Joint Pain

Approved by the Cancer.Net Editorial Board, 07/2021

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

Joint pain can affect your quality of life and make other symptoms or side effects of cancer feel worse. It may cause some people to stop treatment before it is finished. If you are experiencing joint pain, talk with your health care team. Relieving side effects is an important part of cancer care and treatment. This type of care is called palliative care or supportive care. It helps people with any type or stage of cancer feel better.

What are the symptoms of joint pain?

Joint pain can be mild or severe. The pain can last a short time or it can be long-lasting. It can also be sudden or sharp pain during movement or it can be constant pain that does not go away when you rest. Joint pain can affect your ability to do everyday activities.

Joint pain can be associated with other symptoms, such as:

  • Limited range of movement

  • Joint stiffness after inactivity or during activity

  • Joint swelling or tenderness, which is when the joint hurts when pressed on

  • Redness or warmth at a joint

These symptoms can indicate inflammation of the joint. Joint inflammation can be due to an infection, autoimmune disease, or other causes. Joint inflammation is also called arthritis. Your health care team can help you find out why joint inflammation is happening.

What causes joint pain when you have cancer?

When you have cancer, your joint pain can be caused by different parts of the cancer or cancer treatment.

Cancer. Certain types of cancer are more likely to cause joint pain. Cancer that occurs near or in a joint, such as bone cancer and cancer that spreads to the bone, can cause joint pain. Lung cancer, breast cancer, prostate cancer, and multiple myeloma are more likely to involve and spread to the bone. Leukemia can also cause cancer cells to cluster in the joints.

Cancer treatments. Some cancer treatments can cause joint pain. 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. Cancer treatments that may cause joint pain include:

  • 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 (AIs), such as anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara), which are medications used to treat certain types of breast cancer. Around half of the people who take an AI develop joint pain and stiffness.

  • Other hormonal therapies, including fulvestrant (Faslodex), raloxifene (Evista), tamoxifen (Soltamox), and toremifene (Fareston)

  • Some targeted therapies, such as T-DM1 or ado-trastuzumab emtasine (Kadcyla) and olaparib (Lynparza)

  • Some immunotherapies, 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:

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

  • Biophosphonates, which are used to treat bone loss. These include alendronate (Binosto, Fosamax), ibandronate (Boniva), pamidronate (Aredia), risedronate (Actonel), and zoledronic acid (Zometa).

  • Certain pain medications

Other factors. People with cancer can also have joint pain from another medical condition that can be unrelated to the cancer itself. Some conditions that can cause joint pain include rheumatoid arthritis, osteoarthritis, fibromyalgia, lupus, gout, bursitis, and tendinitis. An infection in the join can also cause pain.

How is joint pain diagnosed?

Your health care provider will evaluate your symptoms and medical history. They will do a physical exam and ask you questions such as:

  • Which joint hurts? Is the pain in more than 1 area?

  • How long have you had joint pain?

  • How severe is your joint pain?

  • When does your pain start and stop?

  • 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 provider may recommend trying a different treatment, having treatments less often, or getting a lower dose.

If they are unsure about the cause of your joint pain or if your joint pain does not go away or gets worse, you may need additional tests to help find the cause. These can include:

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

Bone scan. These can find cancer that has started in the bones or spread to the bones.

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

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

X-rays. These create a picture of the structures inside the body and may be able to show the cause of your joint pain.

How is joint pain treated and managed?

When possible, your health care team will treat the condition that is causing the joint pain. Possible treatment options include the information below.

Often, joint pain can be relieved with medications. Some of the medications that your health care team may suggest or prescribe include:

  • Pain relievers including acetaminophen (such as Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (such as Advil and Motrin), naproxen (such as Aleve and Naprosyn) and celecoxib (Celebrex)

  • Corticosteroids, which reduce swelling and inflammation

  • Certain anticonvulsants and antidepressant medications that may block pain signals

  • Antibiotics, if it is a joint infection

Your health care team may also recommend self-care and support methods of treating joint pain. You may decide to do some of these methods in addition to medication or instead of medication for mild 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.

Some self-care and support methods you can use to treat joint pain are:

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. Talk with a health care provider about how long and how often to apply the heat or cold.

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.

Questions to ask the health care team

  • Could my joint pain be caused by cancer? Or is it caused by something else?

  • When should I call you if I develop joint pain or if my joint pain gets worse?

  • How should I track my joint pain?

  • What treatments do you recommend for my joint pain?

  • Do you recommend any other kinds of supportive care for joint pain?

  • Are there things I can do at home to ease my joint pain?

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Medline Plus: Joint Pain