.

Joint pain in memory and metabolic disorders

  • Iron storage disease - hemochromatosis: This storage disease causes abnormal iron deposits in the body. It can be acquired as well hereditary be. The iron storage disease leads to organ damage such as Fibrosis (connective tissue remodeling) of pancreas and the liver, such as Heart failure to a pseudogout (see below) on the joints. A low-iron diet is especially important here, but drug therapy is also essential.
  • Lipid metabolism disorders: Lipid metabolism disorders include both hypertriglyceridaemia and hypercholesterolaemia. In the context of both metabolic disorders it can be too Joint effusions, Pain, overheating and swelling come. However, the course of pain is more severe in hypercholesterolemia. Read more about the topic here: Lipid metabolism disorder
  • Diabetes Mellitus - The Diabetic Disease: Diabetes mellitus is a metabolic disorder which can have various causes. In the final analysis, however, it comes to Disorders in carbohydrate metabolism with serious consequences for the organism. The consequences range from impaired vision, nerve, muscle and organ damage to joint damage.
    Characteristic is the so-called Charcot foot, with which it depends on the severity of the illness Joint destruction comes. Extreme joint destruction occurs, but it can also be painless. The therapy is causally based on the diabetes and includes one depending on the type of disease Insulin therapy or treatment with oral anti-diabetic drugs to improve the metabolism. There are also operations and other orthopedic measures to stabilize the affected joints.

Joint pain in pseudogout

Under a chondrocalcinosis (pseudogout) one understands a deposit of special Calcium compounds (Calcium pyrophosphate) in the cartilage. This will above all Menisci, intervertebral discs and the articular cartilage the small and large joints damaged. Pseudogout is similar in its symptoms to gout and leads to severe pain and restricted mobility. It occurs more frequently in the context of other diseases such as diabetes mellitus, hemochromatosis and overactive parathyroid glands.

Joint bleeding and coagulation disorders

Blood disorders can also affect the joints. In hemophilia (hemophilia) there may be extensive internal bleeding spontaneously or after minor injury, which also occurs in joints (Hemarthrosis) and muscles. The result is severe pain, swelling and, over time, deformities. Therapy with anticoagulant drugs (Anticoagulants) can very rarely lead to joint bleeding.

Joint inflammation in sarcoid

Sarcoid is a systemic autoimmune disease that can affect almost any organ, but prefers the lung. So-called granulomatous deposits. This is a special form Löfgren's Syndromewhich mainly affects young women. It is characterized by the Triassic arthritis, one skin rash (Erythema nodosum) and an infestation more specific Lymph nodes of the lungs (biliary lymphadenopathy). Therapy is symptomatic with anti-inflammatory and analgesic drugs.

Chronic Fatigue Syndrome - Chronic Fatigue Syndrome

Chronic fatigue syndrome is a debilitating one mental and physical exhaustion, who has other characteristic symptoms. These include headache, sore throat, muscle and joint pain, as well as insomnia and difficulty concentrating.

Reactive arthritis / Reiter's disease

Reiter's syndrome, also called Reiter's disease, is one Special form of reactive arthritis and kick after gastrointestinal and urogenital infections on. The main symptoms are arthritis, one Inflammation of the urethra (Urethritis) and the Conjunctiva (Conjunctivitis). Reactive arthritis is generally simply an inflammation of the joints that occurs after an infection with various pathogens. Usually the large joints, such as the knees, are affected.

Fibromyalgia

The Fibromyalgia is a chronic, currently incurable, disease, which leads to a wide variety of complaints.
The main symptoms are chronic Pain in different parts of the body, tiredness and sleep disorders. The pain mainly affects the muscles and joints of the back, chest, neck, arms and legs. It is important to differentiate fibromyalgia from rheumatoid arthritis in the differential diagnosis.

Systemic lupus erythematosus

Systemic lupus is extreme rare diseasewhich mainly affects women. It causes a variety of symptoms, including joint pain. It is an autoimmune disease.

