Swollen Joints (Joint Effusion)

Medically Reviewed by Zilpah Sheikh, MD on August 02, 2024
8 min read

Joint effusion happens when your joint swells up when excess fluid builds up in the tissues surrounding it. The area around your joint may appear larger when compared to the same joint on the other side.

Swelling and fluid around your joint can be caused by inflammation, which is a process in which your body's white blood cells and immune proteins recognize and react to things, such as bacteria and viruses, to help protect you from infection.

Joint swelling is common in various types of arthritis, autoimmune conditions, infections, and injuries. A swollen joint can be a symptom of the following health conditions:

Osteoarthritis (OA). OA is the "wear-and-tear" arthritis that usually happens with aging or after injury. With OA, there's a wearing down of the cartilage that cushions the ends of the bones. OA may cause joint swelling in those joints that bear weight over a lifetime, such as the knees, hips, feet, and spine. Except for the pain in the affected swollen joint, you usually don't feel sick or tired.

Rheumatoid arthritis (RA). RA is an autoimmune condition that is a form of inflammatory arthritis. It can happen at any age, even in young children. In autoimmune conditions like RA, your immune system triggers an inflammatory response even when there is nothing to fight off, causing your body's immune system to damage its own tissues. 

RA causes painful, stiff, and swollen joints. Usually, RA affects hands, feet, and knees, but it can also affect most joints and other parts of the body. RA symptoms can cause trouble in doing daily activities.

Gout. Gout usually strikes suddenly and causes severe joint pain, swelling, warmth, and redness, often in the big toe. Gout causes a painful, swollen joint that's so severe that the weight of bed sheets can cause distress. It usually involves one joint when it strikes, but sometimes gout can affect more than one joint.

With gout, uric acid — a normal chemical in the body — forms crystals that deposit in the joints, causing inflammation and pain. The crystals may also deposit in other areas to become nodules under the skin or stones in the kidney.

Ankylosing spondylitis. The key feature of this is the involvement of the joints at the base of the spine where the spine joins the pelvis, called the sacroiliac joints.

Psoriatic arthritis. Psoriatic arthritis is an inflammatory joint disease that's linked to psoriasis, a skin condition. Up to 30% of people with psoriasis will develop psoriatic arthritis.

Infectious arthritis. Infectious arthritis, or septic arthritis, is the result of a bacterial, viral, or fungal infection in the tissues and fluid of a joint. Joint infection usually occurs after a previous infection in the body. The infection travels to the joint via the bloodstream from another part of the body, such as a person's skin, nose, throat, ears, or an existing wound. Within hours to days, pain, inflammation, swollen joints, and fever develop. The joints most commonly affected by infectious arthritis are the knees, hips, shoulders, ankles, and wrists. Damaged joints are more vulnerable to infection.

Common bacterial causes of infectious arthritis include Neisseria gonorrhoeae and Staphylococcus aureus. Some joint infections may be caused by more than one organism.

Joint injuries. These can result in painful, stiff, and swollen joints. Sometimes, joint pain can be caused by injured or torn muscles, tendons, and ligaments surrounding the joint. Bursitis, tendinitis, dislocations, strains, sprains, and fractures can also cause joint pain.

Symptoms of swollen joints include:

  • Deep, aching pain
  • Warmth to the touch
  • Stiffness
  • Change in ability to move them normally

Often, you’ll have only a few of these symptoms.

Inflammation may also have general flu-like symptoms including:

  • Fever
  • Chills
  • Fatigue/loss of energy
  • Headaches
  • Loss of appetite
  • Stiff muscles
  • Warm skin

Can joint effusion affect internal organs?

Inflammation can affect your organs as part of an autoimmune disorder. The symptoms depend on which organs are affected. For example:

  • Inflammation of your heart (myocarditis) may cause chest pain or fluid retention.
  • Inflammation of the small tubes that bring air to your lungs (bronchiolitis) may cause shortness of breath.
  • Inflammation of your kidneys (nephritis) may cause high blood pressure or kidney failure.
  • Inflammation of your eye (iritis or uveitis) may cause pain or vision problems.
  • Inflammation of your muscles (polymyositis) may cause achiness or weakness.
  • Inflammation of your blood vessels (vasculitis) may cause rash, headaches, or internal organ damage.

Pain may not be a main symptom because many organs don’t have nerves that sense pain.

When you have inflammation, your body releases chemicals into your blood or affected tissues. These chemicals boost blood flow to an area of injury or infection and may cause redness and warmth. Some of the chemicals cause fluid to leak into your tissues, and that can bring on swelling. This process may trigger your nerves and cause pain.

The causes of this swelling include:

  • Overuse of or injury to the joint
  • Certain conditions like RA, gout, osteoarthritis
  • Tumor
  • Infection

 

Diagnosis of inflammatory joint diseases may involve all or some of these exams:

  • Medical history and physical exam, focusing on which joints are involved
  • Evaluation of other symptoms besides joint symptoms
  • X-rays, blood tests, MRI, and ultrasound 
  •  Arthrocentesis, a procedure during which a needle is used to remove fluid and the fluid is then checked for bacteria, crystals, and blood

Your treatment will depend on several things including the type of disease, your age, the type of medications you’re taking, your overall health, your medical history, and how severe your symptoms are. Treatments for inflammatory joint diseases include medications, rest, exercise, and surgery to correct joint damage. 

