Joint pain is often accompanied by swelling from underlying inflammation. If there’s no swelling, doctors can narrow down the cause.

When talking about joint pain, the first condition you might consider is arthritis. There are numerous types of arthritis, but these conditions also cause swelling (inflammation) in the joints.

If you have joint pain but no underlying inflammation, it’s possible that your symptoms may be caused by acute illnesses like the flu or chronic conditions like fibromyalgia.

Here’s what you need to know about multiple joint pain without swelling, including possible causes and treatment methods you can consider discussing with a doctor.

Joint pain is a general term to describe pain and discomfort that develops in your joints, the parts of the body where bones connect and help you move.

With conditions like arthritis or arthralgia, swelling can also accompany joint pain. Signs of underlying joint inflammation may include tenderness, redness, and warmth in your joints. You might also experience stiffness that lasts an hour or longer after waking up.

If you don’t have joint swelling but are still experiencing pain, here are the possible causes to consider.

Fibromyalgia

Fibromyalgia is a relatively common condition, affecting an estimated 2% of adults in the United States. It can cause widespread pain throughout the body, which can include your joints.

Risk factors and triggers

The exact cause of fibromyalgia isn’t known, but it’s thought that issues in the nervous system might contribute to symptoms like joint pain in your knees and other areas of the body.

Possible triggers and risk factors may include:

  • family history of fibromyalgia
  • a personal history of autoimmune disorders, such as rheumatoid arthritis (RA)
  • middle age
  • being female
  • viral infections
  • obesity
  • a history of stress or trauma
  • repetitive injuries

Preventing fibromyalgia

Since there isn’t a single known cause of fibromyalgia, there’s currently no cure or preventive techniques. However, you may be able to reduce your risk by managing some of the known risk factors. This can include:

Benign joint hypermobility syndrome

Benign joint hypermobility syndrome describes extremely flexible joints that can become painful. This condition is part of a spectrum of related disorders, including Ehlers-Danlos syndrome.

Aside from pain in multiple joints and muscles, people might also experience fatigue, as well as frequent sprains, dislocations, and strains.

Risk factors and triggers

Joint hypermobility is most common in children. The exact cause isn’t known, but it’s thought to run in families.

Preventing benign joint hypermobility syndrome

Benign joint hypermobility syndrome isn’t preventable, and there’s currently no cure. The best approach is to see a doctor if you suspect your child has this condition so they can receive prompt treatment.

Flu

The flu is a type of acute respiratory illness caused by the influenza virus. Joint pain is among some of the most common symptoms, along with sore throat, dry cough, fever, and fatigue.

Risk factors and triggers

Anyone can get the flu, and it’s primarily spread by droplets via sneezing, coughing, or talking. However, the following individuals may be more at risk of getting sick with the flu and experiencing complications:

Preventing the flu

Getting your annual flu shot and washing your hands frequently before eating or touching your face can help prevent the flu.

It’s also helpful to avoid others who may be sick with the flu if you can. People with the flu can most easily pass the virus that causes it within the first 3 days of being sick.

COVID-19

Like the flu, COVID-19 can cause a variety of respiratory-related symptoms, as well as fever, headache, and fatigue. It can also cause joint and muscle pain. Unlike the flu, it may cause a loss of smell or taste in some people.

Risk factors and triggers

COVID-19 is spread via droplets from people with the virus. The virus can also be airborne. Risk factors and triggers are similar to those of the flu. People with weakened immune symptoms may be at a higher risk.

Preventing COVID-19

You can help prevent COVID-19 by staying away from others who are sick and by washing your hands frequently. Ask your doctor whether you’re up to date on your recommended COVID-19 vaccinations.

Myalgic encephalomyelitis (chronic fatigue syndrome)

Myalgic encephalomyelitis, also known as chronic fatigue syndrome, causes unexplained chronic fatigue that lasts 6 months or longer. It can cause persistent exhaustion that a good night’s sleep can’t remedy.

