You might think that new pain in your hip or shoulder joint is arthritis. But you may be wrong. While arthritis is a common ailment – particularly in older people – nerve damage can also create chronic joint pain.
Both sources can cause significant discomfort and impact your ability to enjoy life. It’s important that you get the correct diagnosis; treatment may vary, based on where the actual problem is located.
Arthritis vs Nerves
While both arthritis and nerve damage can cause joint pain, they tend to affect your joints in different ways.
Arthritis is a group of conditions that affect your joints – where you bones join. The most common type is osteoarthritis, which is estimated to affect 33 million U.S. adults, though many may not realize they have it. The disease, which is incurable, causes the breakdown of tissues in your joints and can become debilitating in severe cases. Symptoms include:
- Pain that is dull or achy and that gets worse when bending or using the joint
- Joint stiffness that may go away after rest
- Swelling in or around the joint, particularly after activity
- Feeling like your joint is unstable
Nerve-related pain may be linked to numerous conditions. Among the most common is peripheral neuropathy, which refers to any condition (type 2 diabetes is a common cause) that damages the nerves used to communicate with every part of your body outside of your brain and spine. Those nerves can be damaged in many ways, including injuries, tumors, spinal deformities and herniated disks. Symptoms include:
- Numbness
- Sensation of pins and needles
- Shooting pain that may feel sharp
- Pain that radiates out from the joint
Diagnosing Nerve Pain
Diagnosis generally begins with a physical examination, an exploration of your medical history and X-rays of the painful joint. Your doctor will be looking for signs of wear and tear in the joint.
The goal is to determine where the pain is coming from. If it’s not arthritis or some other damage to the joint, the search for answers will often expand to your spine. This will involve more advanced scans, including magnetic resonance imaging (MRI) that may point to referred pain – when an injury or issue in one part of your body is causing pain elsewhere.
Consider that your body is filled with an extensive network of nerves, some of which pass through your joints. One of the more common examples of this is when a patient is having shoulder issues. Images may show no damage in the shoulder joint but instead point to a pinched nerve in the neck. Similarly, hip or knee pain may be related to an issue in the spine. It could be a bulging disk, bone spur or stenosis (a narrowing of the spinal canal) that is putting pressure on the nerve that travels to the painful joint.
What Are Your Treatment Options?
Initial treatment is often similar for both arthritis and nerve pain. Conservative measures will be attempted first. Those include physical therapy, which can help relieve pain and improve mobility by stretching and strengthening the joint.
Medications may also be helpful, starting with over-the-counter pain relievers and advancing to prescription-level medications if needed. Antidepressants and anticonvulsants may be used to treat pain coming from a damaged nerve. Steroids may also help reduce inflammation and improve your mobility.
If these more conservative approaches don’t yield enough relief, your doctor may use a nerve block. The procedure uses a combination of numbing medication and steroid, injected near the nerve that’s causing the pain. The injection, which can be repeated, can quiet the nerves and turn off the pain signal for months at a time.
In some cases, the nerve problem will get better over time. A bulged or herniated disk, for example, may reabsorb the gelatinous material that has leaked out, effectively removing the pressure on the nerve. But in the case of stenosis, that does not typically improve.
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