Tag Archives: joints

Joint Griefs

May 22, 2015 by

This article originally appeared in May/June 2015 edition of 60-Plus.

If you’ve never complained of knee pain, consider yourself lucky. The knee is the largest joint in the body and one of the most commonly injured.

While acute or overuse injuries are the most common causes of knee pain, arthritis is also a common source of discomfort.

To avoid knee pain and injuries, there are some things you can do to help keep your knees healthy and strong, says Dr. Beau Konigsberg, an orthopedic surgeon at Nebraska Medicine.

One of the most important of these is to maintain a healthy weight, says Dr. Konigsberg. Losing as little as 5 percent of your body weight can dramatically reduce your chances of developing knee arthritis, which is the most common cause of knee pain among people in their 60s and 70s, says Dr. Konigsberg. It is estimated that every extra pound you pack on puts about four extra pounds of pressure on your knees.

Staying active is also key to keeping the knee joint supple and to prevent injury, he says. A knee that isn’t used stiffens and the muscles around it will weaken.

Maintaining flexibility, as well as regular strengthening exercises is also important. Focus on the muscles and tendons that connect directly to the knee, such as the hamstrings and the quadriceps, which help support the knees and reduce stress on the knee joints.

There has also been a lot of attention in the news surrounding glucosamine and chondroitin. “While there have been no studies that have proven these supplements can regrow cartilage or slow the degenerative process,” says Dr. Konigsberg,  “some people swear that they provide some relief of knee pain.”

If knee pain becomes debilitating, it might be time to consider a knee replacement. Thousands of knee replacements are performed each year, and for many people, they provide significant relief and a return to mobility, notes Dr. Konigsberg. If you have lost weight, tried anti-inflammatories and cortisone injections and still have significant pain that may be waking you up at night, it may be time to consider a knee replacement.

“A knee replacement is considered only after all other treatment options have been exhausted,” says Dr. Konigsberg.

For 70-year-old Dennis Chin, a knee replacement allowed him to resume his favorite pastime—playing golf. Chin had injured his knee several times in high school sports and had undergone several arthroscopic knee surgeries.

Over the years, the pain in his knee returned and gradually got worse. When he retired, he stepped up his golf game, which made the pain worse. “I was using my club as a crutch and taking Aleve everyday,” he says.

But when the pain began waking him up at night and he could barely get through a golf game, Chin knew he had to do something. Dr. Konigsberg took X-rays and said there was so much damage that his only real option was a knee replacement.

Chin had a knee replacement in January 2013 and was back on the golf course by March. Now he plays five times a week and sometimes twice a day.

“I have no pain and I’m not limping anymore,” says Chin. “No one can even tell that I had an operation.”

Chin couldn’t be happier. He’s doing what he loves and that’s what retirement is all about.


Managing Osteoarthritis

November 10, 2013 by

It might start simply with a few nagging aches and pains. Your knees are hurting more; your shoulders are bothering you; your back is aching. Perhaps these pains have even caused you to cut back on some of your hobbies or affected how you spend your free time: Maybe you’re gardening less or your golf swing’s not as good.

Osteoarthritis, also known as degenerative arthritis, can and will eventually affect everyone. That sounds rather ominous. “Degenerative arthritis is a term that is generally used and obviously differs from rheumatoid arthritis, which is an auto-immune disease,” explains Dr. Michael Morrison of Omaha Orthopedic Clinic and Sports Medicine. “But degenerative arthritis is the same as wear and tear and is associated, just simply, with the aging process.”

Dr. Morrison says that, generally, people in their 50s and 60s will start to feel the aggravating pains and experience the swelling of joints, though these symptoms can occur much later. He shares that some people may experience an accelerated condition 
due to genetics.

While the aging process as a whole leads to the aches and pains we experience, how we choose to exercise can affect the condition as well. High-impact activities, such as running and jumping, are hard on the joints. “Most people believe that if they start to get some aches in their joints, they can just exercise through them, but that probably irritates it more,” says Dr. Morrision. While exercise is always recommended for good health, he suggests lower to no-impact activities, such as swimming, bicycling, or even using 
elliptical machines.

To combat the pain that you already may be feeling, Dr. Randall Neumann of OrthoWest recommends starting out with over-the-counter anti-inflammatory remedies, such as ibuprofen or acetaminophen, to lessen the pain. Dr. Morrison also recommends herbal supplements as a good addition to the OTC regimen: “I’m a big believer in it.” He suggests trying glucosamine MSM. Glucosamine is found naturally in the body and helps with keeping joints healthy. He also recommends SAM-e and drinking cherry juice.

“I’ve seen them help many patients,” Dr. Morrison says. “But what works for one person might not work for another, so you are going to have to experiment with those and see what can give you the most relief.”

If OTC medicines are not providing enough relief, your physician can prescribe an anti-inflammatory that has a somewhat stronger dosage. However, Dr. Neumann cautions against medicating too liberally. “You can take pain pills, but we like the non-narcotic pain medication, such as Tramadol,” he says. “Most physicians are going to shy away from anything as far as narcotic for pain because they all have addicting potential.”

Physician-administered injections into the problem joint are also an option: Cortizone shots work as an anti-inflammatory and hyaluronic acid injected into the joint acts 
as a lubricant.

Finally, joint replacement surgery is an option for those who have end-stage disease, says Dr. Neumann. “These people are hurting, they have pain everyday, and their function is down. They have a hard time working, walking, going up and down stairs, and just having a miserable time in life.” The joint replacement procedure involves replacing the natural joint with a metal and plastic device. “You could still have some soft-tissue pain around there, but usually the pain from wear and tear arthritis is because bone is rubbing on bone there, and it causes an 
inflammatory response.”

Generally, says Dr. Morrison, the time frame for surgery, healing, and rehab is between four to six weeks. Knee replacements tend to involve a little more intensive rehab than hip replacements.

Osteoarthritis can affect joints in the upper extremities (such as shoulders, wrists, elbows) as well, but “is not usually brought on as quickly as in the weight-bearing joints,” Dr. Morrison clarifies.

“The decision to progress with anything surgical is strictly based on the patient’s inability to manage their pain, despite all conservative measure, and their quality of life is significantly hindered,” adds Dr. Morrison. “It is not based on what an x-ray looks like; it is based on the symptoms presented by the patient.”