Don't Ignore Joint Pain

ARTHRITIS IS INFLAMMATION or degeneration of one or more joints. Arthritis involves the breakdown of cartilage. Normal cartilage protects the joints where two bones meet and allows them to move smoothly.

Cartilage also absorbs shock when pressure is placed on a joint, such as when you walk. Without the normal amount of cartilage, bones become damaged and rub together. This causes swelling (inflammation) and stiffness.

Joint inflammation and stiffness may result from general wear and tear on the joints, a broken bone, a viral or bacterial infection, or the formation of crystals such as uric acid or calcium. Another cause is an autoimmune disease in which the body’s immune system attacks healthy tissue. In most cases, the inflammation goes away after the cause goes away or is treated. However, sometimes it does not. When this happens, you have long-term or chronic arthritis. Arthritis occurs in men and women, and there are more than 100 different types of arthritis. Osteoarthritis is the most common; other common types include ankylosing spondylitis, crystal arthritis, juvenile rheumatoid arthritis in children, bacterial infection, reactive arthritis in adults, scleroderma and systemic lupus erythematosus.

Arthritis causes joint pain, swelling and limited joint movement (limited range of motion) as well as redness and warmth of the skin around the joint and joint stiffness, especially in the morning. Some types of arthritis may cause deformity. This could be a sign of severe, untreated, rheumatoid arthritis.

Your health care provider will perform a physical examination and ask about your medical history. Your exam may show fluid around the joint; warm, red, tender joints; and difficulty moving the joint. Blood tests and joint X-rays can check for infection and other causes of arthritis. Your provider may also remove a sample of joint fluid with a needle to send to the lab to test for inflammation crystals or infection.

The goal of treatment is to reduce pain, improve function and prevent further joint damage. The underlying cause often cannot be cured. Lifestyle changes prove the preferred treatment for osteoarthritis and other types of joint swelling. Exercise can help relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your health care team can help you design an exercise program best for you; it may include low-impact aerobic activity such as walking, range-of-motion exercises for flexibility and strength training for muscle tone. Try to make gentle exercise a part of your life.

Your provider may suggest physical therapy which might include heat or ice, water therapy, massage, and splints or orthotics to support joints and improve their position. This is often needed for rheumatoid arthritis.

Be sure to get plenty of sleep. Sleeping 8–10 hours a night and taking naps during the day can help you recover from a flare-up faster and may even prevent flare-ups. Avoid staying in one position too long. Avoid positions or movements that place extra stress on your sore joints. Change your home to make activities easier such as installing grab bars in the shower, tub and near the toilet. Try stress-reducing activities such as meditation, biofeedback, yoga or tai chi. Research shows acupuncture can help relieve the pain of arthritis.

Eat a healthy diet full of fruits and vegetables which contain important minerals and vitamins, especially vitamin E. Eat foods rich in omega-3 fatty acids such as cold-water fish (salmon, mackerel and herring), flaxseed, canola oil, soybeans and soy oil, pumpkin seeds and walnuts. Avoid smoking and excessive alcohol consumption. Apply capsaicin cream over your painful joints; you may feel improvement in three to seven days. Lose weight if you are overweight; weight loss can greatly improve joint pain in legs and feet. Use a cane or other assistive devices to reduce pain from hip, knee, ankle or foot arthritis.

Medications may be prescribed along with lifestyle changes. All medications have some risks. Your provider should closely follow your use of arthritis medications. Over-the-counter options include acetaminophen (Tylenol), aspirin, ibuprofen or naproxen. Prescription medications may include corticosteroids to help with inflammation, disease-modifying antirheumatic drugs to treat autoimmune arthritis, biologics or other medicines for rheumatoid arthritis, and medications for gout.

Take your medication as directed by your provider. If you experience side effects, contact your provider and make sure he or she reviews your current list of all the medications you take. For osteoarthritis of the knee, consult an orthopedic surgeon for injections of steroids or hyaluronic acid, which may provide short-term relief. In some cases, surgery such as arthroscopy, joint replacement or resurfacing of the joint may be required if other treatments have not worked.

Complications of arthritis include long-term pain, disability and difficulty performing daily activities. A few arthritis-related disorders can be completely cured with proper treatment. Most forms of arthritis, however, are long-term, chronic conditions. Early diagnosis and treatment can prevent joint damage. If you have a family history of arthritis, tell your health care provider, even if you do not have joint pain. Avoiding excessive, repeated motions may help protect you against osteoarthritis.