I HAVE JOINT PAIN. WHAT DO I DO?

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As we age, it is typical to start having pain in your joints, most commonly in the knees, hips and hands. But how do you know when this joint pain is more than normal and something that a doctor should evaluate?

If your pain begins to limit what you used to do (golf, biking, or jogging) and normal daily activities become painful (sitting, walking up stairs or writing); it is time to visit your doctor. To better understand your situation, a doctor will take a medical history, ask how long this has been going on, and perform a physical exam. This exam will evaluate the joints range of motion, stability, surrounding muscles as well as look for things that might ‘refer’ pain to that joint (e.g. sometimes knee pain is really a hip or back issue that refers the pain to the knee). Often, an X-ray is ordered to see if something is wrong with the bones, and if soft tissue damage is suspected an MRI scan is done.

With this, a doctor is usually able to determine what is wrong and with then being a process of treatment options.

Medications are usually a good first step.

The most commonly referred medication to try first is over-the-counter (OTC) Tylenol, which is normally tolerated by most people. Additionally, anti-inflammatories may be recommended. If these do not resolve the issues, then the same medication may be increased to prescription strength. Other commonly recommended medications, such as chondroitin sulfate or glucosamine, may result in some pain-relief but they don’t affect arthritis.

Is arthritis common?

Yes, and it is increasing, because the baby boomer population, those in their 40s, 50s and 60s want to remain active at their age putting stress on their joints. While some arthritis results from past injuries (from the high-school football days), much other is resulting from the obesity epidemic and the extra weight many are carrying around. The heavier one is, the more stress and wear on the joints which in turn can result in arthritis.

What additional treatment options are available?

While many treatment options are available, the all depend on what the doctor finds. For example, a minimally arthritic knee with a miniscal tear can be addressed with arthroscopy. However, advanced arthritis may require joint replacement surgery. For arthritis issues that fall somewhere in between, steroid injections or visco-supplementation (a procedure where a gel-like substance is injected into the joint) may be recommended.

When should joint replacement surgery be seriously considered?

When the joint issues really interfere with what you want to do, either by limiting your mobility or when the pain can no longer be controlled with medications. Basically, when you can’t live with it any more.

If surgery is the solution:

Joint replacement surgery is a complex, though common procedure that is mostly done on hips and knees. As far as knee replacements, they can be replaced partially or totally. A partial replacements addresses one of the three parts of the knee joint, while a total knee would replace all three at once. MRIs are very helpful in determining what is needed, but a final decision is often made by the doctor in surgery.

What should I expect from my new joint, after surgery?

After surgery, the initial focus is typically on pain control. While it is impossible to eliminate it, it can be reduced and managed. Next, within a few hours of surgery, patients are up and moving. Early walking and moving of the new joint tends to result in better motion and few complications.

Should a return to normal motion be expected?

Whatever range of motion was seen before surgery is a predictor of the range of motion that can be expected after surgery. Because people often wait a long time to get surgery and by then their motion has been restricted, it’s difficult to get the muscles to fully stretch out to a normal length again. Sometime, patients do special therapy prior to surgery to increase muscle length and strength.

What are common complications?

The most serious and somewhat common complication is infection. Should it happen, it will likely occur in the first month, but proper medical oversight and antibiotics can take care of it before it becomes a problem

Other potential but rare complications are blood clots, which can be prevented by blood thinning medication and early walking, and mechanical complications, such as dislocations for hip replacements.

How is a patient’s life improved?

The most substantial improvement patients see is pain relief. While it’s not 100%relief, for most it’s much better than before surgery. Additionally, many patients have increased function and mobility and are able to return to their normal daily activities.

Staff @ MexicaliMedicalGuide
April 9, 2013

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