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Oh, my aching...

By Dr. Stephen T. Duncan from March 2014 Issue

Joint pain has become so com-mon that one-third of respondents in a recent national survey reported joint pain that affected their quality of life in the preceding 30 days.

What causes my joints to ache all the time?
Joints form the connections between bones. Sandwiched between the bones are bands of smooth, slippery tissue called cartilage. When cartilage breaks down from disease, injury, or age, the gliding surfaces between the cartilage and the bone become rough—much like a strand of yarn that frays and breaks as it is rubbed against wood. This "grinding" or bone-on-bone rubbing leads to inflammation, which can be painful enough to interfere with normal, daily activities.

Obesity compounds the problem. Kentucky is the sixth-most obese state in the country. Joint pain increases with obesity, since the joints of obese people carry more weight than they are designed to bear.

At what point should I be worried about joint pain?
If your joints hurt for more than a few weeks, consider seeing a doctor, who can review your medical history, examine you, and use technology such as X-rays to determine the cause of your joint pain.

Will I need surgery?
Surgery is a last resort. First, your doctor looks for ways to reduce pain and inflammation while maintaining joint function. That often requires you to temporarily avoid activities that make the symptoms worse, while at the same time follow a program to strengthen the muscles that support the affected joints. Weight-loss strategies also improve joint pain by decreasing the stress placed on these joints.

What about taking medicine?
Your doctor may suggest over-the-counter medications such as ibuprofen or naproxen sodium that are intended to reduce inflammation. If your symptoms persist despite these measures, your physician may recommend an injection of numbing medication into your joint and a steroid (a more powerful anti-inflammatory) to reduce the joint inflammation. If the pain persists despite these lifestyle changes and medications, the next step might be a discussion about joint replacement.


DR. STEPHEN T. DUNCAN specializes in joint reconstruction, resurfacing, and hip preservation at UK HealthCare's Department of Orthopaedic Surgery.