Don't Let Joint Pain Slow You Down
You are constantly using your joints. The joints that carry the most weight and feel the most pressure are in your knees and hips. Normally, your joints will work fine, but occasionally, something will happen, and simple movements like walking, bending, and turning will cause pain.
The following information about joint pain and joint replacement is purely informational. Please speak with your physician to see if a joint replacement procedure is right for you.
Understanding the Causes of Joint Pain
What is a Joint?
Joints are formed at the end of two or more bones that are connected by ligaments, and each joint is covered by cartilage, which stops the bones avoid rubbing together. The remaining joint surface is covered by synovium, a thin tissue lining. The synovium acts as additional anti-friction support by produces a fluid that helps reduce rubbing and wear in the joint.
Common Causes of Joint Pain
One of the most common causes of joint pain is arthritis. The most common types of arthritis are:
Osteoarthritis is a form of degenerative arthritis that involves the breakdown of cartilage. When joint cartilage, a protective tissue found at the joint surface, wears away when bones rub against one another, which might cause discomfort. Generally, OA occurs when there is a family history or in people over the age of 50.
Rheumatoid Arthritis (RA)
When someone is diagnosed with Rheumatoid Arthritis, there is a chemical change in the synovial membrane that causes them to become thickened and inflamed. Due to the changes in the synovial membrane, too much synovial fluid is produced. The symptoms of RA include: chronic inflammation, cartilage loss, pain, and stiffness. In general, RA affects three times more women than men*, and it might affect other organs, including the skin and heart.**
If an injury occurs in a joint, post-traumatic arthritis might develop. This means the cartilage and bone in or near your joint might not heal properly. Due to the injury, the joint is no longer smooth and additional joint damage and wear might occur.
When a bone is deprived of its normal blood supply, Avascular Necrosis might occur. This disease might follow an organ transplant or a long-term cortisone treatment. Without proper nutrition from the blood, the structure of the bone will weaken and collapse, which will damage the cartilage.
Obtaining a Quality Diagnosis
If you have been diagnosed with arthritis, you might receive care from a family doctor, an internist, or a rheumatologist, but if the treatment does not work, you might need to consult an orthopaedic surgeon. Your orthopaedic surgeon will help you determine if surgery is the best option for your condition.
In other cases, the orthopaedic surgeon might be the first physician to see a patient and diagnose his or her arthritis.
The Orthopaedic Evaluation
Though most orthopaedic evaluation will be different, most orthopaedic surgeons will use the same basic tests to understand their patients current conditions, including:
- A review of the patient's medical history
- A physical examination
- If necessary, additional testing might be necessary
Your orthopaedic surgeon will review your medical history in hopes of finding the potential cause of your joint pain. Additionally, this will help your orthopaedic surgeon understand how much your joint pain in interfering with your ability to perform daily tasks.
During a physical evaluation, your physician will ask you to perform a few simple tasks, including, demonstrate your posture while standing, walking, sitting, and laying down. These tests will help your physician to determine his diagnosis.In addition to these tests, the physical will also allow your physician to evaluate certain parts your hips and knees, including:
- Size and length
- Range of motion
- Skin condition
To diagnose hip pain, your physician might examine your back because the hip pain might be a direct result of issues with your lower spine.
An X-ray evaluation will follow your physical examination. X-rays will show your physician how much joint damage has occurred or if any other issues exist. An abnormal X-ray might reveal potential issues, including:
- Narrowing of the joint space
- Cysts in the bone
- Spurs on the edge of the bone
- Areas of bone thickening called sclerosis
- Deformity or incorrect alignment
If your physician deems it necessary, additional testing might occur. Most times, the additional tests are done to confirm a diagnosis. Examples of these tests might include blood, urine, or joint fluid samples that are sent to a lab to determine or rule out certain forms of arthritis and diseases. Other times, specialized X-rays or magnetic resonance imaging (MRI) might be used to determine the cause of joint pain or the condition of a damaged joint.
To help your orthopaedic surgeon to make an accurate diagnosis, you might consider the following questions prior to your appointment:
- Where and when do I have pain?
- How long have I had this pain?
- Do I have any redness or swelling around my joints?
- What daily tasks are hard to do now?
- Did I ever hurt the joint or overuse it?
- Does anyone in my family have similar problems, such as spurs on the edge of the bone?
Based upon your orthopaedic evaluation, your treatment options might include:
- Physical therapy
- Joint fluid supplements
- Joint replacement
There are several different medication treatments available for your arthritis, but the most common is the use of an anti-inflammatory. Use of this medication will hopefully result in long-term reduction of the pain and swelling of arthritis.
If anti-inflammatory medication treatment does not help, your physician might suggest the use of corticosteroid injections, also known as cortisone shots. These injections might be used occasionally to treat serious pain and swelling.
If you are seeking relief from Osteoarthritis (OA) or Rheumatoid Arthritis (RA), talk to your physician and see if physical therapy is an option for you. A physical therapist might suggest some of the following pain relief exercises, including:
- Isometric (“pushing”) exercises, which helps build muscle strength, while avoiding wear and tear on inflamed joints.
- Isotonic (“pulling”) exercises help increase muscle strength and help preserve joint and muscle function
- Daily walking, using a cane or other assistive device as needed
Joint Fluid Supplements
If a patient participates in physical therapy, but his or her joint pain does not improve, "joint grease" injections might be used to provide temporary relief. The joint fluid acts as a lubricant to help the damaged joint. When this method of relief is selected, discuss your treatment options with your doctor.
Total Joint Replacement
If a patient suffers from severe arthritis, total joint replacement might be an option. The following circumstances might be considered for this procedure:
- The pain of arthritis limits your daily work and recreational activities.
- Conservative pain relief methods are unsuccessful
- Significant joint stiffness
- X-rays show advanced arthritis or other problems
What is Total Joint Replacement?
Total joint surgery consists of removing and replacing an arthritic, damaged joint with a plastic or metal prosthesis. The prosthesis works just like a natural joint.
Beginning in the 1960s, total joint replacements of the hip and knee have been performed with a 90 to 95 percent success rate, and approximately one million hip and knee replacements are performed each year in the U.S. Additionally, new technology will help extend the life of joint replacements, which is great for younger patients.
Preventing Possible Complications of Surgery
Though the complication rate is very low, serious complications have occurred in less than two percent of patients. With any major surgery, patients who undergo total joint replacement surgery might face complications, including:
- Blood Clots
- Lung Congestion
Getting Moving Again
After a total joint replacement procedure, your physician will encourage you to start moving as early as possible after the surgery. Your orthopaedic surgeon will recommend exercises that will help speed up the recovery process. This might include frequent visits with a physical therapist
Life After Total Joint Replacement
Following a total joint replacement, you will feel less pain in the affected joint and an improved ability to perform daily work-related and recreational tasks.
In the weeks following your procedure, your orthopaedic surgeon will inform you of any physical limitation and how long to wait before returning to all your activities.
In order to ensure your replaced joint remain healthy, physical activities should:
- Not cause pain, including pain felt later
- Not jar the joint, as happens with running or jumping
- Not place the joint in the extremes of its range of motion
- Be pleasurable
Additionally, it is important to maintain normal body weight, in order to keep the new joint from loosening or breaking.
Talk to Your Doctor
Don’t let joint pain stop you from doing what you love. If you are experiencing pain, contact your physician or an orthopaedic surgeon today to see what options might be available to you.