Is it arthritis, bursitis or just overuse-itis?
Do you still have that nagging pain in your knee every time you go for a run? Does your shoulder ache when you get up in the morning? It's not just because you're getting older.
Whether you have a sore knee from overuse or the crippling pain of severe arthritis in your hips and shoulders, joint pain does not make your life happier. It may even make it hard for you to do everyday activities and keep you from doing the things you want to do. The good news is that you can prevent or treat many joint problems.
You can have joint pain in one or more of your joints at the same time. "The joints in your body where pain most commonly occurs, in order, are your knees and hips, then shoulders, followed by ankles, elbows and wrists," says Dr. Andrea Herzka, orthopedic surgeon and assistant professor at Oregon Health & Science University (OHSU) in Portland, Oregon.
You'll probably have joint pain, which can range from mild to severe, at some point in your life. Joint pain, swelling, stiffness and loss of range of motion are often related to one of many types of arthritis, but it can also be caused by other diseases and conditions, injuries or overuse. You may have short-term, temporary joint pain caused by muscle or ligament sprains and strains, tendonitis and other injuries. You generally get long-term joint pain because of disease, including arthritis (usually as you age).
Where does it hurt?
Dr. Christopher Nanson, orthopedic surgeon at Legacy Meridian Park Medical Center in Tualatin, Oregon, explains that you can get joint pain within a joint or outside it in the surrounding soft tissue.
Within the joint, pain may be related to:
- Cartilage injury or cartilage deterioration (osteoarthritis)
- Rheumatoid arthritis
- Mechanical problems
- Bad alignment at birth
- Traumatic injuries
Outside the joint in the surrounding area, pain may be related to:
- Ligaments, tendons, muscles or the small pouches of fluid between a tendon and a bone (bursae)
- Systemic disease (that affects a number of organs or the whole body)
- Overuse or sudden injury
Treating your condition
It's important to see a doctor if you have joint pain that doesn't go away with rest, ice, compression and elevation (RICE) or if you have severe pain or swelling. "Swelling indicates that you have a more urgent need for care," explains Dr. Nanson. "If swelling and pain worsen, seek care as soon as possible, either the same day or within a day or two."
Before your doctor can treat you, you need a diagnosis. "We have many modalities for dealing with the many causes of joint pain," says Dr. Herzka. "Treatments are based on the underlying cause of your pain, and you may have a number of options to choose from.
Dr. Herzka notes that you can begin with self-care, including rest, ice, compression and elevation, for many problems. "This is a good start to reduce swelling and pain related to ligament problems, tendonitis, bursitis, overuse and trauma, but may not be enough."
After you've tried RICE, anti-inflammatory (antiswelling) medication and an over-the-counter brace, the next step is physical therapy, says Dr. Nanson. "If needed, additional options might include injection therapy with corticosteroids or viscosupplements, custom bracing, walkers or walking canes." Viscosupplements are gel-like substances that can take the place of naturally occurring joint fluid.
Weight loss, along with treatments, can help, especially for knee pain. But sometimes people need more radical treatment. According to Dr. Nanson, "If you've failed three or more nonsurgical interventions, if pain is disabling, you're having difficulty with daily activities and are unable to do the things you want to do without significant pain, then it's generally time to consider surgical options." Surgery is designed to relieve pain and let you get back to doing normal activities.
If you do get to the point where you need surgery, newer technology may offer quicker recovery, smaller incisions and more accurate techniques than ever. Dr. Nanson notes that Legacy Meridian Park, where he practices, is the first hospital in Oregon to do MAKOplasty to treat knee arthritis, which uses robot-assisted technology to allow much smaller incisions than older techniques.
Risks, prevention, protection
You can prevent injury-related joint pain by using the right sports gear, getting proper training and using other precautions. You can't always avoid disease-related joint pain, but early diagnosis, treatment and following the tips below can help your joint pain.
Dr. Herzka's top three tips are:
- Keep your ideal body weight.
- Get regular low-impact exercise.
- Balance your exercise between strengthening activities and flexibility activities.
And Dr. Nanson offers these tips:
- Avoid repetitive running and jumping.
- Eat a healthy diet—a good balance of whole, nonprocessed foods.
- Listen to your body. If you have increased pain, back off the activity causing the pain.
Says Dr. Nanson,"These simple precautions can generally keep you out of trouble."
Published on Aug. 1, 2011; updated on June 5, 2014.