Arthralgia

M25.50-59

• Description
• General measures
• Medicine treatment
• Referral

DESCRIPTION

Joint pain without swelling, warmth, redness or systemic manifestations such as fever.

It is usually self-limiting. May be an early manifestation of degenerative joint conditions (osteoarthrosis) or local and systemic diseases. May follow injury to the joint, e.g. work, play and position during sleep.

Suspect rheumatic fever in children, especially if arthralgia affects several joints in succession.

GENERAL MEASURES

• Advise patient to:
  • apply heat locally to the affected joint, taking precautions not to burn themselves
  • exercise once their pain is relieved
  • reduce weight, if overweight, to decrease stress on the joint
• Exclude systematic causes.
• Reassure patient.

MEDICINE TREATMENT

Treat for 1 week (maximum 2 weeks) provided no new signs develop.

Pain:

Children

• Paracetamol, oral, 10-15 mg/kg/dose 6 hourly when required. See Paediatric dosing tool.

Adults

• Paracetamol, oral, 1 g 4–6 hourly when required.
  • Maximum dose: 15 mg/kg/dose.
  • Maximum dose: 4 g in 24 hours.
• Methyl salicylate ointment, topical, may provide some relief.

REFERRAL

• Pain for 1 week in children, and pain for > 2 weeks in adults.
• Recurrent pain.
• Severe pain.
• Fever.
• Involvement of several joints in succession
• Evidence of systemic illness e.g. e.g. sore throat in children, presence of jaundice, anaemia.