Arthralgia

Description

General Measures

Medicine Treatment

Referral

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ICD-10 Code: M25.50-59

DESCRIPTION

• Joint pain without swelling, warmth, redness or systemic manifestations such as fever. It is usually self-limiting. May be an early manifestation of degenerative joint conditions (osteoarthrosis) or local and systemic diseases. May follow injury to the joint, e.g. work, play and position during sleep
• Suspect rheumatic fever in children, especially if arthralgia affects several joints in succession

GENERAL MEASURES

• Advise patient to:
  • Apply heat locally to the affected joint, taking precautions not to burn themselves
  • Exercise once their pain is relieved
  • Reduce weight, if overweight, to decrease stress on the joint
• Exclude systemic causes
• Reassure patient

MEDICINE TREATMENT

• Treat for 1 week (maximum 2 weeks) provided no new signs develop.

Pain:

Children

• Paracetamol, oral, 10–15 mg/kg/dose 6 hourly when required. See: dosing table

Adults

• Paracetamol, oral, 1 g, 4-6 hourly when required 
  • Maximum dose: 15 mg/kg/dose
  • Maximum dose: 4 g in 24 hours
• Methyl salicylate ointment, topical, may provide some relief

REFERRAL

• Pain for 1 week in children, and pain for >2 weeks in adults
• Recurrent pain
• Severe pain
• Fever
• Involvement of several joints in succession
• Evidence of systemic illness e.g. sore throat in children, presence of jaundice, anaemia

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare Level, 2024 Edition