The knee joint is formed from the upper end of the shinbone (tibia) and the lower end of the thighbone – femur and knee cap (patella). The ends of these three bones are covered with smooth slippery cartilage that cushions and protects your knee joint when you move, straighten, or bend your knees. The synovial membrane lining this joint releases a fluid that lubricates the cartilage and reduces friction.

Osteoarthritis of the knee

Between joints a natural cushioning cartilage is present. It acts just like a shock absorber. Over time this soft cartilage wears away resulting in a condition known as osteoarthritis. It is also known as wear-and-tear arthritis. When the cartilage wears away over time, the bones of the joint come closer and begin to rub against each other.

As the cartilage wears away and is lost, it becomes rough. When this happens, the space between the bones decreases resulting in bones rubbing against each other and the formation of painful bone spurs

Osteoarthritis usually develops slowly, and the pain it causes worsens over time.

The loss of cushioning results in friction as the bones rub and cause joint pain, swelling, stiffness, and diminished ability to move.

Most commonly osteoarthritis affects these joints: hands, knees, hips, and spine.

What are the signs and symptoms of Osteoarthritis of the knee?

Osteoarthritis is a progressively degenerative joint condition. The symptoms manifest slowly and worsen over time.

Joint pain is the most common symptom. It becomes severe with activity and movement.

Joint stiffness: easily observable after remaining inactive for some time or waking up from sleep.

Swelling: mostly seen around the joint due to soft tissue inflammation.

Popping or crackling sound or grating sensation while moving the knee joint

Restricted movement and loss of flexibility in the knee joint.

Difficulty in moving the joint through a full range of motion.

Tenderness: when you apply light pressure, you can feel it.

Who gets osteoarthritis of the knee joint?

This type of arthritis is common. Young people too can get it, but the risk most likely increases after age 45 and in older people. Compared to men women are more likely to get this condition.

What are the risk factors for osteoarthritis of the knee joint?

Age is the most common risk factor for osteoarthritis. There is some degree of risk for osteoarthritis for all with advancing age. However, excess body weight; family history due to hereditary predisposition; gender (being women), and repetitive stress injuries can increase the risk manifolds.

People who are involved in long-distance running, tennis, soccer, and hockey are at higher risk for osteoarthritis.

Rheumatoid arthritis, certain metabolic disorders, excess growth hormone or iron overload can also increase the risk.

What should you do to manage osteoarthritis symptoms?

Although the damage caused to your joints cannot be reversed, you can manage the symptoms. To minimize the effects of arthritis on your joints, you should remain active, maintain a healthy body weight, and do some physical exercise and activities under the supervision of an experienced physiotherapist. This will help slow down the progress of osteoarthritis and help improve joint mobility and function by reducing pain.

How is arthritis diagnosed?

Your orthopedic doctor examines you physically to look for tenderness, swelling, redness, or warmth in your joint. The doctor will also see whether you have any joint instability; pain while bearing weight; any injury or problems with movement. The doctor will also see whether you have any grating sensation with joint movement.

After a physical examination, your orthopedic doctor may order X-rays and other imaging tests.

Treatment for Arthritis

Your doctor initially recommends non-surgical treatment based on the severity of your condition – mostly when it is mild to moderate. Your orthopedic doctor will recommend:

• Lifestyle modifications: weight reduction, involvement in low-impact activities such as swimming or cycling.
• Minimizing activities such as climbing stairs, and high-impact activities such as tennis, jogging, and other sports.
• Physical therapy to help improve flexibility and a range of motions
• Assistive devices such as supportive or unloader braces, use of a cane, or wearing plastic bandages.
• Over-the-counter medications or cortisone injections.

Surgical Treatment

Your doctor may recommend surgery if your pain from arthritis causes disability and is not relieved with nonsurgical treatment. There are different surgical procedures and techniques based on the severity of your condition. It is better to consult your orthopedic doctor to know which is the best procedure in your case.

Most common causes of joint pain

Joints help your skeletal bones to move. Some of the common joints include the shoulder, elbow, knee, and hip joint.  Any discomfort, soreness, or pain in any of the joints refers to joint pain. The most common cause of joint pain is arthritis. Any illness, injury, or disease can also cause joint pain.

