Health Features

Focus On: Joint Health

Joint health is a major concern as we age. According to the Centers for Disease Control and Prevention, one in four adults suffers from arthritis. T&S reached out to SLUCare orthopedic surgeon Dr. Ali Dalal to learn more about what happens to our joints as we get older. “Joint health is directly correlated with independence as we age,” he says. “Often, there is a gradual loss of mobility, and people don’t notice that they are starting to self-select themselves out of activities. At some point, they realize they can’t take care of themselves without assistance or a modified living space.”

causes of joint pain
We develop arthritis and other joint pain as we age for a variety of reasons. “It varies per joint,” Dalal explains. “For example, the most common reason for a bad hip is genetics or a past trauma that might not have been serious enough for surgery but did create the potential for arthritis.” Issues with ankles most commonly arise because of a previous injury, whether it’s a broken bone or damaged cartilage.

The most common joint to have a complication is the knee. “Problems can arise because of meniscus or cartilage injury, and we also know it’s the joint most sensitive to weight gain,” Dalal says. “There is a very strong correlation between being overweight and developing knee arthritis.”

keeping active
“As counterintuitive as it may seem, walking and other activities can prevent joint pain,” Dalal notes. He points to recent research that has shown that walking every day can help prevent discomfort related to knee arthritis. While activity is key to staying mobile, it does vary for each joint. Braces can help support knees and ankles, so function can be retained even with arthritis. “However, once a hip goes bad, there is not a lot a person can do,” he says. “Luckily, hip replacement surgery is one of the most successful interventions we have.”

If you are suffering from joint pain, Dalal suggests avoiding high impact activities like running. If you need a replacement activity, swimming and biking are both good options, especially if you have arthritis in your ankle. If you are worried about your hip, he says flexibility is key. “It’s important to stretch, especially in the early stages of hip arthritis,” he explains. “You experience pain when the joint contracts.”

The shoulder is another joint that commonly has issues, but thankfully, it doesn’t impact mobility as much, according to Dalal. “We don’t put our body weight on our arms or shoulders, so it doesn’t hurt as much when we do strenuous activities,” he says. “You can handle games like pickleball or golf with little to no issue.”

treatment options
The most common treatment for joint pain is a steroid injection. Dalal notes that a lot of people are able to manage their discomfort with an occasional cortisol shot. However, if you don’t experience good results with steroids, he recommends platelet rich plasma (PRP). “The process involves taking a blood sample from the patient, running it through a centrifuge so it concentrates the platelets and then injecting it back into the painful area,” he says. “It doesn’t have the same downsides as cortisol, but insurance does see it as experimental treatment, so patients often have to pay out of pocket. Due to its success as a therapy, the cost has come down significantly.”

If surgical intervention is necessary, recovery varies by joint. People who have had a hip replacement are usually the quickest to return to normal activity, followed by ankle and then knee. “It also depends on the patient,” Dalal says. “We all have different levels of pain tolerance and activity. With joint replacement, 85% to 90% of patients have their expectations met. It’s rare to see a procedure with such high satisfaction rates.”

Dalal recommends consulting a doctor as soon as you notice joint pain. “The longer you’re living with a painful joint, the more function you lose and the harder it’s going to be to get it back, even after surgery,” he explains. “Don’t put off treatment. Many of my patients say their biggest mistake was waiting too long.”

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