Diagnosing & Treatment of Joint Pain

Non-Surgical Treatments
In most cases, your doctor will want to try to control joint pain and swelling using non-surgical approaches before considering surgery. These non-surgical options include:

• Medications. When non-prescription medications fail to relieve joint pain and swelling, your doctor may recommend the use of prescription-strength non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce swelling.


• Steroid Injections. In some people, NSAIDs do not provide adequate symptom relief, or they may cause unpleasant side-effects such as damage to the stomach lining. When this occurs, your doctor may inject a steroid directly into the joint. The steroid injection generally provides long-lasting relief from pain.


• Use of a cane. In weightbearing joints such as a hip or knee, the use of a cane during walking can help to relieve pressure on the joint and bring some symptom relief. Your doctor may recommend use of a cane in conjunction with other treatments, such as NSAIDs and steroid injections.

When Surgery is Necessary
In some people, degenerative arthritis causes progressive damage to the joint, making surgery necessary. Surgery is usually considered only after non-surgical treatments have been ineffective in controlling symptoms. There are three common types of surgery for damaged joints:

• Bone fusion. This procedure, which involves fusing the bones of the affected joints together, is performed in smaller joints, such as those of the fingers. Because this results in permanent loss of mobility in the fused joint, it is used only in advanced cases of arthritis, when symptoms are very severe and do not respond to other treatments.


• Arthroscopic surgery. This procedure can be performed in the shoulder, knee, elbow and ankle joints to remove damaged cartilage. The physician inserts a miniature video camera and surgical instruments into the joint to view his work on a monitor, while the small instruments allow him to remove the damaged cartilage. Recovery from arthroscopic surgery is quicker than recovery from open surgery, and patients often can return to their normal activities within a short period of time.


• Total joint replacement. During this procedure, your orthopedic surgeon will remove the damaged joint and replace it with an artificial joint made from a durable metal alloy or strong plastic. This procedure, which usually takes about two hours, is commonly used in the knee and hip joints.

When to Consider Total Joint Replacement
Replacement of a damaged joint will be considered when:

• You experience unrelieved pain for six to 12 months.
  Symptoms significantly affect your ability to perform many normal activities.


• The pain regularly awakens you from your sleep.


• Your quality of life is greatly affected by the pain and loss of mobility.

Following total joint replacement, patients usually experience complete relief from pain and swelling, and can usually resume many favorite activities.

The Outlook for Patients with Joint Pain
Because degenerative arthritis tends to affect more than one area of the body, people with pain in one joint often find that the pain develops elsewhere, too. But with early medical intervention, symptom control and effective treatments, many patients are able to remain active and relatively pain-free.