Joint Pain Prevention – Keep Those Joints Moving

with Thomas Weber, M.D., sports medicine & non-operative orthopaedics, Advanced Healthcare

Last Updated: Sept. 1, 2003

Oh my aching back, and other expletives are likely to be heard on occasion from just about everyone. But what if those aches and pains aren’t resolving, and your joints continue to ache well beyond the norm?

According to Dr. Thomas Weber, an orthopaedics and sports medicine specialist at Advanced Healthcare, joint pain can be attributed to three main sources.

• Injury
  Including trauma, a fall, a twist or overloading of a joint that causes minor damage to the joint. With injury, people generally experience temporary inflammation and pain.
• Degenerative Arthritis or Osteoarthritis
  Frequently found in the hips and knees of people in their 60s and 70s, but also as early as 40 years old. This type of arthritis causes pain based on wear and tear of the joints.
• Inflammatory Joint Disorders
  When the capsule holding the fluid that lubricates the joint becomes inflamed and painful, inflammatory joint disorder is likely the reason. Types include rheumatoid arthritis, gouty arthritis and infectious causes like lyme disease.

Thomas Weber, M.D., sports medicine & non-operative orthopaedics, Advanced Healthcare “Stay active. It seems that people who come in with arthritis or injury are more often than not, inactive, so their joints cannot handle the increased stress.”

When to call the doctor
Dr. Weber suggests that patients who have experienced a traumatic event or who have pain that lasts for more than one week, should visit a physician sooner rather than later.

“If you have pain for no reason, or it doesn’t respond to ice, rest or mild anti-inflammatory drugs, visit the doctor,” he said. “Redness or heat could mean an infection.”

Even more important?

“Stay active,” he said. “It seems that people who come in with arthritis or injury are more often than not, inactive, so their joints cannot handle the increased stress.”

Dr. Weber also cautioned weekend warriors. “Regular exercise is the best thing, not overdoing it.”

Treatment
When a patient comes in to see Dr. Weber, a typical examination includes X-rays, a detailed history of how the symptoms developed, how long it has been painful, how it originally started, what the pain is like, and whether there is inflammation around the joint. If he suspects an infectious catalyst, he might order lab work as well.

“For an injury, rest typically is key to allow the body to heal,” he said.

Sometimes patients are sent home with crutches, walking boots, or, for adults, anti-inflammatory drugs. Another great tool for injuries is ice, which can settle down the pain and swelling. In many cases, Dr. Weber recommends physical therapy to help re-strengthen the muscle around the joint and to re-learn walking techniques.

“So much chronic pain or acute injury comes from the malfunction of the muscles around the joint,” said Dr. Weber. The muscle has three jobs, to move the joint, stabilize the joint and to act as a shock absorber.

For instance, a person with painful knees might find that stronger quadriceps alleviate the pain by putting less stress on the joint.

Osteoarthritis
Treating osteoarthritis related pain is similar to recovery from an injury, including increasing muscle strength, icing and anti-inflammatory drugs. Dr. Weber also recommends the use of Glucosamine and Chondroitin, a joint supplement that can be very helpful.

“Researchers don’t completely understand why it works,” said Dr. Weber. “The working theory is that it helps rebuild small amounts of cartilage, but it is difficult to prove that.”

In addition, as a last resort, cortisone injections can settle down both pain and inflammation. Dr. Weber cautions, however, that too many injections may have the opposite effect, wearing out the joint even faster.

“Joint replacement can completely relieve the pain and the new joint typically lasts ten to fifteen years,” he added.

With inflammatory joint disease, the body is attacking its own cells, so disease-modifying medications are used to settle down the immune system. Oral anti-inflammatory drugs as well as cortisone injections may be used, and if the inflammation is infectious, antibiotics.

“When all conservative measures have been exhausted, we consider surgery,” said Dr. Weber.

Most important, he emphasized, to avoid extreme measures like surgery or joint replacement, “stay active, but stay within your limits and avoid unreasonable strenuous activity.”

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