Joint Pain & Osteoarthritis
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You avoid stairs, because your knee burns. Maybe you can’t play tennis anymore, or even stand or sit for too long. Even walking the dog hurts. What used to come and go has become a constant part of your life. Joint pain that doesn’t give you a day off: You could have osteoarthritis.
Osteoarthritis can take over your life. But it doesn't have to. At UVA, we can help you manage everything from small aches to grating pain. Our specialists work with you to understand how your joint disease is affecting you.
Our goal is to help you move as pain-free as possible.
Joint Use + Time = Pain
Osteoarthritis, or degenerative joint disease, doesn’t happen overnight. You’ve been moving your whole life. Eventually, the cartilage that cushions your joints wears down. Bone grinds on bone. That’s why you experience:
- Soreness
- Dull ache
- Burning
- Stiffness
- Swelling/inflammation
- Redness
- Tenderness
Joint Pain That Gets in the Way
Just because arthritis is common doesn’t make it less tiring. It saps your energy and drive and:
- Makes it hard to focus on your work
- Interrupts your sleep
- Leads to weight gain, which only hurts your joints worse
- Damages your balance, increasing your risk of falls
- Causes you to lose the flexibility you need to stay active
It’s no surprise that your mental health might suffer. What started out as some pain becomes a disability.
If you experience depression, talk to your primary care provider. They can help you find the resources you need.
"Wear and Tear" Arthritis
Osteoarthritis is a “wear-and-tear” form of arthritis. Over time, simple tasks like standing up become painful. Orthopedic surgeon James Browne, MD, discusses osteoarthritis symptoms and the treatment options available at UVA.
So when we think about osteoarthritis, we think about wear and tear of the joint. If you think about your car, the more you drive it, the more you use it, the more the parts start to wear. And ultimately, they fail. It's the same thing with hip joints and knee joints. As we age, we accumulate, wear and tear, we accumulate damage and that can lead to pain, stiffness, and functional problems in the joint. There have been a number of studies, linking body weight to osteoarthritis. So we do think that there's an association between weight and wear and tear on the joints, which is why we recommend weight loss for a lot of patients. Weight loss can not only help with the symptoms, but it's possible that it could potentially reduce the amount of wear and tear on the joint over time as well. We also see trauma as a factor in why patients ultimately develop osteoarthritis. Patients who have a significant injury to the hip joint, or a significant injury to the knee joint may damage the cartilage and that can lead to wear and tear and arthritis over time as well. Whether it's the hip joint or the knee joint, pain, stiffness, and functional problems are common presenting symptoms. So for many patients, it's a soreness that maybe doesn't go away, or it's sometimes it's a sharp pain that they notice with increasing frequency. We think in the adult hip joint, that subtle malalignment contributes to arthritis. If the hip joint, if the ball and socket is just slightly out of alignment, over time, that can lead to accelerated wear and tear. We do occasionally see some patients that have substantial deformity of their knee joint, which is troublesome or can lead to some functional problems. There may be an alignment issue as well. If the knees are slightly out of alignment that can lead to accelerated wear and tear. Ultimately for many patients, it gets to the point where they say that they need to do something about it and look into it. That's typically where we get an x-ray. So whether it's hip arthritis or knee arthritis, we always recommend that patients exhaust non-surgical options before considering joint replacement surgery. Non-surgical options are things like weight loss, over the counter medications, like Tylenol and anti-inflammatories, physical therapy, injections. Cortisone injections into the hip joint for many patients can relieve the symptoms substantially and allow them to continue to function and do what they need to do on a day-to-day basis. So non-operative measures are certainly the mainstay of treatment. It's only after those things have failed, that we start considering joint replacement.
Is it Osteoarthritis?
Fracture, infections, and autoimmune diseases can cause joint pain. An X-ray or MRI can show cartilage damage and help distinguish your condition from other forms of arthritis, like rheumatoid arthritis.
An X-ray can show:
- How much wear and tear exists
- Whether or not osteoarthritis is the cause
- If we need to do further investigation to find the source of the pain
At UVA, our radiologists and orthopedic specialists use high-level technology to identify the root of your pain.
Osteoarthritis Knee Pain
The most common symptoms of knee arthritis are pain and stiffness. You might find it especially hard to walk, climb stairs, and get going after sitting for a long time. Some people experience:
- Buckling, when the joint gives out
- Locking, when the joint stops moving
Osteoarthritis Hip Issues
Pain is the main symptom of osteoarthritis in the hip. You might think you have a groin pull. You might have a little discomfort at night. Over time, the pain progresses. Some people describe a deep, dull ache that doesn't go away. You could also experience:
- Locking
- Grinding
- Limping
- Trouble walking upstairs
- Being unable to stand or sit for long periods
- Difficulty putting on socks and shoes
Osteoarthritis in the Shoulder
Shoulder arthritis shows up as pain that:
- Keeps getting worse
- Shows up everywhere, or just in the back or top of the shoulder
- Stops you from lifting your arm
- Makes a grinding, clicking, or snapping sound
- Hurts badly at night, so you can't sleep
Who Gets Osteoarthritis?
Millions of people of all ages get osteoarthritis. Some people learn to live with it.
But for many, they're too young, too busy, and too invested in activities to just limp along.
Are you in pain but not quite middle-aged? Sometimes, the wearing down happens faster because of:
- Weight – if you’re heavier, your joints do more work and see more stress
- Injury – trauma can start the breakdown of cartilage
- Alignment – joints even a little out of line use up cartilage faster
Osteoarthritis Treatment at UVA Health
Exploring what works best for your body and your life takes time. Choosing the best treatment can feel daunting. No matter what course you pursue, our experts will be with you. We'll help you choose the best treatment for you.
You'll get the highly skilled and compassionate care so many patients trust. We offer:
- Pain management through medicine: Medication can ease all levels of pain. Some antidepressants, as well as anti-inflammation drugs, can help.
- Injections: Cortisone, steroids, and hyaluronic acid all play a role in treating joint pain. Cortisone and steroids reduce inflammation, improving pain and movement.
- Surgery: We only do surgery as a last resort. Painful arthritis that's hurting your daily life could need a surgical solution. But not everyone qualifies for joint replacement.
Osteoarthritis Joint Replacement
About 90-95% of hip and knee replacements in the United States are from osteoarthritis. When nothing relieves your joint pain, and you can't have fun or do work like you used to, joint replacement might be the answer.
But surgery is a big decision. We only recommend that you consider surgery after all other efforts have failed. And your arthritis and symptoms need to be severe enough to benefit from joint replacement and justify the risks of surgery.
Learn more about joint replacement surgery.