Joint Pain

Approved by the Cancer.Net Editorial Board, 12/2018

A joint is where 2 bones in your body connect. Pain in the joints, also called arthralgia, is a possible side effect of cancer and its treatment. Joint pain can occur in the hands, feet, knees, hips, shoulders, lower back, spine, and other joint areas.

Joint pain can affect a person’s quality of life and make other symptoms or side effects of cancer seem worse. It may even cause some people to stop treatment before it is finished. If you are experiencing joint pain, talk with your health care team. Managing symptoms is an important part of your cancer care and treatment. This is called palliative care or supportive care.

Symptoms of joint pain

Joint pain can be mild or severe. The pain may last a short time or may be constant for a long time. Symptoms can include:

  • Pain in a joint with movement or at rest

  • Limited range of movement

  • Stiffness after inactivity or during activity

  • Swelling or tenderness at a joint

  • Redness or warmth at a joint

  • Not being able to do everyday activities

Causes of joint pain

The following factors can cause joint pain.

Cancer. Certain types of cancer are more likely to cause joint pain, including:

  • Cancer that occurs near or in a joint, such as bone cancer

  • Cancer that spreads to the bone

  • Leukemia, which can cause cancer cells to cluster in the joints

Cancer treatments. The following cancer treatments can cause joint pain during treatment. Often, pain goes away after treatment. In some cases, joint pain can be a late effect, which means it occurs months or years after cancer treatment ends.

  • Some types of chemotherapy, such as bleomycin (available as a generic drug), cladribine (available as a generic drug), L-asparaginase (Elspar), and paclitaxel (Taxol) and other taxane-based chemotherapies

  • Aromatase inhibitors, such as anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara), as well as other hormonal therapies, including fulvestrant (Faslodex), raloxifene(Evista), tamoxifen (Soltamox), and toremifene (Fareston)

  • Targeted therapy, such as T-DM1 or ado-trastuzumab emtasine (Kadcyla) and olaparib (Lynparza)

  • Immunotherapy, such as CTLA-4 and PD-1/PD-L1 inhibitors

  • Steroid medications

Other medications. Other medications that may be given during cancer treatment can also cause joint pain:

  • Drugs called white blood cell growth factors that help prevent infection during cancer. These include drugs such as filgrastim (Granix, Neupogen, Zarxio), pegfilgrastim (Fulphila, Neulasta), and sargramostim (Leukine).

  • Drugs to treat bone loss. These include bisphosphonates such as alendronate (Binosto, Fosamax), ibandronate (Boniva), pamidronate (Aredia), risedronate (Actonel), and zoledronic acid (Zometa).

  • Certain pain medications, including piroxicam (Feldene)

Other factors. People with cancer can also have joint pain from many other conditions, such as rheumatoid arthritis, osteoarthritis, fibromyalgia, lupus, gout, bursitis, and tendinitis. An infection in a joint can also cause pain.

Diagnosing joint pain

Your doctor will assess your symptoms and medical history. He or she will also conduct a physical exam and ask you questions such as:

  • Which joints hurt?

  • How long have you had joint pain?

  • How severe is your joint pain?

  • When does your pain stop and start?

  • What makes your joint pain better or worse?

  • Is your joint pain affecting your ability to do everyday tasks?

If severe joint pain is caused by your cancer treatment, your doctor may recommend trying a different treatment.

If your doctor is not sure why you are having joint pain, or it does not go away or gets worse, he or she may order tests to help find out the cause. These may include:

  • Blood tests. These can show if your body has an infection or another condition not related to cancer that can cause joint pain.

  • X-rays. Create a picture of the structures inside the body.

  • Computed tomography (CT or CAT) scan. Makes a 3-dimensional image of the inside of the body.

  • Bone scans. Help find cancer that has started in the bones or spread to the bones.

  • Magnetic resonance imaging (MRI). Uses magnetic fields to produce detailed images of the body.

Contact your doctor right away if you develop symptoms in addition to joint pain, such as:

  • New or more severe back pain

  • Pain around the waist or chest

  • Loss of bladder or bowel control

  • Weakness and/or numbness and tingling in the lower body

These symptoms can be a sign of spinal compression, which needs immediate attention.

Treating and managing joint pain

When possible, doctors treat the condition that causes the joint pain. They may do this in one of the following ways:

Medication. These medications may treat or reduce joint pain:

  • Pain relievers including:

    • Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Motrin), naproxen (Naprosyn), and celecoxib (Celebrex)

    • Acetaminophen, such as Tylenol

  • Corticosteroids, which reduce swelling and inflammation

  • Certain anticonvulsants and antidepressants that may block pain signals

  • Antibiotics, which treat joint infections

Self-care and support methods. Below are methods that may help you better manage joint pain. Some of these practices you can do on your own. Others require you to work with a licensed or certified specialist. Talk with your health care team before trying these methods.

  • Physical therapy. A physical therapist can help restore function in a joint, as well as teach you how to relieve pain using simple exercises or assistive devices.

  • Acupuncture. Some studies show that acupuncture can help relieve joint pain related to aromatase inhibitor therapy. Acupuncture involves placing small needles in specific points of the body.

  • Exercise. Research shows that stretching and gentle exercise may reduce joint pain. Exercise can also help you manage your weight so there is less stress on your joints. It can also strengthen your bones and the muscles around your joints, as well as increase joint flexibility.

  • Heat and cold. Hot or cold compresses, heating pads, or ice packs may help decrease discomfort from joint pain.

  • Massage. A massage therapist who has experience working with people who have cancer can do a gentle therapeutic massage that may help ease joint pain. You or your caregiver can also do simple massage techniques at home.

Track the results of the techniques you use to find out which ones best manage your joint pain. You can use a chart like the one in the ASCO Answers Managing Cancer-Related Pain booklet (PDF) to track your pain.

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More Information

Medline Plus: Joint Pain