Side Effect: Joint Pain

What is Joint Pain?

Joint pain is discomfort, inflammation, or soreness in any of the joints in the body. Common sites of joint pain occur in joints that allow us to bend in certain ways, such as:

• Wrists
• Elbows
• Shoulders
• Hips
• Knees
• Ankles

What does joint pain look like or feel like?

Joint pain can mild feeling or severe, It can be short-lasting (e.g. a minute or two), or it can be persistent and not go away.

Joint pain may present in different ways, including:

• stiffness and loss of range of motion
• dull aching
• burning sensation
• sharp pain
• stabbing pain
• throbbing pain

Depending upon the cause, pain in the joints may be associated with redness, swelling, and warmth around the affected area.

Who gets Joint Pain?

Joint pain, especially in elderly, may be caused by arthritis. However, other causes may exist, such as:

• Patients with cancer may experience joint pain because of the cancer or certain treatments for cancer.
  
  
• Cancer-related joint pain can be caused by bone metastases. This occurs when cancer cells spread from the original tumor to the bones.
  
  
• Joint pain can be a side effect of medications as well, or cancer treatment. Common medications leading to bone and joint pain are:
  • Granulocyte colony stimulating factors, also referred to as “growth factors” used to boost white blood cell counts.
    • Note: Joint pain from growth factors is often a signal that the medication is working to stimulate white blood cell growth
    • Examples of growth factors that stimulate white blood cells include: filgrastim and pegfilgrastim

How to prevent Joint Pain

Preventing joint pain require work on the part of the patient. Areas to focus on include:

• Physical therapy aimed at strengthening muscles around the joint
  • Exercising or moving the body daily can help with joint stiffness. Even short walks when done consistently make a difference.
• Proper nutrition and healthy eating habits to achieve a healthy weight and limit stress on joints

If receiving growth factors after chemotherapy, your doctor may recommend taking loratadine (Claritin®) for joint/bone pain prevention. Loratadine is an inexpensive, over-the-counter, non-sedating antihistamine medication that is often used by people with allergies, or with cold symptoms.

How to treat Joint Pain

If severe and limiting your ability to move, your doctor or physical therapist may initially recommend the R.I.C.E. protocol before prescribing medications or recommending strength exercises.

RICE protocol:

• Rest
• Ice
• Compression
• Elevation

Joint pain management strategies will depend on the cause.

Over-the-counter medications used to treat joint pain:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or meloxicam may be recommended but should be used in caution in people with poor kidney function, those taking methotrexate (may cause toxicity when taken together), or those with a history of stomach ulcers.
  
  
• Supplements such as glucosamine and chondroitin can be used for moderate to severe osteoarthritis when taken in combination but may take weeks to month to take effect. It can be hard to know if these are working. A good way to know is to stop taking glucosamine and chondroitin after a period of 4 weeks to see if the joint pain acutely worsens. Ask your doctor or pharmacist if glucosamine and chondroitin is safe to add to your other medications before taking it.

Prescription medications used to treat joint pain:

• Corticosteroid injections reduce inflammation in the joint and may provide short-term (about 4 to 8 weeks) relief of osteoarthritic flare-ups
  
  
• Hyaluronic acid injections may be more expensive than corticosteroids, or may not be covered by insurance, but can maintain symptom improvement for longer periods without the same side effects as corticosteroids.