The most common causes of joint pain include

Arthritis

1. A common condition in people with advancing age. It damages your joints and causes joint pain, inflammation, and stiffness. Advancing age naturally leads to wear and tear of joints. However, certain joint conditions and injuries can also cause arthritis. It commonly affects the hands & wrists, knees, and hip joints. There are more than 100 different types of arthritis, but osteoarthritis and rheumatoid arthritis are the most common ones.

Osteoarthritis: This is the most common type. It can lead to joint stiffness, pain, and inflammation. It affects people above 40 years of age and is common in women. Osteoarthritis is one of the most common causes of joint pain.

Rheumatoid Arthritis: It is an autoimmune condition. An inflammatory type of arthritis. In this condition, the body’s immune system mistakenly attacks the body’s healthy tissues in the joints causing pain and inflammation. Rheumatoid arthritis can cause permanent damage to joints.

Avascular necrosis

In this condition, bone tissue dies due to a cut-off in the blood supply. It is also known as osteonecrosis.  The bone breaks into tiny pieces and collapses. The condition may take several months to years to develop. Mild to severe pain develops gradually.

Bursitis

Small cushion-like sacs filled with fluid called bursae cushion the muscles, tendons, and bones around the joints. The large joints such as the shoulder, elbow, knees, and hips have major bursae. Inflammation of these bursae is known as bursitis. Injuries, overuse, and infections can cause bursitis. It causes joint pain.

Adult Still Disease

Adult-onset Still’s disease or Wissler-Fanconi syndrome is a type of arthritis with no known cause (idiopathic). It affects both men and women equally. In the beginning, it causes pain in a few joints, but over time, the pain spreads to the entire body.

The disease onset with a high fever (102.2 degrees Fahrenheit) and a pinkish rash on the arms, legs, back, chest, and abdomen. The rash disappears once the fever drops.

The other symptoms may include fatigue, sore throat, headache, abdominal pain, and swollen lymph glands in the neck. A few weeks later, the muscles and joints in the wrists and knee joint begin to swell, pain, and become stiff.

Ankylosing spondylitis

Ankylosing spondylitis (axial spondyloarthritis) is a type of inflammatory arthritis that mostly affects the bones (vertebrae) of the spine. Over time, the vertebrae fuse making the spine less flexible and leading to a hunched posture. The symptoms may include back pain, and stiffness in the lower back and hip joint.

Bottom Line

Joint pain can be due to normal wear and tear or advancing age. However, it can also be due to certain health conditions such as osteoarthritis, rheumatoid arthritis, or an infection or injury. Therefore, if you experience persistent joint pain that doesn’t get better with rest and medication, then you should see a specialist orthopedic doctor. Your orthopedic doctor can comprehensively evaluate your condition based on the symptoms, physical examination, and X-rays. Once the underlying cause is determined, the doctor provides effective treatment.

Meet Dr. Praharsha Mulpur, if you experience persistent joint pain.

The hip joint is a ball-and-socket joint. The femoral head (the top of the femur bone) is the ball; and, the part of the pelvis bone – acetabulum forms the socket. A ring of cartilage on the socket is the labrum. It helps keep the bones of the hip joint in place as you move. An injury to this labrum is known as the labral tear of the hip. Labrum cushions the hip joint. It also acts like a rubber seal to hold the thighbone securely in the hip socket and assist in frictionless motion by keeping the joint fluid inside.

Labral tears are common in people who play golf, football, soccer, and hockey. It can also occur due to structural problems in the hip joint.

Types of Labral Hip Tears

A tear can occur anywhere along the labrum. Depending on the part of the affected joint, hip labral tears are classified as anterior or posterior tears.

Anterior Hip Labral Tears: This type of tear occurs on the front of the hip joint

Posterior Hip Labral Tears: This type of tear occurs on the back of the hip joint.

What are the symptoms of hip labral tear?

Irrespective of the cause and type, the symptoms associated with hip labral tears look similar. However, you may feel symptoms differently depending on the location of the tear – whether it is in the front or back of the hip labrum.

Symptoms include:

• Restricted hip joint motion
• Stiffness in the hip joint
• Pain in the buttocks, groin, or hip joint when you walk, run, sit idle, or sleep
• A locking or clicking sensation in the hip joint when you move
• Some hip labral tears go unnoticed for years as they do not cause any symptoms.

Causes of hip labral tear

• Regular wear and tear of the hip joint
• Overuse of hip joint, repetitive hip motions
• Traumatic hip injuries
• Indulgence in some sports and occupations
• Abnormal hip bone shape, hip dysplasia, and other deformities of the hip joint

Anterior hip labral tears are associated with sports such as hockey, football, golf, and ballet. Whereas traumatic injuries, high-impact sports injuries, accidents, or falls can lead to posterior hip labral tears.

