Arthritis is a condition that is very common, but not well understood by most. It is not a single disease. There are actually more than 100 types of arthritis.
More than 50 million adults and 300,000 children have some type of arthritis. It is more common in women and is the leading cause of disability in America. Common arthritis complaints are joint pain, swelling and stiffness.
Inflammatory arthritis (rheumatoid, lupus) is an overreaction of the body’s immune system. The body attacks the cartilage and destroys it. Metabolic joint disease (gout) occurs when crystals are deposited in the joints and cause acute pain. These are best treated by a primary care physician, nurse practitioner or specialist (rheumatologist) with medications and changes in diet. Blood tests are often used in the diagnosis.
Osteoarthritis (wear and tear arthritis) is the most common type. Cartilage is the thick cushioning surface on the ends of bones. With time this cartilage can wear down (thinning/mild arthritis) and progress to the point where bone rubs on bone (severe arthritis).
Orthopaedic Sports Medicine has significantly advanced the diagnosis and treatment of arthritis. As a physician at NEO Sports Medicine, I am often asked when someone should seek medical treatment. Anyone in their teenage years or younger with a joint that stays swollen for more than a few days should be seen urgently to rule out cartilage damage or juvenile rheumatoid arthritis.
Mild non-traumatic joint pain in someone 30 or older can start initial treatment with weight loss, anti-inflammatory medication (Aleve, Advil, Tylenol), and reasonable exercise that does not cause pain. Primary care physicians can prescribe stronger anti-inflammatories.
If this does not provide relief, a referral to an orthopaedist is the next step. Patients should not assume an appointment means imminent surgery. X-rays will give the doctor a good idea of the condition of the joint. At NEO Sports Medicine, physicians look at the whole person not just a joint. Many times a course of physical therapy to strengthen the muscles (the “shock absorbers” of a joint) will help. A steroid injection into the joint can also provide relief. Braces can also be used on a short-term basis to give the joint a rest.
Joint pain is not always arthritis. Torn cartilage can often be repaired with an outpatient arthroscopic surgery using a small camera that is quite minor. An MRI can be helpful to get a better picture of the joint. For major joint damage that has failed conservative treatment, a joint replacement can provide life-changing relief. Replacements are available for the knee, hip, shoulder and even finger joints.
Modern joint replacements are now meant to last longer than 15 years and can allow patients to get back to a more active lifestyle. My partners and I provide accurate diagnoses and seek to exhaust all forms of conservative treatment. If surgery is indicated, we provide minimally invasive joint surgery to get patients back to the lifestyle they desire.
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