Dr. A Q&A: Why do I have joint pain? (& 1 Commonly Overlooked Cause)

Hey, it's Dr. A. So you take a medicine, you have a chronic illness, you have an acute illness, you do something, maybe you don't take any medicine and your joints hurt. What's going on? I'm Dr. A, and on this channel I answer questions from you guys. Questions probably I've been asked a lot in the past. Sometimes they're brand new, but I base these answers on being a practicing physician for a long, long time, teaching a lot of physicians, writing and doing some research over time. So let's just get into it. I have pain in my joints. Maybe it's small joints like my fingers. Maybe it's bigger joints like the elbows, knees, etc. Maybe it's everywhere. Like, I just feel like the Tin Man on The Wizard of Oz. I'm creaky and all that stuff. Why do I get this as a reaction? Not there all the time. I went to the rheumatologist, the joint doctor, if you will, the inflammatory doctor. And they said, no, I don't have arthritis of any kind. I'm good to go. My joints look great on the x-rays. But I'll tell you what, Doc, they hurt. And, and there's a number of reasons that can happen. Break this down and try and just get right to it in this video. I like these short videos where I can answer just one question at a time. There are many things that can make your joints hurt. Obviously, one is trauma. Now, normally, unless you were unconscious, or really impaired, you know that your thumb here hurts because you fell down and twisted your thumb, right? So yeah, if you fall down and you didn't break your fingers, but the only thing stopping your thumb, you know, the ground was your thumb, something's gonna hurt in there. What if you don't have trauma though? You don't have trauma and you have painful joints, then we have to start thinking about a lot of other things. Now, you mentioned, you know, in the, in the question setup, it was, well, I went to the rheumatologist and they said I don't have any type of arthritis. So there's osteoarthritis, there's rheumatoid arthritis, there's arthritis related to crystals and other problems. Not the crystals like you hang on the wall, but like crystals inside your joint, that sort of stuff. And they're just as pretty, by the way. Not, not if you have them in your joint, they don't feel good, but if you grow them out, they're really nice looking crystals. Well, the bottom line is you might go get screened and you don't have any of those. You don't have, you know, you don't have gout, you don't have rheumatoid arthritis, you don't have osteoarthritis. You x-ray your joints, look perfect. Why do they hurt? Well, the normal reason the joints will hurt is they are a sequestered island of fluid. So the synovial fluid inside your joints, it's in there and it doesn't turn over super fast. It tends through the day to move better when you're moving around and then at night, sometimes what happens is chemistry will influx, will move into the joint space and you may actually wake up. Sometimes you wake up and the joint will hurt more. Now, you can have that for other reasons but the natural ebb and flow of the fluid, the synovial fluid, is joint is it sort of builds up some stuff at night and as you move it during the day it moves along. Well, there's also a thing that happens that as you're, you know, maybe it's not so bad when you wake up but through the day it's like, man, you know, this joint here or both of my wrist joints or my knees or all my joints or whatever, they're just getting angry throughout the day. Here's the thing you want to think about. When your joints are angry and painful, There are usually either internal but normally external inflammatory chemicals being produced in your body and your joint is sort of like the canary in the coal mine. The joint is a place that is going to sequester these chemicals and it's got a lot of nerve endings. You're going to feel it there. The first thing that you want to think about when you have joint pain is if it's not, you know, I mean everyone has pain now and then. So if you have recurrent joint pain or it's at a very high level, you want to go see your healthcare provider and figure out that it's not, you know, something very bad going on. You can have things called like a septic joint, a lot of other bad things, gout and crystal arthropathies and other problems that go on, RA, OA, all that. But let's say they say no, none of that's going on. Are you getting this stuff going on? That's the point of today is why, why do my joints hurt? Well, let's say you've ruled out all the big bad reasons for joint pain. There's a lot of other reasons your joints can hurt. The most common are either when you have an underlying problem that triggers a level of inflammatory activity that reaches a point, whatever that point is for you, and then certain joints will just be, they'll be Your marker, your canary in the coal mine. It's like, as soon as these joints in my thumb start to light up and they're just painful, or as soon as my knees or whatever it is start to light up, I know I'm, you know, my inflammatory level is pretty high. The other time it can happen though that you have to think about is you might start taking a therapy, a treatment for something else, and that treatment especially if it's an anti-infective treatment, may kill some bugs that release some chemistry that cause your immune system to react. Seen this a lot with chronic infectious patients, people with large-scale fungal infections, people with the complex diseases around Lyme disease, Lyme complex