Joint Pain

• Joint pain is a common health condition and may result from one of several known causes. Although usually the results of an injury or sprain, joint pain can results from underlying conditions such as osteoarthritis and rheumatoid arthritis.

Joint Pain Symptoms:

• The symptoms of joint pain will vary according to the cause. Symptoms like pain, swelling, stiffness, and/or warmth in your joints suggest joint inflammation due to an injury or an underlying condition like OA or RA. These symptoms can also be due to an infection in the joint.
  Affected joints may be red, swollen and painful to touch and joint mobility may be restricted. It may be difficult to pinpoint the actual source of pain – the joint itself, the tissues surrounding it or an affected ligament or tendon. When joint pain is severe or ongoing you may need to see a doctor to determine the exact cause and identify the most appropriate treatment.
• The nature and severity of your joint pain symptoms will depend to a great extent on the cause.
  If the joint pain is due to inflammatory disorders such as injury or forms of arthritis, symptoms may include:
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  Fever
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  Redness
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  Swelling of the joint
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  Morning stiffness in the joint
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  Stiffness of the joint after long periods of rest
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  If the pain is caused by non-inflammatory disorders, symptoms may include:
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  Limited morning stiffness in the joint
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  Exacerbation of pain with exercise
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  Relief from pain with rest
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  If you are also experiencing symptoms such as fatigue and weight loss, the pain could be triggered by an underlying infectious disease and you should talk to your doctor.
• Joint Pain Causes
• Wear and tear
  Injury, fracture, cartilage damage, tendonitis, sprain
  Osteoarthritis (OA) is a degenerative condition caused by the wear and tear and eventual loss of the cartilage surrounding the joint
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  Autoimmune Disorders
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  Autoimmune Disordersin which a person’s body produces antibodies against its own body tissues, can also produce joint pain – e.g. Rheumatoid arthritis (RA) and Systemic Lupus Erythematosus (SLE)
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  Inflammation of the joint
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  Septic arthritis caused by bacterial inflammation of the joint may arise locally or may be carried to the joint from another area of infection, through the bloodstream.
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  Infections such as Lyme disease, mumps, rubella, influenza, hepatitis, measles, and rheumatic fever may also cause joint inflammation.
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  Metabolic Disorders
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  Metabolic disorders such as gout and pseudogout, in which materials are deposited into the joints, can cause pain and inflammation
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  Bone Diseases
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  Bone diseases such as osteomyelitis and Paget’s disease can cause diffuse joint pain.
  Tumors and cancers
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  Tumors and cancers near a joint can affect the joint and produce pain

Joint Pain - Treatment and Relief:

• There is currently no known cure for conditions like Osteoarthritis and Rheumatoid Arthritis. Medical treatment of these conditions aims to reduce joint pain, improve joint mobility and quality of life and restrict functional impairment, while limiting toxic side effects of therapy.
  Most drug treatments are prescribed for relief of symptoms and do not offer a cure.
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  Non Steroidal Anti-inflammatory Drugs (NSAIDS).The commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) produce prompt relief of associated pain and inflammation and are considered relatively safe. Examples of NSAIDs include aspirin, indomethacin (Indocin), ibuprofen (Motrin), naproxen (Naprosyn) and piroxicam (Feldene)
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  COX 2 inhibitors: COX-2 inhibitors are a newer class of anti-inflammatory drugs or NSAIDs which selectively block the COX-2 enzyme. This in turn prevents the production of chemical messengers or prostaglandins that are responsible for the pain and swelling of arthritis.
  Drugs such as hydroxychloroquine, gold, penicillamine, azathioprine, sulfasalazine and methotrexate are used to control symptoms and possibly delay disease progression in patients with rheumatoid arthritis. These are slower acting second-line drugs which are usually taken together with NSAIDs.
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  Steroids: Steroids may occasionally be required – either orally in low doses, or as injections into the affected joint. These may be prescribed for rapid relief of pain, swelling and inflammation around affected joints.
  Glucosamine and chondroitin sulphate are used in patients with osteoarthritis. These are dietary supplements which have been shown to ease symptoms in people with moderate to severe joint pain. Studies have shown that these substances can also help restore cartilage. In contrast to the commonly prescribed NSAIDs, these supplements have not been shown to be associated with side effects.
  Drug treatment should be monitored by a physician and needs to be tailored to individual needs.
• Dietary supplements for joint pain
  Dietary supplements are increasingly being used in the management of specific painful joint conditions. Glucosamine and chondroitin sulfate are used in patients with osteoarthritis. These supplements are believed to replenish worn-down connective tissue that cushions the bones. Others include niacinamide (a form of vitamin B3), S-adenosylmethionine (SAMe), as well as ginger and turmeric.More on supplements for joints

Physical therapy

• Physical therapy is often prescribed as a treatment for people with joint pain. This may be limited to daily walking and stretching exercises, or include muscle-strengthening exercises under supervision. Measures like traction (gentle and steady pulling), massage, and manipulation of joints contribute to improved joint mobility and flexibility.
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  Surgery
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  Surgical procedures may sometimes be required either to determine the cause of joint pain by arthroscopy or to provide relief in severely damaged joints through bone fusion or joint replacement.
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  Lifestyle changes
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  Patients suffering from joint pain should try to find an optimal balance between rest and activity. Rest is important when the pain flares but excessive rest may result in stiffness of joints and weakened muscles. Managing joint pain can often be accomplished by a combination of symptoms relief, weight control and exercise, which can reduce wear and tear on the joints.
  Physical exercise, in consultation with your doctor, improves muscle strength and flexibility and improves joint mobility. Excessive weight can aggravate joint pain. Weight reduction is therefore crucial to the management of joint pain. A healthy well-balanced diet coupled with exercise will help in reducing weight.
  Giving up smoking is advisable since smoking adversely affects bone health.

Other treatments for joint pain:

Heat application: Relief of pain may be obtained by applying heat to painful, stiff joints for 20 minutes up to three times a day. Heat increases local blood flow and improves flexibility. Warm towels, hot packs and heating pads may be used.
Cold therapy: Using cold packs or over the counter cooling sprays may relieve acute pain by numbing nerves around the joint.
Hydrotherapy: Exercising or relaxing in warm water reduces muscle tension. The water itself takes some weight off painful joints, thereby making exercising easier.
Supportive devices: Supports like walking sticks may help by taking weight off affected hips. Sleeping on a firm orthopaedic mattress helps ease pain in the spine. Splints and braces provide rest and support to weak and painful joints and must be used only in consultation with your doctor.
Coping strategies: Relaxation techniques release muscle tension throughout the body. Keep yourself busy but make sure you also find time for yourself. Focus on things you enjoy doing and set yourself small but important goals. Joining a support group may help you avoid isolation.
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