Don't Let
Joint, Arthritis & Muscle Pain
Slow You Down!

eGuide

There are over 100 joints in the human body which are designed to give a broad range of motion to the body. There are several different types of joints in the human body:

• Ball and Socket - A ball and socket joint allows for radial movement in almost any direction. The are found in the hips and shoulders.
• Saddle - A Saddle joint allows movement back and forth and up and down, but does not allow for rotation like a ball and socket joint. They includes the fingers and toes.
• Hinge - A hinge joint allows extension and retraction of an apendage. They include the elbows and knees.
• Pivot - A pivot joint allows rotation around an axis. The neck and forearms have pivot joints.
• Gliding - A Gliding, or plane, joint allow bones to slide past each other. This includes the midcarpel and midtarsal joints.

Cartilage covers the bones at the joints and provide a smooth surface for the bones to glide across; thus acting as a natural shock absorber. Pain, loss of mobility, deformity and dysfunction can all reasult from the grinding of bones in a joint that has lost cartilage.

The joint cavity has a capsule that allows for movement yet is strong enough to prevent dislocation. The synovium inside of the capsule produces a think fluid which lubricates and nourishes the joint. Inflammation of the synovium can damage the bone and cartilage.

What is Joint Pain?

Joint pain occurs in one or more joints where a form of trauma, either injury or other condition, is present.  Some common causes of joint pains are as follows:

• Unusual exertion or overuse which can include strains or sprains
• Osteoarthritis which is a wearing of the cartilage in the joints
• Septic arthritis which is an inflammation of the joints from a bacterial invasion
• Autoimmune disease such as lupus and rheumatoid arthritis. 
• Tendonitis which is an inflammation of the tendon
• Injury such as a fracture
• Bursitis which is an inflammation of the fluid sac around a tendon
• Infectious disease such as influenza, measles, Rheumatic fever, Epstein-Barr, Hepatitis, Mumps, Rubella, and Varicella
• Gout which is a metabolic disease that attack the joint leaving uric acid deposits
• Osteomyelitis which is a bone infection usually bacterial
• Chondromalacia patellae which is a softening of the cartilage in the knee

What is muscle pain?

Muscle pain usually involves tendons, ligaments and surrounding soft tissue. While they don’t always, muscle pain can also involve multiple muscles at the same time.  Most muscle pain is from overuse, tension or injury from exercise or physically demanding work.  There is usually a specific muscle involved and the pain usually starts during or shortly after the activity.  The pain can also be a sign of an underlying condition, such as the arthritis or even the flu. 

Some causes of Muscle pain include:

• Fibromyalgia
• Polymyositis
• Dermatomyositis
• Polymyalgia rheumatica
• Rhabdomyolysis
• Electrolyte imbalances such as too little potassium or calcium
• Drugs such as cocaine, statins for lowering cholesterol such as atorvastatin, simvastatin and lovastatin, ACE inhibitors for lowering blood pressure such as enalapril and captopril, and many others

If the muscle pain is a result of injury, restoring proper muscle tone with regular exercise such as walking, cycling and swimming can help.  Stretching, toning and aerobic exercises can help as long as the exercise is started slow and increased gradually without high impact aerobics or weight lifting well in pain or during an injury.  Reducing stress and getting plenty of sleep with yoga, meditation or other methods can lower the pain.  If the pain is from an underlying condition, you should treat that condition.  Some ways to prevent pain are listed below.

• If you work in the same position most of the day such as sitting at a computer then stretch at least every hour
• Warm up before exercising and cool down afterward
• Stretch before and after exercising
• Drink lots of fluids before, during, and after exercise

What is Arthritis?

Arthritis is the most common type of joint disorder. The cartilage that cushions the bones at the joint wears away and leads to pain and stiffness. Although factors are known to lead to osteoarthritis, such as aging, metabolic, genetic, chemical and mechanical factors, there is no known cause. Osteoarthritis is extremely common in people over the age of 70. However, between the ages of 55 and 70, more females develop it than men. Prior to the age 55, it is equally common in both sexes.

There are two main types of osteoarthritis - primary and secondary. Primary osteoarthritis occurs without any injury or identifiable cause; whereas, secondary osteoarthritis is usually due to another disease or underlying condition. Patients often experience long term limited mobility due to osteoarthritis. While function can improve with treatment, there is no overall cure for arthritis.

Types of Arthritis

There are over 100 types of arthritis affecting over 46 million Americans.