illness, complex chronic illness, anything that's chronic. As soon as you start to treat it, You can get this inflammatory reaction in the joints. Why? Because now you're killing stuff. Wait a minute, why didn't I have the pain before? Well, here's the really nasty thing about joint pain and infections and other triggers. It goes both ways, unfortunately. You can have so much infection in your body that your joints really don't hurt anymore because your body's kind of come to an immunologic peace with that. It's not good, but it's It's a place, right? Then you start to kill these bugs and then they scream dying and let off all this chemistry and then your immune system creates other chemicals that cause joints to swell and ache and hurt. It can also go the other way with infections where you are at baseline getting wandering joint pains or joint pains that are fixed that come and go because of the infections. And it won't go away till you start to kill them. So it goes both ways. Now, there's some famous types of joint pain that literally have what I said, wandering, moving. So, you know, it's in your wrists in the morning and then your shoulders in the afternoon and then it's in your ankles or whatever. Those are hallmarks that your doctor will look at. They'll check for certain types of infections. But here's the other problem with infections. And joint pain. You gotta find and make sure you don't have one of the big bad, you know, crystal reasons, infectious reasons, joint damage reasons. So you look for all that stuff, immunologic reasons. All those can be negative on the normal tests and you can still have this. Who are the most common people that have it? People with overwhelming amounts of chronic infections that like to fly under the radar. So fungus is one reason. So if you don't have advanced diabetes or immunodeficiency disorders, etc. A lot of people have fungal infections that don't go crazy, but they're pretty high in the body. And if you don't have, you know, an advanced case of diabetes, immunodeficiencies, etc., they won't take your body over, but they'll be bad enough. So that's one reason. Another is opportunistic infections. The human herpesvirus family that people, they hear herpes and they think Oh, you know, the genital herpes, right? That's a family, okay? There's a bunch of HHV, human herpes virus, and it might be HHV-1 or 2. Usually 1 is like oral herpes and 2 is genital herpes, but there's a bunch of other herpes. Obviously, if there's 1 and 2, there's other numbers, right? Well, HHV includes things like Epstein-Barr and cytomegalovirus. Your kid can get HHV-6 and other, all manner of Well, those guys are opportunistic and they usually take advantage of you. They're around us all the time. Take advantage of you when you're chronically ill, get run down, etc. They are famous for creating joint pain, especially joint pain that can come and go. There are also infections that rheumatologists will check you for if you look like you have rheumatoid arthritis, but your rheumatoid arthritis panel is negative. They'll check you for Parvovirus, Parvo B19. Now people hear Parvo, they think, well, my dog had Parvo. Well, it's a little bit different virus, but it's the same family. Well, Parvo B19 in adults is a reason that they'll get a rheumatoid arthritis-like syndrome, but they don't have rheumatoid arthritis. And there's other viruses that do this, and then there's bacteria that can do it too. So the big thing is, if you've gone through, uh, back to the, you know, the main question Why do my joints hurt? Normally, if there's no trauma, then you got to go down the line and have your healthcare provider look for the big things. Is it, is it a major infectious cause, you know, like streptococcal, or there's a couple others in there? Is it a trauma? Is it an immunologic cause like rheumatoid arthritis, etc.? Positive, you know, whatever on the immune panel. Is it osteoarthritis? Is it any of those? Get those ruled out and still have joint pain and problems, then you want to back up and say, maybe I need to step back and look for other reasons for inflammation in my body. That could be things like digestive system. Digestive system is huge, has a huge digestive nervous system and immune system, communicates with the rest of you, create a lot of inflammation. Digestive system is a big cause of this stuff. Chronic infections are a big cause and sometimes other things like toxins, etc. So if you get to that point, you've ruled out all the big bad things and rheumatologist said we can't find any reason you would have joint pain and you haven't hurt yourself, there's no trauma, then you want to start looking at these other things which are usually infectious, toxic, and GI and a few other things. So that's why the pain can come. Sometimes if you need to kill these bugs, Let's say it's bugs. Need to kill them. It can get worse in the beginning, then get better. And then a lot of times what happens is the joint pain coming back is a way your body's trying to tell you that there's something else stirring up some inflammation. So that's a reason to get back with your healthcare provider and work on that. All right, well, I'm Dr. A. These things are great fun. Thank you. Put those questions in the comment section. Like, share, and subscribe. Please. And thank you so much to all you guys who have subscribed to the channel. Uh, it's really, really helpful to the channel. It's helpful to me to see it, and it keeps me doing this and answering your questions. I'll see you all on the next video.