It happens all too often in today’s rushed environment that someone goes in for an appointment for joint pain only to be told that they have arthritis, with no explanation of what that means. Unfortunately, with doctors visits getting shorter and shorter (and in my opinion crappier), there is absolutely no time for patient education. That’s one reason why I book my appointments for an hour at a time, to make sure that everyone understands what is going on and where to go next. So your doctor told you that you have arthritis, now what?

What is arthritis?

Arthritis simply means that the cartilage in a joint has worn away. Cartilage is white and shiny, and if you have eaten chicken wings, then you likely have seen it before on the ends of the bones (you may have even eaten it). Underneath this shiny white cartilage layer is exposed bone, just like any other area on the bone. The problem becomes when the cartilage has worn away and the bones are now touching each other, which usually causes pain with movement. There are different degrees of arthritis, with some people only having a few spots where the cartilage is worn, and others having almost no cartilage left. Unfortunately, once the cartilage is gone, your body has no way of regrowing it.

I was told I have arthritis, do I need surgery?

Possibly the most important thing to know about arthritis is that if you don’t have any pain, then you can just ignore it. It doesn’t matter if it’s in your back, shoulder, knee, hip, or hand, if it doesn’t hurt you, then leave it alone. I’m extremely hesitant to do surgery on someone who isn’t having any pain. The surgery will certainly create pain, and then you will be worse off than you were before. There is a saying in orthopedics that you don’t operate on the x-ray, you operate on the person. Interestingly enough, just because you have arthritis doesn’t always mean you have pain. In fact there are many people walking around with bulging discs in their back, and arthritic knees who don’t even know it! The reason for this is poorly understood, and just shows us how little we know about what causes pain. 

That being said, if the pain in one of your joints is absolutely unbearable, and you can’t live with it anymore, surgery can be a good option if everything else has failed. Surgery for arthritis usually means replacing the joint, such as in the hip or knee. This basically entails cutting out your old knee, and putting in metal where the cartilage used to be with a piece of plastic in the middle. For the right person this is a great surgery, but 20% of people aren’t happy with their knee replacement. 

Is there anything else I can do to help my arthritis?

Once you lose cartilage, there is no non-surgical way to get it back. But, all is not lost. The interaction between arthritis and pain is complex, and there are a few things you can do to help with your pain, even if you have bad arthritis. One way to decrease the pain in your joint is by decreasing inflammation which can be done with a cortisone shot. Some people can get by for years on cortisone shots alone. Also, while difficult, a loss in weight can sometimes be a godsend to your joints both by decreasing the mechanical force, and lowering inflammation. Lastly, your joints were meant to move, keeping them in motion and pursuing moderate exercise will help keep your joints healthy.

I hope I was able to answer all of your questions about arthritis. If I didn’t, then I encourage you to contact me and we can continue the conversation.

– Written by Dr. Daniel Paull