You probably aren’t imagining that your joints seem to hurt every time you move—research suggests that up to 70% of people ages 65 and older have painful joints.
And, as if an aching knee or a sore shoulder aren’t enough, many older people report that they have joint pain all over their body, a phenomenon known as polyarthralgia. But what causes joint pain all over the body?
Painful joints may simply be a sign of overexertion, or they may be caused by something more serious, says David C. Thomas, MD, MS, MHPE, a professor of medicine at Mount Sinai. “Anyone who experiences persistent joint pain or joint pain that gets worse should get evaluated by their doctor,” Dr. Thomas advises. “Joint pain should never be considered a ‘normal’ part of aging, and putting up with it may affect your physical health, mood, and quality of life.”
What Is Joint Pain All Over the Body?
Polyarthralgia (also referred to as polyarticular joint pain) is defined as having pain in five or more joints. This widespread joint pain differs from localized pain in that there often isn’t an obvious single cause—for example, an injury or bursitis (inflammation of one of the fluid-filled sacs that cushion and protect the joints).
“Instead, there typically is a broader, systemic cause,” Dr. Thomas says. “That can present a challenge when it comes to diagnosis, since any number of systemic conditions can be a factor in polyarthralgia, and they frequently have overlapping symptoms.”
Common Causes of Widespread Joint Pain
Widespread joint pain can have acute or chronic underlying causes. Acute causes include infections, injuries, and gout. Chronic causes include arthritis, problems with the thyroid gland, and a condition called fibromyalgia.
ACUTE CAUSES
Infections that are associated with widespread joint pain can be viral, bacterial, and even insect-borne.
Viruses often cause inflammation, which is one of the body’s most effective tools for fighting off infections. “While a minor cold probably isn’t going to cause too many aches and pains, more severe infections, like the flu and COVID-19, can cause more intense joint pain all over the body,” Dr. Thomas notes. “Another infection that can cause widespread joint pain is hepatitis—there are several types, with varying risk factors. Pain affecting multiple joints also can be an early sign of HIV.”
Bacteria transmitted through tick bites can cause widespread joint pain if it spreads to the joints, which occurs in about 60% of untreated Lyme disease cases, according to the Centers for Disease Control and Prevention. If you spot the telltale bullseye-shaped rash that usually develops around a tick bite within about seven days, alert your doctor, since Lyme disease can be effectively treated with antibiotics. But keep in mind that about 20% of infected people do not develop this rash, so don’t rely on it as a warning sign.
Accidents can result in widespread joint pain if multiple joints are injured or an injury to one joint, such as the knee or hip, alters the way you walk. Surgery and even hobbies you enjoy can have the same effect. “Nobody wants to feel pain as they walk, so they might subconsciously shift their weight a certain way to avoid placing pressure on a painful joint,” Dr. Thomas says. “In doing so, they can inadvertently place additional stress on other joints, causing those to ache, too. Or perhaps they tend to spend long hours hunched over a workbench building model airplanes or similar kit projects. Even small intricate movements of the hand can exert stress on the wrists and forearms, while leaning forward for long periods of time can cause pain in the shoulders, neck, and back.”
Gout occurs when uric acid—which is produced when the body metabolizes purines (substances that occur naturally in the body and also are contained in many foods)—forms tiny sharp crystals in one or more joints. You may associate gout with the big toe joint, but in older people gout flare-ups often affect multiple small joints in the hand, along with the wrists, elbows, ankles, and knees. Gout pain can be excruciating, but many people are lucky enough to experience an attack just once. If it recurs, follow your doctor’s advice when it comes to the lifestyle changes and medications that can relieve the problem.
CHRONIC CAUSES
Chronic conditions associated with polyarthralgia include osteoarthritis, autoimmune conditions including rheumatoid arthritis and lupus, fibromyalgia, and hypothyroidism.
Osteoarthritis, which often is referred to as “wear-and-tear arthritis,” typically begins in one joint but spreads to others because one of the major risk factors for osteoarthritis—obesity—exerts great stress on all of the joints. “In osteoarthritis, cartilage—a slippery substance that cushions and lubricates the ends of the bones in a joint—gradually wears away,” Dr. Thomas explains. “As more and more cartilage is lost, the bones start to grind on each other, causing pain, swelling, and stiffness in the affected joints.”
Another type of arthritis—rheumatoid arthritis—is an autoimmune condition. “In these conditions, the immune system mistakenly identifies the healthy tissue as potentially dangerous and launches an immune response against it,” Dr. Thomas says. “Immune cells can cause significant damage to the joints by attacking and inflaming the synovium, which is the delicate tissue that lines the inner surfaces of the joint.” Rheumatoid arthritis affects the joints on both sides of the body, starting in smaller joints like the hands and wrists, before spreading to larger joints. Medical advances mean that a range of highly effective medications are available to relieve the discomfort caused by rheumatoid arthritis, as well as reducing the joint damage it can cause. Widespread joint pain also is a symptom of lupus, another autoimmune condition, but compared with rheumatoid arthritis it is less likely to cause serious joint damage.
Fibromyalgia doesn’t damage the joints or cause swelling, but it can cause widespread joint pain by affecting the way your brain processes pain signals sent by the body. “It essentially makes you hypersensitive to pain, meaning that you will perceive high levels of pain from discomfort that other people might consider minor,” Dr. Thomas says. Conversely, hypothyroidism (also known as underactive thyroid), an endocrine disorder caused by abnormal levels of thyroid hormones, is more likely to cause relatively mild pain.