Diagnosis of Hip Labral tears

An orthopedic doctor physically examines the patient to assess whether the patient has inflammation, swelling, and pain in the hip joint with movements.

The doctor may order an X-ray to detect abnormalities in the alignment and shape of the hip joint and also to see the signs of arthritis. To have a clearer view of the tissue surrounding the hip joint including the hip labrum, the doctor may order an MRI scan as well.

Treatment of the Hip Labral Tears

Minor hip labral tears not causing severe pain or restricting movement, can be managed without requiring surgical repair. In some cases, an orthopedic doctor provides nonsurgical treatments first, but when the labral tear and pain are severe, surgical repair remains the best option.

Non-surgical treatments include over-the-counter medications to manage pain, and inflammation, rest, activity modification, physiotherapy, and injection use.

Surgery

When nonsurgical options do not provide any relief from pain, your orthopedic doctor may recommend surgery. The common procedure to repair labral tears is orthoscopic surgery. The procedure is minimally invasive with a faster recovery period.

If you have any concerns with your hip joint with severe pain and walking difficulty, meet Dr. Praharsha Mulpur.

Fracture and dislocation: A fracture occurs when the bone is broken. It requires medical care. If a person sustains severe injuries or trauma with broken bones, then call your local emergency number. Also, seek immediate emergency medical care if the joint or the limb appears deformed with severe pain.

A ‘closed’ fracture occurs when the person’s skin is unbroken and there is no cut.

An ‘open’ fracture occurs when a person’s bone cuts through their skin.

Dislocations occur when bones are pulled out of their proper place or joints.

What to look for?

Pain: The wounded region hurts.

Swelling or bruising are lumps or bumps surrounding the wounded region.

Deformity: The wounded region appears crooked or different in shape than the uninjured portion on the opposite side.

Difficulty moving: The person is unable to move the affected body part normally.

A wound: The person’s bone might have broken through the skin.

Pins and needles: The sufferer may experience prickling or numbness of the skin.

Grating: The sufferer may feel as if their bones are scraping against one another.

A shattering sound: The individual may have heard or felt the bone snap.

In case of a bone fracture and dislocation, don’t move the affected person – otherwise, the person may suffer further injury.

How Can You Help with Fractures?

Fractured thigh 

The thigh is the portion of your leg above the knee. 

The thighbone (femur) is a big bone with the potential for catastrophic fracture.

If you encounter a thigh fracture, call an emergency service or an ambulance right away immediately.

 Fractured face or jaw

If there is a cut, apply pressure to the lesion with a clean towel to stop the bleeding. (Do not push on the injury.)

If the person is cognizant, allow them to relax in a position that is comfortable for them.

If the individual is unconscious but breathing regularly, place them on their side with their chin inclined up and mouth facing the ground (the recovery position).

A fractured arm, wrist, or collarbone

If there is a cut, apply pressure to the lesion with a clean towel to stop the bleeding. (Don’t press on the injury.)

Place the person in a posture that is comfortable for them and hold them still.

Use a cushion or folded cloth to support the individual’s arm.

Create a sling to support their arm.

Fractured ribs

Place the person in a posture that is comfortable for them and hold them still.

Arrange for the individual to visit a hospital or a doctor as soon as possible.

Fractured ankle

It is difficult to determine whether an ankle is broken or twisted. If you’re unsure, try the following (R.I.C.E):

REST: make the individual comfortable and let him or her remain still.

ICE: Apply ice wrapped in a towel or something extremely cold to the ankle (to minimize edema).

COMPRESSION: Wrap the ankle with a clean elastic bandage that is not too tight.

ELEVATION: prop the ankle up with a cushion or folded garments below.

How Can You Help: Dislocations

Put ice or cold compresses around the dislocated joint to reduce swelling and build-up of fluid around the injured joint.

Don’t move the dislocated joint and don’t try to put it back in its normal position. If you try to force the dislocated portion back into place, it will damage soft tissues – blood vessels, nerves, ligaments, and muscles surrounding the joint.

Dislocated shoulder

Keep the person motionless and comfortable.

Wrap a large amount of soft material (bandage or fabric) around their hand or fingers. 

Make a sling to support their hand, but take care not to contact their hand or fingers when tying the knot.