Joint pain with a cold

Joint pain typically occurs as part of a flu-like infection (Cold) on. Much stronger they occur in the context of a flu on. This pain is triggered through the messenger substancesthat the immune system sends out while it fights the infection. These messenger substances lead to a reduced pain threshold. If the pain persists even after the cold has healed, a doctor should be consulted.

Joint pain that only occurs days to a few weeks after infection can be signs of a Reactive arthritis be.

Joint pain with fever

As part of a rheumatic disease it may be that the joint pain is from a general weakness and slight fever to be accompanied. Fever can also be a sign of a infectious joint inflammation be. Bacterial joint inflammation develops often in the hip or knee joint. The bacteria can come from outside, e.g. get into the joint as part of a joint endoscopy or through the blood. Also one transmitted by ticks bacterial Lyme disease can manifest as joint pain with fever.

  • Rheumatoid arthritis
  • Symptoms of borreliosis

Joint pain after consuming alcohol

If joint pain occurs after drinking alcohol, it may be one acute gout attack act. In gout, the uric acid concentration in the blood is increased. As a result, store themselves Uric acid crystals in the joints and lead to pain. This is particularly common Big toe joint affected. But it can too Inflammation of the knee, the finger joints, the elbow joint, the ankle joint or similar come.

alcohol leads as well as meat consumption increased uric acid levels in the blood.

Other causes

There are also many other conditions that can cause joint pain. Other causes are the Scleroderma, various Vasculitis (Vascular inflammation), Rheumatic fever, the Sjogren's Syndrome and much more

diagnosis

The diagnosis of joint pain is based on several different procedures.
First, a Conversation with the family doctorin which he gets an overall picture of the patient. The focus is on the joint pain, but also other important symptoms must be observed in order to determine the exact cause.
Besides the complaints are Previous illnesses in the family, stress at work and everyday life as well as personal Medical history of high relevance.
The next important pillar in diagnostics, besides the conversation, is the physical examination. If there are any abnormalities, a Transfer to another specialist, e.g. to an orthopedic surgeon or dermatologist.
One is still important Blood analysis. The blood can provide information about the underlying disease. At a rheumatic disease there are so-called Rheumatoid factors in blood. The Sedimentation rate (BSG) and the CRP (C-reactive protein) indicate inflammation.
Also be Trade-offs, Urine samples, genetic analysis and tests on certain Bacterial strains used in the diagnosis of joint pain.
Serve last imaging procedures the cause of investigation. Various methods are used for this. This includes the Magnetic resonance imaging (MRI), the CT, the roentgen- such as Ultrasound diagnostics and also the Arthroscopy. The latter can also be used as a therapeutic intervention. The imaging methods have the advantage that they can map the situation in the affected joints and thus provide a precise insight.

When should you see a doctor?

Joint pain is partly harmless and results, for example, from mild Incorrect loads or larger physical exertion. However, if the pain is additionally caused by Redness, Swelling, fever and Restrictions on movement it is advisable to consult a doctor as soon as possible.
This also applies to joint pain that is on more joints overlap.

Joint pain therapy - what really helps?

