Sometimes we can take every day movement for granted. Walking in the park, going up and down stairs or simply sitting in your car can turn into a difficult experience if you are afflicted with joint pain. Although most common in elderly persons, joint pain is non-discriminating: it can affect anyone at any age. Known as arthralgia, pain in the joints can range from a slight ache to a debilitating pain and can be caused by a number of conditions. “Arthritis is the most common cause of chronic joint pain,” says David Goodman, MD, an orthopedic surgeon specializing in joint reconstruction and sports medicine with Resurgens Orthopaedics. Other causes include acute joint injury, stiffness, inflammation, infection and instability.
Joint pain, whether tolerable or excruciating, is more than a physical ailment—ongoing pain can impact a person’s quality of life by making every day tasks or exercising more difficult. “Pain associated with swelling, mechanical symptoms, and/or loss of motion of the joint can be used as guidelines for when to see a physician,” says Jeffrey J. Kovacic, MD, board certified orthopedic surgeon and sports medicine specialist at Orthopedic Surgery & Sports Medicine Center in Smyrna. “In the absence of injury, pain that worsens over time or persists for several days to a week despite modifying activities is also an indication to see your physician. Furthermore, pain associated with an acute injury should also be evaluated by a doctor.”
What Is Joint Pain?
Joint pain is a feeling of discomfort in one or more joints of the body. Made up of ligaments, tendons, cartilage, bursas and the synovial membrane, joints allow the bones to move. Painful, stiff joints can be incapacitating.
According to Jessica Herzinger Loncar, MS, PT, Cert. MDT, OCS, co-owner of Stability Pilates & Physical Therapy in Atlanta, “Signs of joint pain can include pain or tenderness in a joint that might be aggravated by movement or activity; inflammation indicated by joint swelling, stiffness, warmth and/or redness; joint deformity; range of motion or flexibility loss; and Crepitus (creaking, popping or snapping in the joints).”
How Mild or Severe Can It Be?
Joint pain can be classified as acute or chronic. Acute joint pain is pain that occurs more suddenly whereas chronic arthralgia is joint pain that lasts three months or more. According to Christopher Haraszti, MD, a DeKalb Medical Orthopedist, "The acute onset of joint pain is usually the result of some injury. It can also be caused by other conditions such as gout or even infection. A joint infection called a septic joint can be characterized by swelling, pain, decreased motion and fevers. An infection in a joint can be caused by bacteria being directly introduced such as with a deep cut or it can be caused by bacteria in the blood stream. A septic joint is a medical emergency and if left untreated can quickly result in permanent destruction of the joint and can even progress to become life threatening. Septic joints are usually treated with surgical drainage and cleaning followed by antibiotics."
Haraszti goes on to explain that chronic joint pain is joint pain that lasts longer than three months. Chronic joint pain has many causes including rheumatoid arthritis and osteoarthritis also called Degenerative Joint Disease (DJD). Chronic arthritis can also be due to a systemic condition such as leukemia or bone cancer. The term arthritis is a general term that refers to inflammation in a joint. There are many types of arthritis such as rheumatoid arthritis, gouty arthritis and osteoarthritis. In rheumatoid arthritis, the body’s own cells attack the synovium and cartilage and over time can be disabling. Modern medicine has developed several newer drugs that are proving very helpful in preserving function in these patients. Most drugs for rheumatoid arthritis work by slowing the body’s cellular “attack” system.
Osteoarthritis is the most common cause of arthritis. It typically affects people who are older; however younger patients can get arthritis as well, especially as a long term effect of damage to the joint caused by a severe acute trauma, such as a broken bone that involves the joint itself. "Osteoarthritis or DJD at its most basic level is characterized by loss of the cartilage covering of the end of the bone," says Haraszti. "To think about what DJD looks like, imagine the end of a fried chicken leg. Once you remove the skin and meat there is a white shiny rubbery covering at the end of the bone. This is what the ends of your bones look like as well. At your joints, the two ends move against each other when you move your knee or elbow or hip for instance. They move against each other so smoothly that the coefficient of friction which is a measure of how two objects slide against each other is about the same for a joint as ice sliding on ice. In DJD, the smooth cartilage thins and cracks and eventually the underlying bone is exposed."
Can Joint Pain Be Prevented?
“Joint pain can result from genetic predisposition but usually is a result of environmental factors (like athletic injuries, heavy labor, and obesity),” says Charles M. Pesson, MD, orthopedic surgeon at Pinnacle Orthopedics and Sports Medicine. While joint diseases like osteoarthritis are not strictly genetic, having a personal or family history increases a person’s risk for developing the condition.
Aches and pains could also potentially develop from a flu or cold virus and even weather changes can sometimes cause chronic pain. Other contributing factors could be nutrition or your routine physical activity.
“While genetic disposition might be contributory, I believe that personal lifestyle choices play a larger role in joint pain,” says Bruce L. Salzinger, DC, CCSP, of Chiropractic Healthcare of Buckhead. Lack of exercise, poor posture, stress, an unhealthy diet or a prolonged activity over the years (i.e. jogging) are just a few lifestyle factors that can cause arthralgia.
“Joint pain cannot be prevented completely,” notes Pesson. Nevertheless, there are measures that can be taken to minimize the amount of degeneration that occurs and prevent injury. Maintaining a healthy weight, eating nutritious foods and implementing a well-rounded exercise regimen will keep joints strong.
