Joint pain is one of the key symptoms of arthritis; but the complexity of the human nervous system, the variety of forms of arthritis and the number of conditions presenting with similar symptoms make certain diagnosis and recommending effective treatment very challenging.
Anybody who is suffering from chronic joint pain should be encouraged to see their doctor for a careful examination rather than suffer in silence or attempt self-diagnosis. Some types of arthritis respond well to timely intervention; while other manifestations of joint pain (including referred pain) are linked to unexpected problems elsewhere in the body rendering a few treatments ineffective, counterproductive or even harmful.
Understanding Referred Pain
Referred pain is a pain which occurs in an area apparently unrelated to the source of the pathology causing it. For example, one of the early signs of cholecystitis is sometimes a pain in the right shoulder, or with appendicitis, pain in the center of the belly- around the umbilicus. This is a result of how the nervous system develops with nerves from disparate locations, butsometimes sharing pathways as a result of migration during development. Referred pain is distinct from radiating pain, which starts in one area and spreads out along nerve pathways to affect other areas.
In the case of arthritis, patients will sometimes see their doctor with, for example, a knee complaint. However, after examination and careful diagnostic tests, including X-rays, it may become apparent that there is arthritis in the hip and that the knees are fine. Interventions can then be implemented for the hip, possibly preventing further joint deterioration.
Types of Arthritis and their Causes
Arthritis is sometimes conflated with the natural wearing process that is part and parcel of aging but it is an umbrella term for a collection of dozens of different diseases all involving joint inflammation- including gout and psoriasis. Arthritis can affect any of the joints of the body, from the large joints of the hips and knees to the shoulders, elbows, ankles and the extremities of the hands and feet. Although it generally affects older people, arthritis can appear in young adults and even children (e.g. Still’s disease).
Arthritis is a pervasive illness, affecting all aspects of a persons life from their ability to do their job to their family relationships and their social activities. It is definitely not something to accept as part and parcel of ‘getting old.’
The most common form of arthritis is osteoarthritis (officially osteoarthrosis), which affects the cartilage of the joints and is essentially a wear-and-tear phenomenon. Cartilage is a unique tissue which forms a protective surface between bones, simultaneously absorbing impact while allowing virtually friction-free movement, owing to its smooth surface and a thin layer of the lubricating synovial fluid. In arthritis, the cartilage loses its elasticity and becomes stiff, wearing away and causing bones to come into contact and tendons and ligaments to become stretched. Osteoarthritis is a degenerative condition and patients often end up requiring joint replacement surgery to maintain an active life.
Rheumatoid arthritis (RA), on the other hand, is another form of arthritis which is often distinguished by the symmetry of its symptoms. As well as the common symptoms of joint pain and swelling, rheumatoid arthritis can include pleuritis (pleurisy), which is inflammation of the membrane covering the lung; the formation of nodules under the skin (rheumatic nodules); low-grade fever; fatigue and a condition known as Sjögren’s syndrome, which attacks the mucus-secreting glands of the body- especially the eyes and mouth, leading to dry eyes and mouth amongst other symptoms. RA is an autoimmune disease that may become crippling and requires early, aggressive treatment.
Polymyalgia rheumatica (PMR) and temporal arthritis (TA) often occur together. The PMR usually affects the larger joints and leads to symptoms of joint pain, weight loss, fatigue, stiffness and fever; while TA targets the blood vessels of the head and neck, including the eyes, causing headaches and posing a risk of blindness, TIA or even stroke.
Then there are the poorly understood conditions such as fibromyalgia, which often present with symptoms which are similar to arthritis, including joint pain and fatigue, although the pain tends to be more diffuse, mostly around the neck and shoulders.
Pros and Cons of Joint Pain Treatments
There are several different methods of treating the various forms of arthritis, mainly focused on relieving symptoms and slowing disease progression. These range from anti-inflammatory and pain medications to exercise and lifestyle changes to supplements and joint replacement surgery. Pioneering stem cell and regenerative medicine research is also opening up a whole new field of opportunity for researchers looking into developing regenerative therapies for arthritis and other orthopedic conditions.
Giving up smoking and losing weight is recommended for all those with arthritis who smoke or who are overweight. Reduction of 11 pounds reduces the chances of developing osteoarthritis by 50 per cent according to some studies. Exercise can also be of significant benefit as long as the right type of activity is undertaken. Water-based exercise, such as swimming and water aerobics, helps to support the joints; while walking and cycling can also be beneficial. Jogging and running are not recommended for the weight-bearing joints, owing to the significant impact on those joints.
Several types of supplement have been found to be helpful by some patients including chondroitin sulfate and glucosamine. The latter, often obtained from the exoskeletons of shellfish, can help to replenish fluid and encourage the construction of cartilage but is slow acting. Ginger has been found to have an anti-inflammatory effect; and local injections of synthetic hyaluronic acid (a lubricant and shock absorber) and steroids have been popular with orthopedic surgeons.
Medications are available for the treatment of joint pain and include aspirin and acetaminophen for mild pain and non-steroidal anti-inflammatory medicines (NSAIDS) such as ibuprofen, naproxen and celecoxib, a selective NSAID. However, many of these medications come with possible side effects and some (not mentioned) have even been withdrawn from the market after reports of unacceptable side-effects in a few patients. Corticosteroids are used to reduce inflammation but these are only suitable for short-term interventions due to side effects, including damage to bone tissue by osteoporosis.
Although the treatments above can relieve joint pain and sometimes slow the advance of arthritis, most people with the condition eventually end up electing for replacement operations whereby the degraded joint is replaced by a synthetic (plastic and metal) prosthesis. This can offer a new lease of life to arthritis patients but, despite advances in surgery, there is a risk of complications including infection, leading in rare circumstances to death.
The Role of Stem Cells in Orthopedic Therapy
Stem cells are a specialized type of cell that can both replicate and differentiate into different tissue types. Depending on their type, stem cells can be encouraged to grow into nerve cells, blood elements, bone, skin, cartilage and many other types of tissue.
We all have stem cells within our bodies and these are activated in response to injury. However, they are often in insufficient numbers or are unable to migrate to the site of injury to fully repair damage, especially with advancing age. Some current research looks at ways to extract and redeploy a patient’s own stem cells to potentially repair damaged tissues. The Gulf Coast Stem Cell and Regenerative Medicine Center employs a quick and safe technique for harvesting a stem-cell-rich liquid from adipose (fat) tissue, also rich in growth factors and cytokines, and deploying it locally into the affected joint. By stimulating the body to heal itself, using its own cells and signaling molecules, medical providers hope to ease symptoms and prolong the life of existing joints, ultimately (hopefully) reducing the need for replacement surgery altogether.
If you are, or someone you know is living with an orthopedic condition affecting joints, such as arthritis, we invite you to contact one of our friendly, professional team on (866) 885 4823. We also have more information on orthopedic conditions and stem cell deployment for research on our website at http://www.gulfcoaststemcell.com