Identifying causes of joint pain

Published Oct 21, 2014

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QUESTION: My dad is 67 years old and suffers from terrible pain in his left leg due to arthritis. He can barely walk at times. What is the best medication you would recommend, do you think it could be his bones and when should we consider X-rays? What else could also affect his walking?

 

ANSWER: Thanks for your sincere e-mail and appropriate questions. Products such as Osteoeze Gold, Procydin, Spirulina and many more, are used daily by thousands of people who claim that they not only assist with prevention of joint degeneration, but also help in acute cases.

Science still maintains that the prime contributory factors remain genetic, activity and diet. Like any good machinery, maintenance is essential. The oil needs to be changed and the load on the joint spaces well-regulated to prevent injury.

 

The treatment of arthralgia (joint pain) remains a major challenge in the medical field. The problems have become controversial for many different reasons. Here are a few of the challenges facing your doctor.

 

The causes:

There is a multitude of causes for joint pain, besides the ever common conditions such as rheumatoid arthritis, osteoarthritis and gout.

Reactive joint pain after infections such as a sore throat and influenza is not uncommon while overtraining and poor diet also plays a significant role. Large campaigns dedicated to protecting the joints seem to have made an impact on active and sedentary people as products like chondroitin and cartilage enhancers move rapidly off our pharmacy shelves.

A gradual increase in workload instead of the sudden “high-impact” comeback to training is an important point to remember.

Along with the biokinetics of exercise comes the environmental factors such as terrain (hard tarred roads and grass), jogging versus swimming or cycling. The corporate identity of hard flat-point shoes for males and the daring stilettos or platforms for women are forces that drive our struggle against joint pain.

There are family histories of joint pain and abnormal bone metabolism. Osteoarthritis from ageing and wear-and-tear is very common and leads to significant mechanical joint pain. Degeneration of the vertebrae of the spine compounded by dehydration of the discs has debilitating effects on mobility and agility.

 

The diagnosis:

When consulting your doctor, remember to describe the onset, course and duration of joint pain. Ensure your diagnosis is correct before agreeing to take medication chronically. No drug is without side effects. We use the age of onset, types of joints involved, as well as the radiological (X-ray) picture to guide us in making an accurate diagnosis. Raised uric acid levels in gout and rheumatoid factor, as well as the inflammatory markers such as the ESR (Erithrocyte sedimentation rate) and C-reactive protein (CRP) levels.

It is good to know that there is a group of conditions which physicians commonly refer to as “connective tissue” disorders. These are often systemic illnesses or syndromes that include joint involvement. Some are caused on an auto-immune basis. A simple example is systemic Lupus erythematosus or “Lupus”, which is very common among the coloured female population in the Western Cape.

 

What about children?

Joint pain in young children is often mistreated and ascribed to growing pains, parents should be vigilant. Flagged conditions that shouldn’t be missed include juvenile rheumatoid arthritis, Kifoscoliosis and septic arthritis. The life-threatening medical emergency called septic arthritis should never be missed. We see this in young children under 5 years when they present with a sudden limp or painful gait due to ankle or hip pain.

 

The must-do hit list:

l Diet: Eat foods rich in omega-3 fatty acids, pain-fighting polyphenols and vitamins C, K and D.

l Don’t ignore pain.

l Move to improve joint pain. Exercise triggers the production of lubricating synovial fluid and feel-good brain chemicals, and improves joint pain.

l Weight: Take pressure off your knees, and reduce hip and back pain.

l Work with your doctor: an orthopedic specialist or physical therapist may be better equipped to tailor an effective pain-treatment plan.

l Pace yourself avoid activities that aggravate your joint pain.

l Use a daily pain diary to note the activities that worsen or improve your joint symptoms. – www.realage.com

 

Why treating joint pain is controversial:

l Correct diagnosis pertaining to the cause of the problem.

l Differentiation between disease modification or symptomatic treatment.

l Consideration of co-morbidities and individual patient profile.

l Side-effect profiles of medication.

l Drug interactions that follow.

l Addiction to painkillers.

Cape Argus

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