“It is not uncommon for joint pain to be the result of relative overuse of a joint that has otherwise minor abnormalities. In this setting, avoiding overuse can be a very effective means of preventing pain,” adds Kovacic.
When you move your body, it increases blood flow and lubricates your joints. If you are not use to weekly work outs, start with low impact movements like walking or swimming. Choose exercise machines like the elliptical machine that moves your body with minimal impact on your joints.
“Maintaining a normal exercise plan can often prevent the effects of joint pain from becoming a problem for most individuals,” explains Tony Smith, the director of nursing at Reconstructive Joint Center at Piedmont Hospital. “Simple, regular activities such as walking or water aerobics for seniors can provide benefit. Check with your physician for recommendations based on your specific needs.”
If you are experiencing joint pain already, you should avoid unnecessarily stressing your joints. Don’t keep your joints in the same position for a prolonged period of time or give your joints the chance to become stiff.
“When joint pain begins to impair mobility or otherwise keeps a person from doing the things they want to do, it may be time to seek advice from an orthopaedist,” says Smith.
What Are My Treatment Options?
Depending on the severity of your pain, there are several different remedies and treatments available. However, before you try any of them you should always check with your doctor first to see which one would be right for the pain you are experiencing.
“One of the mainstays of treatment for joint pain is nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen,” notes Kovacic. “All anti-inflammatory medication can have side effects and should only be used intermittently. Tylenol (acetaminophen) is a good pain-reliever that does not contain anti-inflammatory properties.”
Severe pain that lasts longer than a few weeks may call for a stronger remedy. “Physicians can prescribe stronger medications as appropriate, and often suggest physical therapy to rehabilitate the affected joint and slow progression of osteoarthritis,” adds Katrina Baker, PT, DPT, of Northside Hospital.
Do-it-yourself remedies for joint pain include hot and cold therapy (heating pads and ice packs) throughout the day, warm baths, stretching, adequate rest, massage and relaxation and elevation. “Homeopathic methods may include nutritional supplements (i.e. glucosamine and chondroitin), herbal remedies, specific anti-inflammatory foods, distraction/meditation, transcutaneous electrical nerve stimulation (TENS) and acupuncture/acupressure treatment,” says Herzinger Loncar.
"For most acute cases of mild arthralgia due to injury or overstressing the RICE method is useful," says Haraszti. "This treatment consists of Rest, Ice, Compression and Elevation. Anti inflammatory medication such as ibubrofen can also help to relieve pain."
Whatever you choose to do, don’t let the pain go for too long untreated, as the condition may worsen leaving you with a more serious case of pain than you bargained for.
Know Where Your Pain Is Coming From
Arthritis: recurring joint inflammation. There are more than 100 types. The most common are osteoarthritis and rheumatoid arthritis as well as gout. Aging and weight gain are some common causes, so are heavy lifting and poor posture.
Inflammation: the process of white blood cells incorrectly targeting healthy tissues, which can lead to arthritis. Marked by redness, swelling, joint pain/stiffness or loss of joint function. This may also be associated with some flu-like symptoms.
Osteoarthritis: (degenerative joint disease) most common form of arthritis. Associated with deterioration of cartilage in the joints, most commonly in the knees, hips and spine but can happen in any joint. Marked by pain, aches and soreness during or after movement or inactivity.
Rheumatoid Arthritis: occurs on both sides of the body, usually experienced in hands, wrists and knees. Characterized by soreness or swelling, stiffness after prolonged inactivity and fatigue. Inflammation can produce excessive joint fluid and narrowed space between bones over time causing them to painfully rub together.
Fibromyalgia: pain or stiffness in the muscles without damaging joints. Muscle pain in the body along with anxiety, fatigue, tenderness and sleep problems are common signs. Women are 10 times more likely to experience it than men. Triggered by stress, poor sleep and sometimes weather.
What You Should Know About Glucosamine
Glucosamine is a natural compound composed of glucose and glutamine (an amino acid) and is an essential part of a molecule that strengthens and repairs the cartilage in your joints. As the degenerative osteoarthritis (OA) occurs, however, glucosamine production decreases. As with any supplement, it’s best to check with your doctor before taking it.
- Glucosamine supplements are typically used for osteoarthritis, particularly knee osteoarthritis.
- This nutritional supplement is thought to help repair damaged cartilage by augmenting the body's supply of glucosamine.
- Some stores sell glucosamine as a dietary supplement, but the benefit of this treatment is inconclusive. As a dietary supplement, the FDA does not regulate glucosamine sold in stores, so it’s best to consult with your physician before taking it.
- Early studies have shown positive but not statistically significant results for moderate-to-severe pain for individuals using glucosamine, but follow-up studies have yielded less beneficial results.
- A trial period of up to three months is enough to determine how helpful glucosamine is but should not be initiated without permission from your doctor.
- Some glucosamine is extracted from the outer coverings of shellfish and should be avoided by those with allergies. Labels aren’t required to include this information, so make sure to check with the manufacturer before buying it.
Chiropractic Healthcare of Buckhead, www.drsalzinger.com
DeKalb Medical Center, www.dekalbmedical.org
Northside Hospital, www.northside.com
Orthopedic Surgery & Sports Medicine Center in Smyrna, www.orthosportsmedcenter.com
Pinnacle Orthopedics and Sports Medicine, www.pinnacle-ortho.com
Reconstructive Joint Center at Piedmont Hospital, www.piedmonthospital.org
Resurgens Orthopaedics, www.resurgens.com
Stability Pilates & Physical Therapy, www.stabilityatlanta.com