Widespread joint pain: possible causes, tests and when to see a GP

Joint pain is not a single diagnosis. It is a symptom, and when several joints are involved it points doctors towards a different group of explanations than pain in a single knee or shoulder. The NHS lists the usual places: knees, shoulders, hips, feet and ankles, hands and wrists, elbows and arms, and the neck. It points out that you might have pain in one joint or in several at once.

People often describe this as aching all over, a feeling that every joint is a little sore, or pain that moves from one area to another. It helps to note which joints are involved, whether both sides of the body are affected, when it is worst (after rest, after activity, or at night) and how long morning stiffness lasts. Those details are exactly what a GP will ask about, and they do much of the work of narrowing down the cause.

The NHS sets out a short guide to what different patterns of pain can mean. It stresses not to self-diagnose and to see a GP if you are worried, because several of these conditions overlap and some are treatable in ways that depend on a timely diagnosis.

Osteoarthritis is described by the NHS as the most common type of arthritis in the UK. The protective cartilage on the ends of bones breaks down, causing pain, stiffness and problems moving the joint. Almost any joint can be affected, but it most often involves the knees, hips and small joints of the hands. A GP may suspect it if you are 45 or older, your joint pain gets worse the more you use the joints, and morning stiffness is absent or lasts less than 30 minutes.

Rheumatoid arthritis is an autoimmune disease: the immune system attacks the cells lining the joints by mistake, making them swollen, stiff and painful. The NHS says it usually affects the hands, feet and wrists, that flares can come and go, and that diagnosing it quickly matters because early treatment can prevent it getting worse and reduce the risk of joint damage. The NHS lists being a woman, having a family history and smoking as factors that increase the risk.

Fibromyalgia is a long-term condition that causes pain all over the body. The NHS says other symptoms include increased sensitivity to pain, muscle stiffness, poor sleep with fatigue, problems with concentration or memory, headaches, irritable bowel syndrome and low mood. It is more common in women and typically develops between the ages of 25 and 55. There is no specific test, so diagnosis relies on the symptoms and on ruling out other conditions.

Hormonal change can also be part of the picture. The NHS notes that perimenopause and menopause can cause aching, painful joints due to lowered oestrogen, which is worth mentioning to a GP if the timing fits.

The NHS suggests seeing a GP if joint pain is stopping you doing normal activities or affecting your sleep, if the pain or swelling is getting worse or keeps coming back, if it has not improved after 2 weeks of home treatment, if your joints are stiff for more than 30 minutes after waking, or if a child has joint problems.

• Ask for an urgent GP appointment or call NHS 111 if the skin around a painful joint is swollen and hot to the touch, or if you have joint pain and feel generally unwell, have a high temperature or feel hot, cold or shivery.

• Go to A&E or call 999 for very bad joint pain after a fall or injury, if you cannot walk or put weight on a joint, if a joint has moved out of place, or if you have tingling or no feeling around the joint after an injury.

A GP will usually start with questions about your symptoms and an examination of your joints. For osteoarthritis the NHS says further tests such as X-rays or blood tests are not usually necessary, but may be used to rule out other causes such as rheumatoid arthritis or a fractured bone. Blood tests and imaging become more important when an inflammatory arthritis is suspected, and the GP may refer you to a rheumatologist for further assessment.

In many areas the NHS also lets you refer yourself to a community musculoskeletal (MSK) service for help such as physiotherapy without seeing a GP first. This is useful for aching joints that are mainly mechanical and affecting daily life.

The NHS advises resting an affected joint if you can, but not stopping movement altogether, using an ice pack wrapped in a towel for up to 20 minutes every 2 to 3 hours, asking a pharmacist or GP which painkiller to use, losing weight if you are overweight, eating a balanced diet and exercising regularly. For osteoarthritis it also suggests suitable footwear and devices that reduce strain on joints in everyday activities, and for fibromyalgia it highlights exercise, relaxation techniques, talking therapies such as CBT and sometimes medicines such as antidepressants.

Medical treatment depends entirely on the cause. For joint pain generally the NHS lists stronger painkillers, antibiotics for infection, physiotherapy, steroid injections, referral for X-ray, scan or specialist treatment including surgery, and lifestyle advice. Rheumatoid arthritis is treated with long-term medicines to relieve symptoms and slow progression, supported by physiotherapy and occupational therapy.

Most people begin with a GP or an MSK service on the NHS, and those with suspected inflammatory arthritis are referred to rheumatology. Private rheumatology and physiotherapy can shorten the wait for an appointment or for blood tests and scans, but the principles of diagnosis are the same. Whichever route you choose, a record of your symptoms, the joints affected and what makes them better or worse is the most useful thing to bring.