Achilles tendinitis Achondroplasia Acromegalic arthropathy Adhesive capsulitis Adult onset Still's disease Ankylosing spondylitis Anserine bursitis Arthritis of Ulcerative colitis Avascular necrosis Behcet's syndrome Bicipital tendonitis Blount's disease Brucellar spondylitis Bursitis Calcaneal bursitis Calcium pyrophosphate dihydrate Caplan's syndrome Carpal tunnel syndrome Chondrocalcinosis Chondromalacia patellae Chronic recurrent multifocal Osteomyelitis Chronic synovitis Churg-Strauss syndrome Cogan's syndrome Corticosteroid-induced osteoporosis Costosternal syndrome CREST syndrome Cryoglobulinemia Crystal deposition disease Degenerative joint disease Dermatomyositis Diabetic finger sclerosis Diffuse idiopathic skeletal hyperostosis Discitis Discoid lupus erythematosus Disease of bone Drug-induced lupus Duchenne's muscular dystrophy Dupuytren's contracture Ehlers-Danlos syndrome Enteropathic arthritis Epicondylitis Erosive inflammatory osteoarthritis Exercise-induced compartment syndrome Fabry's disease Familial Mediterranean fever Farber's lipogranulomatosis Felty's syndrome Fibromyalgia Fifth's disease Flat feet Foreign body synovitis Freiberg's disease Fungal arthritis Gaucher's disease Giant cell arteritis Gonococcal arthritis Goodpasture's syndrome Gout Granulomatous arteritis Hemarthrosis Hemochromatosis Henoch-Schonlein purpura Hepatitis B surface antigen disease Hip dysplasia Hurler syndrome Hypermobility syndrome Hypersensitivity vasculitis Hypertrophic osteoarthropathy Immune complex disease Impingement syndrome Jaccoud's arthropathy Juvenile ankylosing spondylitis Juvenile dermatomyositis Juvenile rheumatoid arthritis Kawasaki disease Kienbock's disease Legg-Calve-Perthes disease Lesch-Nyhan syndrome Linear scleroderma Lipoid dermatoarthritis Lofgren's syndrome Lyme disease Marfan's syndrome Medial plica syndrome

Metastatic carcinomatous arthritis Mixed connective tissue disease Mixed cryoglobulinemia Mucopolysaccharidosis Multicentric reticulohistiocytosis Multiple epiphyseal dysplasia Mycoplasmal arthritis Myofascial pain syndrome         Malignant synovioma Neonatal lupus Neuropathic arthropathy Nodular panniculitis Ochronosis Olecranon bursitis Osgood-Schlatter's disease Osteoarthritis Osteochondromatosis Osteogenesis imperfecta Osteomalacia Osteomyelitis Osteonecrosis Osteoporosis Overlap syndrome Pachydermoperiostosis Paget's Palindromic rheumatism Patellofemoral pain syndrome Pellegrini-Stieda syndrome Pigmented villonodular synovitis Piriformis syndrome Plantar fasciitis Polyarteritis nodosa Polymyalgia rheumatica Polymyositis Popliteal cysts Posterior tibial tendonitis Pott's disease Prepatellar bursitis Prosthetic joint infection Pseudoxanthoma elasticum Psoriatic arthritis Raynaud's phenomenon Reactive arthritis/Reiter's syndrome Reflex sympathetic dystrophy syndrome Relapsing polychondritis Retrocalcaneal bursitis Rheumatic fever Rheumatoid arthritis Rheumatoid vasculitis Rotator cuff tendinitis Sacroiliitis Salmonella osteomyelitis Sarcoidosis Saturnine gout Scheuermann's osteochondritis Scleroderma Septic arthritis Seronegative arthritis Shigella arthritis Shoulder-hand syndrome Sickle cell arthropathy Sjogren's syndrome Slipped capital femoral epiphysis Spinal stenosis Spondylolysis Staphylococcus arthritis Stickler syndrome Subacute cutaneous lupus Sweet's syndrome Sydenham's chorea Syphilitic arthritis Systemic lupus erythematosus Takayasu's arteritis Tarsal tunnel syndrome Tennis elbow Tietse's syndrome Transient osteoporosis Traumatic arthritis Trochanteric bursitis Tuberculosis arthritis Undifferentiated connective tissue syndrome Urticarial vasculitis Viral arthritis Wegener's granulomatosis Whipple's disease Wilson's disease Yersinial arthritis

Signs of Arthritis

Some common symptoms and signs are listed below.

• Gradual, subtle onset of deep aching joint pain that is worse after exercise or weight bearing and often relieved by rest
• Morning stiffness
• Joint grating with movement
• Joint swelling
• Limited movement
• Joint pain in rainy weather
• There may be no symptoms
• Limited range of motion
• Tenderness
• Loss of joint space
• Wearing down of the bone ends
• Bone spurs
• Decreased ability to walk
• Decreased ability to perform activities of daily living such as personal hygiene, household chores or cooking

Comfort and Exercise Tips

There are many ways to increase comfort if you suffer from Arthritis. 

