"Why do my joints hurt? Could it be arthritis?" 

By: Dr. Daniel Pepe, Family Physician | April 14th, 2019

Nearly everday patients come into the office with sore joints. There are many joints in our body - hips, knees, fingers, toes, wrists, elbows, shoulders. At each of these joints are made up of two bones which come togehter and are covered in a capsule. At the end of each bone there is usually a covering of cartilage. Cartilage inside the joint capsule is hard and acts as a slippery surface with low friction to allow bones to slide past eachother. As well, in most joints there is a small amount of fluid called synovial fluid that acts like WD-40 or grease to minimize any friction. 

Over time and for a number of reasons this cartilage can break down. Most commonly, arthritis impacts older patients as they have simply been using their joints for a longer time.  As protective cartilage breaks down the underlying bone is exposed and this can lead to worsening damage. Once bone is exposed, this damage becomes worse and the degeneration tends to occur more quickly. This cycle continues and more damage is done to the bone. Despite this damage, many patients can continue to walk on their joints (if arthritis in hips or knees) or keep using their hands and arms. 

Most of the time - patients are unaware that they even have osteoarthritis and it is found inicdentally on an x-ray. In this case, no special management is needed.

For patients who have arthritis in their hips or knees it will usually get worse over time. However, there are always things you can do to improve your pain. 

• Weight loss - for every 1 pound of weight you lose it takes of 4 lbs of pressure on your joint! 
  • Here are some small lifestyle changes that might help:
    • Reducing or eliminating: pop, chips, or fast food
    • Trying not to snack before bed 
• Exercise - A goal of 5 minutes of walking per day is a great way to start. Most doctors recommend a goal of 30 minutes 5 times per week. 
• Pedorthist Assessment: make sure that you have an assessment by a pedorthist. These are individuals who can watch how you walk and see if there are any issues with the arches in your feet, positioning or your ankles or your overall gait (a term used to describe the process of walking). 
• Physiotherapists can be incredibly helpful in managing both early and late stage arthritis. An assessment by a physiotherapist can often help you learn exercises to strengthen your muscles and take strain off of the affected joint. 
• Family Physicians are able to offer temporary relief in nearly all cases of osteoarthritis by injecting steroids and local anesthetic into the joint. For some patients, this can offer up to 3 months of pain relief and is most helpful and effective 
• If the arthritis becomes severe enough or is severely limiting your quality of life you may be referred to a surgeon who specializes in joint replacement (Also called- arthoplasty) to discuss the process of getting ready for surgery. 

Ultimately, our skeleton and bones are a delicate balance (like a game of Jenga) and when one bone gets worn down it will cause other bones to wear abnormally or breakdown. This is most commonly seen by a patient developing arthritis in a knee and then subsequently going on to develop arthritis in their hips and knees. 

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