Movement can be difficult due to disorders that restrict joint movement or cause weakness, stiffness, tremors, or difficulty initiating movement (for example, Parkinson’s disease). Movement may also be limited when it causes pain. People who have muscle, ligament, bone, or joint pain tend to intentionally or unintentionally reduce movement. This limitation of movement often gives the impression of weakness even though the nervous system and muscles are able to do the movement.
The joint may have a limited range of motion due to:
Previous injury to the joint caused by severe tissue scarring
Prolonged immobilization of the joint (for example, when a person’s arm is paralyzed from a stroke or in a sling) that shortens the tendons
Fluid buildup in the joint due to arthritis or an acute injury (it feels like the joint is locked)
A piece of torn cartilage (usually from a knee injury) prevents the joint from moving.
Although many people complain of weakness when they feel tired or stressed, true weakness means that making full effort does not cause severe or normal muscle contractions. Normal voluntary muscle contraction requires the brain to send a signal that travels through the spinal cord and nerves to reach a normally functioning muscle. Therefore, true weakness can result from injury or disease that affects the nervous system, the muscles, or the connections that connect them (the neuromuscular junction). Weakness is weakness.
Evaluation and treatment
Doctors can often diagnose weakness based on a person’s symptoms and the results of a physical examination. Doctors first try to determine if the person can contract the muscle with normal force. If muscle strength is normal, and the person has difficulty moving the joint, the doctor will try to move the person’s joint while the person is at rest (passive motion). If movement is painful, arthritis may be the problem. If passive movement causes little pain but is restricted, the problem may be a joint that has contracted (for example, due to scar tissue) or stiffness due to spasticity (hypertension) or rigidity in the nervous system. If passive movement causes little pain and is not restricted, doctors encourage the person to try to move as hard as possible. If movement continues to be difficult but does not cause pain, true weakness is likely.
For joints with a limited range of motion, joint flexibility can be increased through stretching exercises and physical therapy. If the joint’s range of motion is severely restricted due to tissue scarring, surgery may be necessary. The best way to relieve weakness is to treat the disorder that is causing it, but physical therapy helps a lot even when there is no ideal drug treatment.
Musculoskeletal pain can be caused by disorders of the bones, joints, muscles, tendons, ligaments, or bursae, or a combination of these disorders. Injuries are the most common cause of pain.
Bone pain is deep, piercing, or dull. It is usually caused by an injury. Other less common causes of bone pain include bone infection (osteomyelitis), endocrine disorders, and tumors.
Muscle pain (known as myalgia) is often less severe than bone pain but can be very bothersome. For example, a muscle spasm or spasm (a persistent, painful muscle contraction) of the calf is an intense pain often called a muscle stiffness. Pain can occur when a muscle is affected by an injury, lack of blood flow to the muscle, infection, or a tumor.
Tendon or ligament pain is often less severe than bone pain. They are often described as “acute” and are exacerbated when the affected tendon or ligament is stretched or moved and are usually relieved by rest. Common causes of tendon pain include tendinitis, tenosynovitis, lateral or medial epicondylitis, and tendon injuries. The most common cause of ligament pain is an injury (sprain).
Bursae, small fluid-filled sacs, provide a protective cushion around the joints. Bursa pain can be caused by bruising, overuse, gout, or infection. The pain usually worsens with a movement involving the bursae and is relieved at rest. The affected bursa may swell.
It’s possible that joint pain (called arthralgia) is related to inflammation of the joints (called arthritis). Arthritis may cause swelling as well as pain. A wide range of disorders can cause arthritis, including inflammatory arthritis (such as rheumatoid arthritis), osteoarthritis, infective arthritis, gout and related disorders, autoimmune disorders, lupus erythematosus, and lupus erythematosus (systemic lupus erythematosus). Injuries that affect part of the bone inside the joint. Arthritis-related pain can be new (acute, such as when caused by infections, injuries, or gout) or long-lasting (chronic, such as from rheumatoid arthritis or osteoarthritis). Pain from arthritis usually worsens when the joint is moved but is usually present even when the joint is immobile. Sometimes the pain in the structures near the joint, such as ligaments, tendons, and scabs, comes from the joint.
fibromyalgia (see fibromyalgia) can cause pain in muscles, tendons, or ligaments. The pain is usually severe or causes tenderness in several places and may be difficult to describe, but usually does not come from the joints. Affected people usually have other symptoms, such as tiredness and poor sleep.
Some musculoskeletal disorders cause pain by putting pressure on nerves. These conditions include tunnel syndromes (eg, carpal tunnel syndrome see carpal tunnel syndrome, cubital tunnel syndrome see carpal tunnel syndrome). The pain tends to radiate along the nerve pathway, which may give a burning feeling. It is usually accompanied by tingling, numbness, or both.