Aside from severe fatigue, it’s known to cause joint pain without swelling, as well as headaches and muscle pain. Some people also experience flu-like symptoms, such as sore throat, chills, and tender lymph nodes.

Risk factors and triggers

The exact cause isn’t known. Some people develop it following a viral infection or after a stressful life event. Autoimmune diseases and fibromyalgia may also increase your risk. It’s most common in people of color and females.

Preventing myalgic encephalomyelitis

It’s not clear whether myalgic encephalomyelitis is preventable. Stress management and other lifestyle modifications may help.

Post-viral complications

While inflammatory arthritis might be caused by viral infections, multiple joint pain without swelling may also be associated with post-viral complications. These include long COVID-19, fibromyalgia, and myalgic encephalomyelitis.

Other symptoms associated with post-viral complications include brain fog, post-exertional malaise, and severe fatigue.

Risk factors and triggers

The exact cause of post-viral complications isn’t clear, but possible health and lifestyle risk factors may include:

  • having an autoimmune disease
  • smoking
  • having obesity
  • having diabetes

Preventing post-viral complications

It’s not clear whether post-viral complications like joint pain can be prevented. However, you can help by monitoring your symptoms for signs of joint pain with or without swelling.

A sudden onset of joint pain is more likely to be caused by acute causes rather than chronic illnesses. Examples include:

  • the flu
  • COVID-19
  • an injury

If you’re experiencing ongoing joint pain without any identifiable cause, talk with a doctor. This is especially the case if home remedies, such as ice packs or rest, fail to improve your symptoms. You’ll also want to talk with a doctor if you have joint pain from an injury.

Medical emergency

Get medical help right away at the nearest emergency room if you experience possible signs of complications from an acute viral infection, such as:

  • difficulty breathing
  • pale, bluish, or gray-colored skin, depending on your natural skin tone
  • chest pain
  • frequent vomiting
  • confusion

One of the key methods of diagnosing multiple joint pain without swelling is to see whether you have signs of inflammation or damage in your joints. If a doctor determines you have none of these, they might consider one of the above causes of non-inflammatory joint pain.

A doctor can help determine if your joint pain has an inflammatory cause with the following tests:

  • physical examination
  • taking a history of your symptoms and when they started
  • X-rays to look for signs of joint damage
  • a Beighton Scoring System test to assess joint flexibility (for benign joint hypermobility syndrome)
  • blood tests to determine whether you have an autoimmune disease, such as RA
  • a COVID-19 nasal swab test

The exact treatment for pain in multiple joints without swelling depends on the underlying cause.

In the case of an acute illness, such as the flu, home remedies may help you gradually recover.

Long-term conditions, such as fibromyalgia and myalgic encephalomyelitis, may require a combination of home remedies and medical treatments.

Home remedies and over-the-counter (OTC) treatment

Possible home remedies and OTC treatments for multiple joint pain without swelling include:

  • taking pain relievers, such as acetaminophen (Tylenol)
  • drinking plenty of fluids if you’re sick
  • getting regular exercise (with the exception of when you’re sick)
  • getting adequate rest, particularly when you’re recovering from an acute viral infection
  • practicing sleep hygiene
  • taking warm baths to help soothe pain
  • practicing stress management techniques, such as breathing exercises or meditation
  • managing myalgic encephalomyelitis symptoms with physical and mental pacing
  • decreasing alcohol, caffeine, and sugar intake (this may help with myalgic encephalomyelitis)

Medical treatment

A doctor may also consider the following medical treatments to help address joint pain without swelling:

  • cognitive behavioral therapy for fibromyalgia or myalgic encephalomyelitis
  • physical therapy to help improve muscle strength, especially in benign joint hypermobility syndrome and myalgic encephalomyelitis
  • prescription antiviral treatments for the flu or for COVID-19

If you don’t have symptoms of swelling, redness, or warmth at the site of your joint pain, there may be another underlying cause.

Illnesses like the flu can cause temporary joint pain, while myalgic encephalomyelitis is an example of a chronic condition in which pain may come and go. If persistent joint pain interferes with your quality of life, talk with a doctor for further treatment.