Joints are surrounded by various structures such as muscles, tendons, ligaments and bursae (Bursa = fluid filled sac between bone and tendons meant for easier movements of tendons). Pain in these structures (also known as soft tissue rheumatism) can be confused with pain from within the joint. These conditions are quite common and can be very distressing.Usually caused by overuse, they can interfere with day-to-day activities and adversely affect work performance. Weakness or deformity of a joint strains adjoining structures and can predispose such conditions. Soft tissue rheumatism can thus coexist with joint disease and pose diagnostic problem for general doctors. Soft tissue rheumatism can be easily differentiated from arthritis as the pain in these conditions is superficial and sharply localized. There is a localized area of tenderness (pain on pressure). There will be pain when you move your joint (active movement) but will not occur when someone else moves it (passive movement). Soft tissue rheumatism generally needs adequate rest (an appliance may be needed), training in proper use of affected area and properly guided exercises. Your doctor will prescribe you pain medication (oral drug and ointment for local application) that reduces swelling too. Physiotherapy measures such as ultrasonic heat can be of help in selected cases.