Symptoms to Watch For
Persistent pain affecting several joints simultaneously, whether it is acute and stabbing or characterized by a dull, nagging ache, should be evaluated by a healthcare provider. Dr. Thomas says this is particularly important if there is no obvious cause, since there may be an underlying disease process that can be treated quite easily.
“If you experience pain that spreads to other joints and worsens with activity, especially if it is interfering with your ability to perform everyday tasks, causing you to avoid physical activity, and disturbing your sleep, call your doctor,” he advises. Also contact your doctor if you develop joint pain after being bitten by a tick or spending time outdoors without using tick repellent.
When to Seek Medical Attention
Dr. Thomas emphasizes that joint pain that starts suddenly and rapidly worsens, is accompanied by swelling and redness in the joints and/or fever and affects your ability to bear weight should be treated as a medical emergency.
Diagnosis: How Doctors Identify the Cause
Your doctor probably will carry out a careful physical examination to assess painful joints for swelling, stiffness, redness, and heat, and also ask you about any symptoms you have experienced other than joint pain, such as fever.
“We pay close attention is paid to the pattern of joint involvement—what joints were affected first, how exactly the pain spread through multiple joints and whether the spread was symmetrical, which may signal rheumatoid arthritis, or involved larger joints first, which tends to point to osteoarthritis,” Dr. Thomas says. “Other clues include whether the pain is worse in the mornings and then subsides or gradually worsens during the day.”
Blood tests may be performed to check for inflammatory substances that can increase if you have autoimmune joint pain and/or for thyroid hormone imbalances. You may be tested for infections like Lyme disease, too. Your doctor also may recommend imaging tests to examine joint damage more closely.
Treatment for Joint Pain
Self-help strategies can help protect you against some of the underlying causes of polyarthralgia and ease your joint pain. Physical therapy and medications also are effective.
- Lifestyle Changes and Self-Care. If you are overweight or obese, discuss with your doctor how you can achieve slow, steady, and sustainable weight loss. Healthy eating—plenty of fruits, vegetables, whole grains and healthy fats—is key, along with physical activity. If you are struggling to manage weight gain, you may meet prescribing criteria for glucagon-like peptide-1 (GLP-1) receptor agonists, a class of weight-loss drugs that can be highly effective. But don’t see GLP-1 medications as an easy way to shed pounds without committing to healthy lifestyle choices—the drugs do come with side effects, and most people need to take the drugs long-term to maintain their weight loss.
- Medications. Drugs that can help relieve joint pain include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve). “Your doctor may prescribe stronger versions of these medications if over-the-counter (OTC) options don’t provide sufficient relief, but older adults need to be careful with NSAIDs, since they are associated with potentially serious side effects in this age group,” Dr. Thomas cautions. He adds that you will be less likely to suffer these complications if you use a topical NSAID like diclofenac (Voltaren Arthritis Pain Gel). Gout can be managed with colchicine (Colcrys), a drug that relieves inflammation. Other medications—allopurinol (Aloprim) and febuxostat (Uloric)—reduce uric acid production in the body, while probenecid (Probalan) helps the body excrete uric acid. “Disease-modifying antirheumatic drugs, biologics, and targeted-therapy drugs can have dramatic benefits for rheumatoid arthritis, reducing pain and controlling the underlying immune processes that characterize autoimmune conditions, Dr. Thomas notes. “Physical therapy can help by strengthening the muscles that support painful joints and maximizing range of motion.”
- Surgery. You may want to consider joint replacement if pain and stiffness is limiting your function and preventing you from sleeping well. The procedure removes the ends of the bones in an arthritic joint and replaces them with a prosthetic joint. “Depending on which joint is replaced, full recovery can take months, but many people with arthritis report that joint replacement is life-changing,” says Dr. Thomas.
Practical Tips for Managing Joint Pain
Along with OTC painkillers, hot and cold therapy, massage, meditation, and acupuncture—a form of traditional Chinese medicine—may bring relief. “You also may want to try applying pain-relieving creams that contain menthol or camphor,” says Dr. Thomas. “These are believed to help because they have a counterirritant effect that essentially distracts you from pain. A similar choice is capsaicin creams, which contain the active ingredient in hot peppers.”
Numerous dietary supplements are marketed as treatment options for widespread joint pain and autoimmune joint pain, but they have not undergone rigorous clinical testing and are not regulated by the U.S. Food & Drug Administration. Dietary supplements can interact with conventional drugs you may be taking, so take the precaution of checking with your doctor before trying any. It also is vital to let your doctor know if you are considering using cannabis (“medical marijuana”) to manage joint pain. “There are reports it can be helpful, but it is associated with potentially serious side effects in older adults, including low blood pressure and balance issues that raise the risk of falls, and abnormal heart rhythms,” Dr. Thomas warns.
Also think in terms of prevention. Getting vaccinated against the flu and COVID-19 can help you avoid associated aches and pains and protect you against potentially life-threatening illness. Safe, effective vaccines also exist to protect against hepatitis A and hepatitis B. The vaccines typically are given in childhood, but if you have not been vaccinated ask your doctor if you should be.
And take steps to protect yourself against tick bites if you are spending time outdoors in areas frequented by deer, which carry the ticks that spread Lyme disease. “Protective strategies include avoiding hikes in wooded or high-grass areas, wearing insect repellent that contains DEET, and using products that contain permethrin on clothing and camping gear, showering immediately after spending time outdoors, and thoroughly checking yourself and any pets for ticks,” Dr. Thomas says.