For toes, lie the sufferer down and place a cushion or folded cloth beneath their feet. Apply ice wrapped in a towel or something very cold to their toes (to reduce edema).

Joint pain is a common ailment that can affect people of all ages, from athletes to the elderly. It can range from mild discomfort to debilitating pain, impacting daily activities and overall quality of life. Understanding the causes, symptoms, and treatment options for joint pain is crucial for effectively managing this condition.

Joint Pain Causes

Joint pain can stem from various underlying conditions, including:

1. Arthritis: Osteoarthritis, rheumatoid arthritis, and other forms of arthritis are common culprits of joint pain. These conditions involve inflammation, deterioration of cartilage, and joint damage over time.

2. Injury: Traumatic injuries like sprains, strains, and fractures can lead to acute joint pain. These injuries may result from accidents, sports activities, or repetitive motion.

3. Overuse: Repetitive movements or excessive strain on a particular joint can cause overuse injuries, leading to inflammation and pain. This is common in occupations or activities that involve repetitive motions, such as typing or lifting heavy objects.

4. Infection: Infections such as septic arthritis can cause inflammation and pain in the affected joint. Bacterial, viral, or fungal infections can infiltrate the joint space, resulting in severe symptoms that require prompt medical attention.

5. Autoimmune Disorders: Conditions like lupus, psoriatic arthritis, and ankylosing spondylitis involve the body’s immune system attacking its tissues, including the joints. This can lead to chronic inflammation and joint pain.

6. Other Medical Conditions: Certain medical conditions like fibromyalgia, gout, and Lyme disease can also manifest with joint pain as a prominent symptom.

Symptoms of Joint Pain

The symptoms of joint pain can vary depending on the underlying cause and severity of the condition. Common signs and symptoms include:

– Pain, swelling, and stiffness in the affected joint(s)

– Limited range of motion

– Warmth or redness around the joint

– Weakness or instability

– Difficulty performing daily activities or tasks that require joint movement

– Grinding sensation (crepitus) during joint movement

It’s essential to pay attention to these symptoms and seek medical advice if they persist or worsen over time.

Diagnosis and Treatment

Diagnosing the underlying cause of joint pain typically involves a combination of medical history assessment, physical examination, imaging tests (such as X-rays, MRI, or ultrasound), and laboratory tests (such as blood tests or joint fluid analysis).

Treatment

Treatment for joint pain aims to alleviate symptoms, improve joint function, and address the underlying cause. Depending on the specific diagnosis, treatment options may include:

1. Medications: Pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologic agents may be prescribed to manage pain and inflammation associated with joint conditions.

2. Physical Therapy: A physical therapist can develop a customized exercise program to improve joint flexibility, strength, and range of motion. They may also use modalities such as heat, cold, ultrasound, or electrical stimulation to alleviate pain and promote healing.

3. Lifestyle Modifications: Adopting healthy lifestyle habits such as maintaining a balanced diet, staying physically active, managing stress, and avoiding activities that exacerbate joint pain can help improve overall joint health.

4. Assistive Devices: Using assistive devices such as braces, splints, canes, or orthotic shoe inserts can provide support and alleviate pressure on the affected joints, reducing pain and improving mobility.

5. Surgical Interventions: In cases of severe joint damage or when conservative treatments fail to provide relief, surgical options such as joint replacement surgery, arthroscopy, or joint fusion may be recommended to repair or replace damaged joint tissues.

Preventing Joint Pain

While some joint pain causes may be unavoidable, there are steps you can take to reduce your risk and promote joint health:

– Maintain a healthy weight to reduce strain on your joints.

– Regular exercise can help strengthen muscles, improve flexibility, and support joint function.

– Practice proper posture and body mechanics to avoid undue stress on your joints.

– Wear appropriate protective gear during sports or activities with a joint injury risk.

– Take breaks and avoid repetitive motions to prevent overuse injuries.

– Stay hydrated and consume a balanced diet rich in nutrients that support joint health, such as omega-3 fatty acids, antioxidants, and vitamins C and D.

Bottom Line

Joint pain is a prevalent and often debilitating condition that can significantly impact one’s quality of life. By understanding joint pain causes, symptoms, and treatment options, individuals can take proactive steps to manage their condition effectively. Whether through medication, therapy, lifestyle modifications, or surgical intervention, seeking timely medical attention and adopting healthy habits are essential for promoting joint health and overall well-being.