Allergy, immunity & body
Joint pain & osteoarthritis
Aching knees: wear and tear, or something that needs a doctor today?
Most joint pain in adults is osteoarthritis, which has no cure but responds to exercise, weight loss and careful use of pain relievers. Some joint pain is different: gout, rheumatoid arthritis and joint infection need prompt, specific care.
In 30 seconds
The short answer
Osteoarthritis is the most common type of arthritis.1 It has no cure but usually worsens slowly, and a lot can be done.2 Treatment starts with exercise and, if needed, weight loss;56 pain relievers help but carry risks.1214 Other causes of joint pain, such as gout, rheumatoid arthritis and infection, need different and sometimes urgent care.181920
Four common causes of joint pain
| Cause | Typical clue |
|---|---|
| Osteoarthritis | Pain with use; morning stiffness under 30 minutes.3 |
| Rheumatoid arthritis | Same joints on both sides.19 |
| Gout | Sudden flare, often at night, often the big toe.18 |
| Joint infection | Fever and one hot, swollen joint.20 |
Only a clinician can tell them apart; the clues guide when to go.
Popular joint remedies
| Remedy | What the evidence says |
|---|---|
| Glucosamine and chondroitin | Still uncertain; one major guideline advises against.1516 |
| Turmeric (curcumin) | Early evidence positive, not conclusive.17 |
| Strong curcumin products | Some may harm the liver.17 |
| Acupuncture | Some research says it may ease pain.11 |
Show any supplement to your pharmacist.
The clinic's approach
The Pakistan Institute of Medical Advancement in Karachi, whose documents inform this site, promotes joint-pain treatment in its Urdu brochure and DMSO sheets. Here is what its documents say, and what independent evidence shows.
The clinic's joint-pain claims, and what the evidence shows
Two claims from the clinic's documents, each with the clinic's words first, then independent evidence.
"Bye-bye joint and knee pain!": joint and muscle pain treated "effectively" with unnamed "advanced allopathy"
Promoted in a clinic leafletNot proven- Where the clinic says this
- Urdu trifold brochure, side 1 (ProperHealth translation).24
- The clinic's stated rationale
- The brochure says its medicines treat "every kind of pain"; it does not name the medicines or the condition being treated.24
- Evidence and limitations
- Joint pain has different causes that need different care.181920 Osteoarthritis, the most common, has no cure; treatment manages symptoms, starting with exercise and weight loss.256
- What this means for you
- Ask any clinic which diagnosis and which medicine it means, and check new pain relievers with a pharmacist.
DMSO for arthritis, rheumatism, gout and sprains
Promoted in a clinic leafletNot proven- Where the clinic says this
- Urdu DMSO sheet, items 11 and 13;25 brochure DMSO sheet.26
- The clinic's stated rationale
- The sheets call DMSO a powerful anti-inflammatory that relieves pain and repairs tissue damage.2526
- Evidence and limitations
- The only approved DMSO medicine is a bladder solution for interstitial cystitis; it is not approved for any other use.22 On the skin it is absorbed into the body.23
- What this means for you
- Treat DMSO as a medicine, not a rub: check with a pharmacist first, especially with other medicines.
From the Dr. Majid Ali archive
A historical perspective
“But what are the energetic-molecular events that cause rheumatoid arthritis? The answer is we do not know.”— Dr. Majid Ali, 2017-06-05Writing as a pathologist, Dr. Ali noted that for many kinds of arthritis the first events that start the disease are still unknown.
That candour is consistent with current sources: researchers are still not sure what causes osteoarthritis.21
Where ProperHealth stops. Dr. Ali also proposed that there are only three kinds of arthritis, all caused by oxidative injury, and that joint pain comes from too much insulin. The sources used here describe distinct causes, such as uric acid in gout and the need for early treatment in rheumatoid arthritis,1819 and do not support those claims.
Medicines, supplements and safety
A pharmacist can check your pain relievers, creams and supplements for overlap and risks. A pharmacist does not diagnose the cause of joint pain or inject joints.
Compared
Conventional and integrative care, compared
What pain relievers, injections and surgery do for osteoarthritis, what the pills cost, what raises the risk, and the evidence on exercise, acupuncture, glucosamine and the clinic's DMSO.
What conventional treatment does
- There is no cure for osteoarthritis, but it usually worsens slowly and a lot can be done to manage symptoms.2 Some pain relievers and creams are sold without a prescription — ask your provider before using them;8 steroid injections into the joint can relieve pain for a time;9 if other treatments do not help and damage is extensive, surgery such as joint replacement may be an option.10
- Other joint diseases are treated differently: rheumatoid arthritis usually affects the same joints on both sides, and early treatment helps prevent joint damage;19 gout comes from uric acid build-up, with flares often starting suddenly at night.18
Limits and adverse effects
What contributes to the condition
- Researchers are not sure what causes osteoarthritis;21 extra weight and past joint injury or surgery raise the chance.4 Its pain comes with use and may ease with rest, and morning stiffness usually lasts less than 30 minutes.3 It is the most common type of arthritis, usually in the hands, knees, hips, neck and lower back.1
Integrative and naturopathic approaches, by evidence
Evidence levels: EstablishedEmergingHypothesisNot supported
- Established
Exercise can reduce joint pain and stiffness and build flexibility, strength and endurance;5 for people who are overweight, losing weight can reduce pain and improve joint mobility.6 Low-impact options include walking, cycling, swimming, tai chi and water aerobics.7 Heat and ice can help,11 and fitted braces or shoe inserts can too.8
- Emerging
Some research suggests acupuncture may ease osteoarthritis pain.11 Early evidence on turmeric for osteoarthritis is positive but not conclusive, and highly absorbable curcumin products may harm the liver.17
- Not supported
It is still uncertain whether glucosamine and chondroitin help knee osteoarthritis,15 and a 2019 U.S. rheumatology guideline strongly recommends against them.16 The clinic's brochure promises "Bye-bye joint and knee pain!" and treatment of "every kind of pain" without naming the treatment;24 its DMSO sheet calls DMSO a powerful anti-inflammatory in arthritis, rheumatism, sprains and gout,25 and a brochure says it repairs tissue damage.26 The only approved DMSO medicine is a bladder solution for interstitial cystitis, not approved for any other use,22 and DMSO put on the skin is absorbed into the body's tissues and fluids.23
A hot, red, swollen joint with fever is a joint infection until proven otherwise — seek care the same day;27 everything else on this page is for a planned visit.
When to get help now
Each warning sign cites the official guidance behind it. The wording still needs pharmacist sign-off.
- A hot, red, swollen joint with fever — seek care the same day.2728
- After an injury: severe pain, a joint that looks out of position, or you cannot use the joint — go to the hospital right away or call 911.29
- Chest pain, shortness of breath, weakness on one side or slurred speech while taking an anti-inflammatory pain reliever — get emergency help (911). Black stools or vomiting blood — stop the medicine and get medical help right away.3031
- Back pain with leg weakness or loss of bladder control — go to the emergency department.3233
- Swollen joints on both sides with long morning stiffness — book a visit soon.3435