The goals of treatment are to:

  • Treat the disease that’s causing your inflammation
  • Relieve pain with medications and by changing your activities
  • Maintain joint movement, muscle strength, and overall function with physical therapy and exercise
  • Reduce stress on your joints by using braces, splints, or canes as needed

Not all swollen joints are treated the same way. Treatment for swollen joints depends on the problem or diagnosis.

Joint effusion medication

Many drugs are available to ease joint pain, swelling, or inflammation and to help keep your inflammatory disease from getting worse. These medications include:

Anti-inflammatory pain relievers (nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, or naproxen). For inflammatory types of arthritis such as RA, psoriatic arthritis, and ankylosing spondylitis, treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs),  which may also help reduce pain and swelling. Acute gout can be treated with a medicine called colchicine, which is a prescription drug that helps to ease swollen joints, pain, and inflammation caused by the crystal deposits in the joint. Sometimes, stronger painkillers are needed.

Corticosteroids (such as prednisone).  Injecting an anti-inflammatory drug such as a steroid into a joint is another treatment method.  Steroids block the production of inflammatory chemicals in the body. The injection goes directly into the swollen joint -- the source of inflammation and pain. Injections usually give the patient temporary but rapid relief of joint swelling and pain. Fluid removal is part of this procedure in most circumstances.  Steroid medications taken orally for a short period may also be effective in reducing painful, swollen joints.

Other medications (such as chemotherapy drugs, disease-modifying treatments, biologic therapy, and narcotic pain relievers). The newer types of drugs that affect the immune system, including disease-modifying antirheumatic drugs (DMARDs), biologic agents such as tumor necrosis factor inhibitors, and enzyme inhibitors, can block the proteins that cause inflammation. Some of these medications treat other conditions, such as cancer and inflammatory bowel disease, or they prevent organ rejection after transplants. These are strong medications, and your doctor will want to keep a close eye on you while you take them.

Antibiotics. Swollen joints and pain from infectious arthritis are treated with antibiotics to stop the infection. Sometimes, surgery may be needed to allow the drainage of infected fluid. If you’re taking any prescription drug, it’s important to visit your doctor regularly so they can check how well it’s working and whether you have any side effects.

You can lower your risk of getting inflammation by making some changes in your daily life. These include:

  • Keep a healthy weight.
  • Exercise regularly, including low-impact options that don't cause stress on your joints and those that build strength in the area around your joint.
  • Don’t smoke.
  • Eat a healthy diet with lots of fruits, vegetables, and omega-3 fatty acids.

Swollen joints happen when there's an increase of fluid in the tissues that surround the joints. Joint swelling is common with different types of arthritis, infections, and injuries and can be a symptom of many health conditions. Treatments for inflammatory joint diseases, which include medications, rest, exercise, and surgery to correct joint damage, will depend on several things including the disease, your age, the type of medications you’re taking, your overall health, your medical history, and how severe your symptoms are. If your swelling lasts more than a few days, is warm or red, or you're unsure why it started, talk to your doctor for proper diagnosis and treatment.

How long does a joint effusion take to heal? The amount of time it takes for your joint effusion to heal depends on what's causing the condition. If you have a broken bone, recovery could take weeks or months. Joint effusion may become a long-term issue if it's caused by osteoarthritis.

What happens if a joint effusion is left untreated? Inflammation that continues for a long time can cause complications such as joints that are less flexible and more prone to injury.

How do you treat joint effusion? Treatment for effusion is based on the cause, and not all joint effusion can be cured. Many treatment options can be used more for managing your symptoms. Some of these include antibiotics and steroids.

Will fluid in a joint go away on its own? Some at-home treatments such as cold packs, nonsteroidal anti-inflammatory drugs (NSAIDs), resting your joint, and taking weight off of it can help you get rid of fluid if you have a milder form of joint effusion.

Is joint effusion the same as arthritis? Having joint effusion can be a sign of arthritis or another condition. If you have arthritis, joint swelling can be a symptom.

What exercises get rid of fluid on the knee? Flexibility and strengthening exercises (such as quadricep stretches and leg presses) that focus on stretching and supporting the muscles around your knee can help with conditioning your knee after an injury.

How can I naturally drain fluid from my knee? Your doctor can perform procedures such as arthrocentesis to drain fluid from your knee, which can help ease some of the pressure surrounding your knee. At-home treatments for relieving knee pain and the swelling that comes with it include using ice packs, an elastic wrap, or over-the-counter pain relievers such as NSAIDs or acetaminophen.

What is suprapatellar joint effusion? Suprapatellar joint effusion is another name for knee effusion, which happens when fluid builds up in the tissues surrounding your joint. It can be caused by overuse, trauma, or a medical condition.