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Joint damage
Joints are the hinges which connect bones and allow them to move smoothly. The places where moving bones meet are connected and cushioned by cartilage. If the cartilage is damaged or wears away, movement can become restricted and painful.
Osteoarthritis is the most common cause of joint damage, but rheumatoid arthritis, poor blood supply and bone tumors can also damage joints.
Treatment Options
Weight Control
Knee and hip joints support most of the weight of the body. The additional stress caused by excess weight and can cause increased wear or damage to joints. One of the simplest ways to prevent further joint damage is to lose weight.
Exercise
Exercise is one of the best ways to alleviate joint pain caused by osteoarthritis. Exercise reduces pain, increases flexibility and promotes blood flow. Exercise can also help control or reduce body weight, which decreases stress on worn or damaged joints. It is important to avoid over-exercising, which can harm already-damaged joints. "No pain, no gain," doesn't apply in this case. People with joint problems should not exercise so much or so strenuously that it causes pain.
Pain Relief Without Drugs
Moist heat can reduce joint pain and stiffness. A warm bath or shower, a heated pool or whirlpool bath, a heating pad or even a warm, moist towel applied to the joint can all relieve pain temporarily.
Cold can numb painful joints. An ice bag, ice wrapped in a towel, a reusable ice pack or other cold object can be used. There should be a layer of fabric between the cold object and the skin to avoid discomfort.
Insoles that redistribute weight or cushioned shoes to reduce impact and joint stress can also minimize joint pain.
Medicines
Over-the-counter NSAIDS (non-steroidal anti-inflammatory drugs) such as aspirin, acetaminophen and ibuprofen can relieve pain and inflammation in damaged joints. Other NSAIDS in the salicylate, arylalkanoic acid, profen, fenamic acid, pyrazolidine, oxicam, COX-2 and sulphonanilide families can also be effective.
Although NSAIDS are relatively safe, they do have possible adverse side effects, including gastrointestinal and kidney problems. Some combinations of NSAIDS have also been shown to increase the risk of heart attack and heart failure. A physician should determine the choice and dosage of NSAIDS used to alleviate joint pain and inflammation.
Topical creams and sprays which are applied to the skin over a painful or inflamed joint can also be effective. Many of these are based on capsaicin, the naturally-occurring crystalline alkaloid which gives chili peppers their heat.
In some cases, doctors may prescribe stronger medications, such as mild narcotic pain relievers, corticosteroids or hyaluronic acid, to treat joint pain or inflammation.
Surgery
Four types of surgery are most commonly performed to repair joint damage.
- Arthroscopy removes small pieces of cartilage which have worn or broken off and remain inside the joint, where they grind on the joint surface and causing pain with movement.
- Osteotomy cuts and realigns the bone above or below the joint to straighten the limb to even out cartilage wear. This procedure is primarily performed on younger people, and those whose joint damage and limb misalignment is not extreme.
- Partial Joint Replacement resurfaces the worn portion of a knee or hip joint with metal or plastic implant, rather than replacing the entire joint. This procedure can be used when only a portion of the joint is worn or damaged.
- Total Joint Replacement replaces the entire worn or damaged joint with a metal or plastic prosthesis grafted onto the ends of both connecting bones.
When the nature, degree and location of the joint wear or damage permit, minimally-invasive techniques may be used to minimize discomfort and speed healing.
Joint replacement surgery can restore movement and relieve pain to permit people with joint wear or damage to resume routine activities, work and most other movement. Like all surgery, there are risks as well as benefits. Only an orthopedic surgeon can determine if surgery is appropriate, and which type is best in a specific situation.
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