What Causes Joint Pain?

Perhaps you recently experienced a twinge of joint pain and dismissed it as an inevitable part of aging.  More likely, what you felt was a warning that something is amiss in your lifestyle.  Of course, some wear on joints is inevitable with aging, although it might be a challenging point on which to persuade an 85-year old that still runs marathons in under 4 hours.  Nationwide, the number of people age 70 and older that participated in triathlons grew by 168% between 2009 and 2017.

If you have experienced one of those unwelcomed joint pain twinges, you likely felt it the first time while walking on a sloping surface, squatting, jumping or running. Under each of those situations, the effective weight on the knees and hips increases significantly, and the possibility for a twinge of pain increases if the joint isn’t healthy.

Under the best of lifestyle conditions, joints should remain healthy for a lifetime.  Except for injuries, autoimmune diseases, and a few rare medical conditions, the cause of the first twinge is usually lifestyle, and the best cure is often a change of lifestyle.  Fortunately, the bones and soft tissues (cartilage, ligaments, and tendons) that joints are formed from gain their strength from what we eat, stimulation from regular use, and periods of rest for rebuilding.  Of course, if joint deterioration has progressed too far, a lifestyle change will not be sufficient.  At that point, orthopedic surgeons can often repair or replace joints that have worn beyond the point of recovery.  Unlike cars, replacement parts for the human body rarely measure up to our original equipment.  Just know that your original equipment may be the best you will ever have.  That makes taking care of what you have a very wise investment in quality of life.

The most common cause of joint deterioration is excess body weight.  While occasional heavy loads on our joints are seldom a problem, a constant load of excess body weight stresses joint and causes progressive wear that the body can’t recover from.  The fat associated with excess weight also takes a toll on joints by creating inflammatory factors that affect not only the joints under stress but also other joints, especially finger joints.

The negative effect of excess weight on knees and hip joints is more than you might suspect.  Overweight women may have 4 times the risk of knee osteoarthritis (OA).  For overweight men the risk may be 5 times greater.  People in the highest quintile (top one-fifth) of body weight have up to 10 times the risk of knee OA compared with those in the lowest quintile (lowest one-fifth).

Now the good news, for a woman of average height, for every 11 lb of weight loss (approximately 2 BMI units), the risk of knee OA is reduced more than 50%.  For protecting joints, no medication or medical procedure has the advantages weight loss offers.

As a rule of thumb, adding one pound of abdominal weight effectively adds about four pounds of additional weight to the knees.  In practice, depending on the activity, the range of effective weight on joints can between 3 and 20 pounds for each additional pound of abdominal fat.

While losing weight tops the list of preventative measures for avoiding joint pain, there are more ways to reduce the risk for joint pain and to minimize the discomfort without resorting to pain medications or surgical procedures.

  1. Lose weight.  Losing a few pounds can go a long way toward reducing the pressure on the knees and hips. A sustained 10 to 15-pound weight loss significantly reduces the risk of osteoarthritis later in life.
  2. Strengthen muscles.  This helps muscles absorb stress and also helps stabilize joints. It’s best to work with a physical therapist that can evaluate your needs and develop an individualized strengthening program that’s right for you.
  3. Increase range of motion.  Most lose range of motion as they age due to decreased activity.  Regaining and maintaining range of motion with appropriate stretching is worth the effort.  People that maintain their range of motion have fewer joint problems.
  4. Avoid high-impact activities.  When recovering, avoid jogging and exercises that involve jumping.  Walking and non-impact exercises are better choices.

While joint injury and lifestyle are the root cause for most joint problems, they are not the only cause.  Other causes generally involve inflammatory conditions caused by Lyme disease, lupus, rheumatoid arthritis, etc.  Tumors rarely impact joints, but when they do, they are usually benign and can be removed by surgery.

Fortunately, joint pain often goes away without treatment.  Unlike the warning provided by the canary in the coal mine, you may be left with the feeling that all is well because there was no lingering reminder.  Just know that when joint pain appears, it’s usually a heads up that you are due for a lifestyle change.

An excellent first step toward heading off joint pain in life is a daily walk that incorporates a full range of stretching.  Take that daily walk in a natural setting (park, greenway, etc.) and you will have made it even better.  Don’t believe it?  Well, join me Saturday morning for a walk around the lakes and I’ll make you a believer.

Nancy Neighbors, MD

A Few Tips For Getting Started

            From the physical therapist at Austin Physical Therapy, here are a couple of tips you may find helpful.

            In case you were wondering, the above information is not a paid advertisement from Austin Physical Therapy.  No service I refer patients to or mention in my newsletters pays for being recommended.  When I like a service I’m likely to mention it. My referrals can’t be bought.  They are earned by providing my patients with good service.

Published by Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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