• Weight loss - Every pound overweight adds four times the stress on the knees.  Therefore even a pound of weight loss can add a big releif and 11 pounds can cut the risk of developing osteoarthritis by 50 percent. 
• Eating proper portions - A serving of meat is 3 ounces or the size of a palm.  A serving of dairy is 2 ounces of cheese or the size of a pair of dominoes and a serving of vegetables is one cup or the size of a fist.
• Eating better - This includes boosting calcium intake and avoiding fast food.  If fast food is a must, go with grilled instead of fried, lettuce and tomato instead of mayo, a salad instead of fries with a little dressing and water instead of soda.  Increasing vitamin C and antioxidants in meals can also reduce the risk of osteoarthritis.  Increasing fish intake can help joint pain.  Eat precut fruits and veggies for a snack.  Grazing throughout the day is better than three big meals in that it boosts the metabolism.  Lower caffine intake can help bones. 
• Watching less television - Television slows the metabloism and encourages being sedentary or laziness
• Getting outside - The fresh air is relaxing and adds ways to burn calories. 
• Take a load off your joints - Exercising in a pool is a great way to exercise with less pressure on your joints
• Hiking - This burns calories, builds denser bones and strengthens muscles. 
• Proper shoes are very important - Shoes should be flexible and supportive with squared or rounded toes, rubber soles and flex at the ball. 
• Lighten Up - If joints still ache two hours after a workout then next time lighted your routine. Work up towards heavier exercises, starting slowly.
• Stretch - Keep your muscles and ligaments flexible and strong by stretching throughout the day even at the office. 
• Yoga, Pilates or tai chi - Keep joints strong, muscles limber and ease stress
• Lifting weights - Help stabilize and protect joints with stronger muscles and denser bones
• Get advise from a trainer - Learn how to exercise properly to prevent joint injury and stress. 
• Avoid Feet pounding exercises - kickboxing and step aerobics are tough on joints 
• Soak -A warm bath after exercising helps to sooth aching joints and muscles.
• Reduce neck strain - Use eye level document holders on the monitor and hands free telephone headsets. 
• Sit properly at the computer - 20-26 inches from the monitor with the top of the monitor and the top of the head level.  Also have arms at sides with right angled elbows and wrists relaxed while typing. 
• Wear Flats - Heels can add stress to the knees and a three inch heel adds seven times the foot stress of a one inch heel. 
• Move Around - Sitting or standing all day can lock the body in one position.  So moving about every 30 minutes or so can help.  
• Massages - Relieve muscle tension and lower fatigue by getting a massage

Treating Arthritis

Treatment varies with the location of arthritis.  However, the goals remain the same - pain relief, improve or maintain mobility, improve strength, and reduce disabling affects. 

Nonsteroidal antiinflammatory drugs(NSAIDs), such as ibuprofen, aspirin and naproxen, are the most common medication used on osteoarthritis.  They reduce pain and swelling but have side effects such as abdominal or stomach cramps, pain or discomfort, diarrhea, dizziness, drowsiness, swelling feet, gastrointestinal bleeding, headaches, indigestion, heartburn, nausea, vomiting or peptic ulcers.  The risk of serious blood clots, heart attacks and stoke are increased when on these drugs and the risk is greater if cardiovascular disease already exists.  Patients on long term NSAIDs should have blood counts and liver enzymes checked periodically.

COX-2 inhibitors, such as vioxx, celebrex and bextra, are also used to treat osteoarthritis.  COX-2 inhibitors were believed to work as well as NSAID, but with less stomach problems.  However, the risk of heart attack and stroke is so great that certain medications have been removed from the market or recommended to have the lowest dose for the shortest duration possible.
Corticosteroids, such as decadron, are injected in order to reduce pain and inflammation but have side effects of bruising, cataracts, elevated cholesterol and triglycerides, elevated blood sugar, hardening of the arteries, hypertension, increased appetite, indigestion, insomnia, mood swings, muscle weakness, nervousness, restlessness, osteoporosis, susceptibility to infection and thin skin. 

Synvisc and Hyalgan are artificial joint fluid that can be injected into the knee.  The side effects include injection site pain, swelling, itching, heat or redness of the joint and headaches. 

Surgery may be needed in severe cases to replace or repair the joint. The options are arthroplasty partial or total replacement with an artificial joint. Arthroscopic surgery may be needed to trim cartilage and wash out joint.  An osteotomy relieves stress by changing the alignment of the bone.  Arthrodesis fuses the bones usually in the back.  Some risks and other considerations to surgery are listed below.

• Strain of surgery may be too much for someone with other medical conditions, even if they are under control.
• Blood clots may develop.
• If the patient is overweight it may add stress to the heart and lungs during surgery.
• The surgery is only a success after several weeks of recovery which is a lot of effort.
• The cost is very high.

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