Causes for Joint Pain and How to Know When You Need a Joint Replacement

Our joints play an important role in helping us walk, run, bend and stretch with ease. Yet, for millions of people around the world, joint pain can be an unwelcomed companion. Whether brought on by injury, wear and tear or a chronic condition, joint pain can seriously impact a person’s quality of life. Dr. Rafael Serrano, UnityPoint Health, explains what can cause joint pain and when it might be time for a joint replacement.

What causes joint pain?

Dr. Serrano says there are two types of joint pain:

• Pain that’s a result of an injury. This type of pain is commonly seen in the emergency room from an injury playing sports and usually impacts the ligaments (tough and flexible bands of tissue that bind bones together and stabilize joints) and/or meniscus (wedge-shaped cartilage that acts as a cushion in the knee joint).
• Chronic pain. This is typically from arthritis (an inflammatory disease) or a degenerative meniscus (the deterioration of cartilage in the knee joint).

What helps relieve joint pain?

There are several treatments that can give your joints some relief and improve joint function. However, the best way to know what’s most effective for your joint pain is to identify the underlying cause. Dr. Serrano suggests the following to ease joint pain:

• Physical therapy. A physical therapist can create a personalized plan to strengthen muscles around the impacted joint, improve flexibility and reduce pain.
• Tylenol or Ibuprofen. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) can help reduce pain and inflammation in the joints. In some cases, your doctor may prescribe strong pain relievers for certain types of arthritis.
• Injections: Injecting corticosteroids or hyaluronic acid into the impacted joint can reduce inflammation and increase joint lubrication.

“When conversative treatments fail, that’s when you and your doctor can talk about surgery,” Dr. Serrano says.

Thumb Joint Pain

• What causes thumb joint pain? The most common cause of thumb joint pain is arthritis of the thumb. There are different types of arthritis, but this can include degenerative joint disease, where the cartilage that cushions the joint wears away, or rheumatoid arthritis, an autoimmune disease that can affect multiple joints leading to pain, swelling and joint damage.
• How to relieve thumb joint pain? Dr. Serrano says NSAIDS, injections and a brace or splint can help relieve thumb joint pain. Some additional pain relief techniques to try include icing the thumb, heat therapy, gentle range-of-motion exercises instructed by a healthcare professional or physical/occupational therapy. 

Shoulder Pain

• What causes shoulder joint pain without injury? Most non-traumatic shoulder pain is caused by the rotator cuff or arthritis. In the case of a rotator cuff issue, this can be as a result of an inflamed tendon or tear. Dr. Serrano says shoulder pain can also be the result of something called referred pain. This can be confusing, because the location of the pain doesn’t match up with the location of the problem. Examples of this may include neck pain that’s felt in the shoulder.
• How to relieve shoulder joint pain? Dr. Serrano says physical therapy and injections are often the first line of options to get relief from shoulder joint pain. If the pain persists, a healthy rotator cuff can be fixed with a minimally invasive procedure. Otherwise, a shoulder replacement or reverse shoulder replacement are options depending on the underlying medical issue.

Sacroiliac (SI) Pain Causes and Treatment

• Where does SI joint pain hurt? The sacroiliac joint, known as the SI joint, doesn’t behave as a normal joint, says Dr Serrano, because it barely has any motion. It connects the pelvis to the lower spine and helps with bearing the weight of our bodies for things like standing, walking and running. SI joint pain or inflammation, known as sacroiliitis, can show up as pain in the lower back, hip or buttock. Dr. Serrano says common causes likely stem from other areas of the body, such as an issues with the lumbar spine, spondylitis, arthritis in the hip or pregnancy-related pelvic pain.
• How do you sit with SI joint pain? Sitting with SI joint pain can be frustrating and challenging. Sitting for too long can make the pain worse for some people, too. While Dr. Serrano says there’s not necessarily a correct way to sit, there are several strategies for sitting that can reduce discomfort, including:
  • Using a chair with lumbar support
  • Sitting up straight
  • Using a pillow or cushion to sit
  • Changing positions

Knee Pain

What’s the difference between knee surgery and knee joint replacement surgery?

Total knee replacement (TKR) and partial knee replacement (PKR) are two different surgeries to address knee joint problems.

• A TKR involves replacing the entire knee joint, including the thigh bone, shin bone and part of the kneecap, with artificial components.
• A PKR is when only a portion of the knee is replaced. This includes the inside, outside or front part of the knee, leaving the healthy parts of the knee intact.

Dr. Serrano says arthritis or an injury are the two biggest reasons someone might need a total knee replacement. 

What is total joint replacement?

A total joint replacement is when a damaged or arthritic joint is replaced with an artificial joint during surgery. It’s most often performed on the hip or knee but can impact other joints, such as the shoulder, elbow or ankle.

“During surgery, the damaged or worn-out surfaces giving the patient trouble are removed and a new surface is inserted that gives patients significant pain relief and better quality of life,” Dr. Serrano says.

What should you consider before having joint replacement surgery?

Before considering joint replacement surgery, Dr. Serrano says it’s best to control symptoms for any other health conditions you’re struggling with, such as diabetes, heart issues or obesity.
“You really want to control and treat any risk factors before surgery, because it could affect the outcome of the joint replacement. Anytime you have surgery, there’s risk of infection or other complications. Sometimes, symptoms can get better to the point where the person doesn’t need a joint replacement,” he says.

How long does it take to recover from joint replacement surgery?

Dr. Serrano says the recovery time for every joint replacement surgery is different, and powerful pain control methods are available to make recovery easier, such as nerve blocks, local anesthetics and more. Typical recovery times include:

• Thumb joint replacement: Several weeks
• Shoulder replacement: 6 weeks
• Knee replacement: 3 months, although a PRK is faster
• Hip replacement: 6 weeks

If you’re experiencing joint pain that isn’t responding to treatment and reducing your quality of life, talk to your doctor about next steps and the possibility of joint replacement surgery.