When our joints make life difficult - and what we can do about it

Which joints cause the most pain?
Large, weight-bearing joints such as the hip and knee joints are susceptible to osteoarthritis with advancing age and are often painfully affected. Shoulder pain is also not uncommon, usually caused by inflammation of soft tissue. The small intervertebral joints of the spine also cause back pain in many people and pain in the thumb-saddle joint is very common from the age of 50.
Should joint pain always be seen as a warning sign?
Fortunately not! But if the pain persists for a long time and/or at night, or if the joint is stiff for a long time in the morning, a specialist assessment should definitely be carried out.

What are common causes of joint pain?
Such pain is most frequently caused by wear and tear of the joint cartilage (osteoarthritis) or inflammation of the surrounding soft tissue, e.g. bursae. Joint capsule pain in people with congenital joint hyperextensibility (hypermotility) is also common but often unrecognised. Approximately 3% of the population suffers from an inflammatory cause. The most common is metabolic pseudogout or chondrocalcinosis, which is "related" to gout, which is also common. Rheumatoid arthritis, which affects 1% of the population and can lead to disability without treatment, is also not uncommon.

Is joint pain rare in young people?
Unfortunately not. Inflammatory joint diseases can also occur in young people, even children. Inflammatory rheumatism in children and adolescents is often aggressive and requires rapid and effective anti-inflammatory therapy.

Are there particularly severe forms of joint disease?
Yes, in the case of metabolic joint diseases, large joints such as the shoulder or knee joint can be completely destroyed, so that only the use of a joint prosthesis can help. In large weight-bearing joints, especially the hip joint, an infarction of the joint head, known as head necrosis, can also occur, which also requires prosthetic treatment.

Do people with joint disease have to put up with the pain for the rest of their lives?
No, this should no longer be the case in this day and age.
In cases of chronic back pain, we often successfully use targeted infiltration of the small vertebral joints under X-ray control, followed by physiotherapy. Great progress has also been made in joint prosthetics over the last 20 years. It is often the case that patients who have been plagued by severe hip arthrosis and severe pain for years are able to walk again without pain within a very short time after a hip prosthesis has been fitted.

Don't the examinations take an infinitely long time before a diagnosis can be made?
We usually diagnose an inflammatory joint or soft tissue disease in our outpatient arthritis consultation on the same day. In addition to the clinical examination and the laboratory, we have highly sensitive ultrasound equipment at our disposal, which allows us to view the joints and inflammatory processes with millimetre precision. The categorisation of an inflammatory disease sometimes takes a little longer, as we have to wait for laboratory results. However, we usually make a diagnosis within 2-4 weeks.

What happens once the cause of the joint pain has been found?
We then discuss all relevant findings with the patient. After a joint choice of treatment, we inform the patient about the risks and the necessary follow-up checks. We also discuss the physiotherapeutic and physical options, particularly in the case of soft tissue and osteoarthritis pain. Physiotherapy and, for example, the application of heat or water therapy, play a very important role here, and we therefore also discuss this treatment and the course of therapy with our physiotherapists. If severe osteoarthritis is found to be the cause of pain, e.g. in the knee, we utilise the interdisciplinary services available in-house and refer the patient to the "University Orthopaedics Clinic at Bethesda Hospital" on request.