Standard therapy for joint pain cannot simply be formulated like that. This becomes apparent when looking at the many different causes of pain. A Fighting causes is initially important and depends on the underlying clinical picture.
For example, does the joint pain come from someone Diabetes mellitusSo it is important to use the metabolic status insulin or Antidiabetic drugs to manage.
But you can also do something about joint pain as such. Provide for very severe pain Painkiller Relief. Also one Protection and cooling of the joint can help. Inflammation of the joints is usually treated. with so-called Non-steroidal anti-inflammatory drugs (NSAIDs). These include, for example aspirin. Your effect is anti-inflammatory. Also cortisone is used in therapy, e.g. in the form of injections into the joints. This also works anti-inflammatory. It also works oppressive on the Immune response of the body (immunosuppressive) and takes place at, for example arthrosis, rheumatic diseases and Autoimmune diseases Application.
A newer approach in therapy is the so-called Immunobiologics which are specifically used in autoimmune diseases and intervene in the autoimmune reaction.
Another approach in the therapy of pain are Physiotherapy and physiotherapy exerciseswhich promote joint mobility. Also Massages can increase the quality of life and contribute to pain relief.
In addition, there is the Iontophoresiswhich is used, among other things, for rheumatic diseases. This is a form of Current therapywhose mechanism of action is not yet fully understood. But it probably increases the absorption of pain relieving agents into the joints and ensures greater efficiency in pain therapy.
As part of all pain therapy procedures, an accompanying psychotherapy be helpful. With the help of various methods such as the Biofeedback or behavioral approaches can pain sufferers Relaxation techniques learn and thus influence the pain intensity of your joint disease yourself.
Despite all these conservative therapeutic approaches, in some cases and with certain clinical pictures a surgery be necessary. For example, parts of the joint, especially the Synovial membrane (Synovial membrane) should be removed. This is called a synovectomy. Joint effusions are through Punctures relieved. In the case of severe damage, for example, a Cartilage transplant be indexed or a complete one Joint replacement in the sense of a prosthesis.
If you just want to alleviate the symptoms of mild joint pain (without treating a cause), you can do something on the outside of the body region Horse ointment Instruct.
The possibilities and procedures are very different, as are the symptoms of joint pain. A generally applicable therapy for joint pain cannot be formulated in this way. This article serves only as an overview and as a rough guide.

There are also some homeopathic medicines for joint pain, e.g. Zeel® comp. N.

Ointment dressing with Voltaren Emulgel

Voltaren Emulgel can be used for local application at arthrosis, acute Muscle aches, Tendinitis or pain in the soft tissues surrounding the joint. It contains the Active ingredient diclofenac. This is a Inflammation and pain reliever drug. Voltaren Emulgel must not be used on open wounds or on inflamed or eczema-covered skin.

For treatment, the affected area 3 to 4 times a day rubbed with the gel. If used for more than three weeks or if you are pregnant / breastfeeding, you should consult a doctor before use.

Diet and joint pain

Good diet can relieve joint pain. It is not only a reduced occurrence of ObesityThat puts stress on the joints matter, but the ingredients themselves also affect the joints. It is believed that foods that contain the Omega-6 fatty acid arachidonic acid contain one Promote joint inflammation. This includes besides meat and sausage also high fat dairy products. As anti-inflammatory however, the Omega-3 fatty acids, the high-fat cold water fish, walnuts, soybeans, and rapeseed and olive oil contain. Also ginger should have an anti-inflammatory effect and can therefore relieve the symptoms of joint inflammation.

Alcohol and nicotine should generally be avoided as these can worsen the symptoms due to poor blood circulation.

Some studies advise increasing the intake of a mixture Vitamin A, C, E and Selenium. However, there is too little data to be able to say with certainty whether the increased intake of vitamins is actually helpful. Because excessive vitamin intake is also associated with strong side effects.

Overall, the study situation regarding the influence of diet on joint pain is not clear.

Tips for joint pain

There are a few things you can do yourself to relieve your joint pain. Below is an overview of some Tips against joint pain:

  • Regular Move and Endurance sports can they Joints and Muscles strengthen and thus relieve joint pain or even prevent it. Sports that are gentle on the joints are recommended, such as swim, To go biking and Walking.
  • Just at arthrosis and rheumatic diseases are very rigid seating positions to avoid. You have to pay attention to sufficient and alternating loads.
  • Existing Obesity should be reduced. It puts additional stress on the joints.
  • Also mental stress and stress contribute to the development of joint pain. It can help yourself Relaxation techniques learn and reduce stress.
  • Generally one promotes healthy lifestyle the recovery. It should be on a healthy eating be respected. alcohol- and Nicotine consumption are not recommended.