Joint pain – how an early intervention helps?


As someone who helps the patient get rid of their pain, I am often surprised how many people just keep ignoring their joint pains until it becomes much worse. There is an understanding that something like this should be just accepted as part of aging. However, this acceptance of pain can often lead to much more adverse circumstances, which could have been easily avoided through early diagnosis and intervention. The most common reason for joint pains is arthritis, although sometimes injuries to the tissues such as tendons and ligaments can also cause the pain.

Arthritis is a generic term that has more than 100 different forms! Arthritis word came from the combination of two Greek language words, namely Arth (joint) and Itis (inflammation), hence inflammation of the joints. The most common types of arthritis include Osteoarthritis, Rheumatoid Arthritis and other forms such as Gout.[1] Among all the forms, Osteoarthritis is the most common disease that impacts mainly the knee and hip joints. It is a degenerative disease that becomes severe with age. It is estimated that approximately 25% adults of 60 years or above i.e. every one in four suffers from some limitation due to Osteoarthritis. [2, 3]

India is still a relatively young country in terms of median age compared to developed countries. United States data reports that nearly 49% adults of 65 years and above reported a doctor diagnosed arthritis. Therefore, as the median age of India increases, the incidence of this disease is also likely to grow. [4] The prevalence of Rheumatoid Arthritis is much less i.e. less than 1 person in a pool of 100 people suffers from RA. More women get affected by RA than men, i.e. nearly three times more.

Difference between Osteoarthritis and Rheumatoid Arthritis

Osteoarthritis Rheumatoid Arthritis
Time of pain: You will mostly find that the pain and stiffness are reduced when you wake up, but as the day goes by, the motion becomes difficult and painful. Time of pain: You would typically find that the joints are stiff and painful when they get up, but as they go about the daily activities, it becomes better.
One-sided: One of your knee or hip joints begin to give more problems in the initial stages. Symmetrical: RA in most cases impacts the same joints on both left and right side of the body.
Larger Joints: Osteoarthritis mostly impacts the larger joints such as knee and hip joint. Smaller Joints: RA first targets the small joints like the knuckles etc.
Age of onset: It usually manifests at the later age after you have crossed 45-50 years. Age of Onset: RA can get triggered anytime but most likely between when someone is 30-40 years old.
Impact Area: Localized pain but the patient does not have general fatigue.Damage is localized to the affected joint. Impact Area: Causes systemic inflammation and symptoms such as dry eyes, muscle aches, lumps,etc. RA affects the whole body functioning.
Disease Type: Degenerative disease that leads to the loss of cartilage which makes joint motion difficult. Disease Type: Auto-immune disease in which body attacks its synovial tissue that covers the joints.

Please note that these are by no means a fixed set of rules to differentiate and distinguish one type of arthritis from the other, but the most likely characteristics of each disease.

Why mild joint pain should not be ignored

If one is suffering from a persistent pain in any of their joints, the longer you ignore it, the more severe the disease is likely to become. Instead, one should think about consulting either an orthopedic expert or rheumatologist to first diagnose the reason for the joint pain. Any number of reasons are possible including the diseases mentioned above, or you may have accidentally injured a connective tissue like a tendon or ligament.

Benefits of early diagnosis and intervention

One of the primary benefits of early diagnosis is that you begin to get a suitable treatment for the disease. Be aware that neither Osteoarthritis nor Rheumatoid Arthritis and many other forms of Arthritis are not completely curable.

However, with the right treatment, you can delay the disease progression to a great extent. This would help you live a relatively pain-free and active life for longer, as well as avoid the need to undergo more invasive treatments that involve surgeries such as hip or knee replacement. There are many types of conservative treatments available for both types of diseases.

Cost of early-stage diagnosis

Once you visit an orthopedic expert or rheumatologist in your area, he or she may suggest few tests. For instance, if the doctor suspects you may be suffering from an auto-immune disorder, few blood tests may be advised such as the ESR, CRP, and the RA-Factor. The cost varies from place to place, but all of these tests put together costs somewhere between Rs 1000 to 1200.

If the doctor suspects Osteoarthritis, then the most typically recommendation is to get an X-Ray, which can show if there is any narrowing of space between joints, bone spurs growth,etc. Sometimes, when the disease is in early stages, X-Ray may not show enough details to the doctor. In such cases, an MRI may be suggested which displays the damage to any soft tissues like cartilage and other structures.

An X-Ray may cost approximately a few hundred rupees, depending on the diagnostic center. However, MRI is relatively costlier ranging anywhere from Rs 3500 to Rs 7500, again varying based on diagnostic facility.

Have a question?

Feel free to ask us for any help or information here!

References:

  1. http://www.cdc.gov/arthritis/basics/index.html
  2. http://www.recentscientific.com/sites/default/files/2133.pdf
  3. http://www.japi.org/july2005/U-634.pdf
  4. http://www.cdc.gov/arthritis/data_statistics/arthritis-related-stats.htm
  5. http://www.ncbi.nlm.nih.gov/pubmed/8310203
  6. Photo Credit: http://news.stanford.edu/news/2014/april/images/13763-walking_news.jpg
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