Joint Wear: Causes, Diagnosis, and Care Tips

Joint wear and tear

Dr.
Chen: Hello.
I have been hiking for over ten years, but in the past two years, I have started to feel discomfort in my knees when going downhill.
Last week, both of my knees became red, swollen, painful, and made noise, and my legs were a bit swollen.
I visited a nearby internal medicine doctor who prescribed pain medication and recommended seeing an orthopedic specialist.
Today, I finally saw the orthopedic doctor, who listened to my concerns and examined my knees, stating that I have joint degeneration.
He prescribed pain medication again and advised me to stop hiking, limit stair climbing, and rest more, suggesting that I return if I experience further discomfort.

I have a few questions:
1.
How can I determine the extent of my joint degeneration? What tests are necessary?
2.
Can I recover just by taking pain medication and resting?
3.
How should I take care of my joints in the future to prevent further deterioration?
Thank you! Perhaps you could recommend a book for me as well.
Thank you!

Shuhua, 40~49 year old female. Ask Date: 2002/11/02

Dr. Chen Xingyuan reply Orthopedics

Dear Shuhua,
There are many reasons for knee joint pain, but based on your description, it is highly likely that the pain is due to overuse leading to joint inflammation.
The knee joint experiences greater pressure when bearing weight, going up and down slopes, or squatting.
If the cartilage on the joint surface is worn or damaged, it can easily lead to pain and inflammation.
A knee arthroscopy can clearly observe the internal changes in the joint, but this is a more invasive procedure.
Generally, an X-ray of the knee can be taken first to understand the condition of the knee bones.
Knowing the underlying cause of the problem is essential for the best prevention.
Therefore, if the inflammation is due to overuse, it is important to rest and avoid excessive use.

While pain-relieving and anti-inflammatory medications can effectively alleviate symptoms, medication is only part of the treatment.
It should be used cautiously, with the goal of allowing the knee joint to heal or preventing further deterioration.
Additionally, soaking the knee in warm water or applying heat can serve as a form of care to maintain the joint in optimal condition.
If you enjoy exercising, swimming is a good option to consider.

Professor Hou Sheng-Mao from National Taiwan University’s Orthopedics Department has authored "A Doctor's Friend," which introduces many common orthopedic conditions in an easy-to-understand manner and may serve as a useful reference.
For now, you can try the medication, reduce activities that increase the burden on your knee joint, and continue with warm water soaks or heat application.
If symptoms do not improve, you should return for a follow-up consultation in the orthopedic clinic.
Wishing you peace and health!
Sincerely,
Dr.
Chen

Reply Date: 2002/11/02

More Info

Hello! Thank you for your questions regarding joint wear, particularly in your knees. It sounds like you have been experiencing some discomfort and are seeking a better understanding of your condition, as well as ways to manage it effectively. Let’s break down your concerns one by one.

1. Understanding the Degree of Joint Wear
To determine the extent of joint wear, also known as osteoarthritis or degenerative joint disease, several diagnostic tests can be performed. While your doctor has already conducted a physical examination, additional imaging studies can provide more detailed information about the condition of your knee joints. Here are some common diagnostic methods:
- X-rays: These can show the presence of bone spurs and the narrowing of joint spaces, which are indicative of osteoarthritis.

- MRI (Magnetic Resonance Imaging): This is more detailed than X-rays and can visualize soft tissues, including cartilage, ligaments, and menisci. An MRI can help assess the degree of cartilage loss and any other potential injuries.

- Ultrasound: This can be used to visualize the joint and assess for fluid accumulation or inflammation.

Discuss with your orthopedic specialist about the necessity of these tests based on your symptoms and physical examination findings.

2. Recovery with Pain Medication and Rest
While pain medications can help alleviate discomfort, they do not address the underlying issue of joint wear. Rest is crucial, especially if you are experiencing pain during activities like hiking or climbing stairs. However, simply relying on pain medications and rest may not lead to complete recovery.
A comprehensive approach to management is often recommended, which may include:
- Physical Therapy: A physical therapist can design a tailored exercise program to strengthen the muscles around your knee, improve flexibility, and enhance overall joint function. This can help reduce pain and prevent further deterioration.

- Weight Management: If applicable, maintaining a healthy weight can reduce stress on your knees, which is particularly important for individuals who engage in high-impact activities.

- Activity Modification: As advised by your doctor, reducing activities that exacerbate your symptoms (like hiking downhill) is essential. Gradually reintroducing low-impact exercises, such as swimming or cycling, can be beneficial.

3. Joint Care and Prevention of Further Deterioration
To prevent further joint wear and maintain knee health, consider the following strategies:
- Regular Low-Impact Exercise: Engage in activities that do not put excessive strain on your knees. Swimming, cycling, and walking are excellent options.

- Strength Training: Focus on strengthening the muscles around your knees, including the quadriceps and hamstrings. Stronger muscles can provide better support to the joint.

- Flexibility Exercises: Incorporate stretching into your routine to maintain joint flexibility and reduce stiffness.

- Proper Footwear: Invest in supportive shoes, especially when engaging in physical activities. Proper footwear can help align your body and reduce stress on your knees.

- Diet and Nutrition: A balanced diet rich in anti-inflammatory foods (like omega-3 fatty acids found in fish, nuts, and seeds) can support joint health. Staying hydrated is also important.

Recommended Reading
For further understanding of joint health and management strategies, I recommend the book "The Arthritis Foundation's Guide to Good Living with Osteoarthritis." This book provides practical advice on managing arthritis, including exercise, nutrition, and coping strategies.

In conclusion, while pain management is essential, a multifaceted approach that includes physical therapy, lifestyle modifications, and possibly further diagnostic testing will provide the best chance for long-term relief and joint health. Always consult with your healthcare provider before making significant changes to your treatment plan. Wishing you the best on your journey to recovery!

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