Arthritis treatment Tempe: why is your joint sore?

What may be causing this soreness?

Osteoarthritis often brings an ache during use and stiffness after rest. Some swelling may come and go as the day passes. It doesn't need to feel the same from one day to another.

An old injury can also leave a joint sore years later. A tendon is the tough cord that joins a muscle to a bone. Where the ache sits and when it starts help a doctor tell them apart.

What can I do at home today?

Move the joint only as far as feels safe and steady. Warm water can ease early stiffness before you start moving. Cold may calm swelling that appears after a busy part of your day.

Rest when soreness or swelling rises, but don't stay still all day. Several short walks may feel better than one long walk. Before using pain medicine, ask whether it is safe with your other pills.

When should I have it checked?

Arrange a visit when the ache keeps returning or interrupts your sleep. A nurse or doctor will ask which movements bring on the soreness. The exam checks how far the joint moves and where it feels tender.

Get prompt care if the joint becomes hot, very swollen, or stiff with fever. An injury that keeps you from standing also needs quick help. An ache that changes fast can't wait for a routine visit.

Sources

1. CDC estimated 58.5 million US adults (23.7%) reported arthritis in 2016-2018 and 25.7 million reported arthritis-attributable activity limitation - 43.9% of everyone with arthritis. Arthritis has been the most frequently reported main cause of disability among US adults for more than 15 years and was responsible for more than $300 billion in direct and indirect annual costs in 2013.

   Theis KA, et al. — Prevalence of Arthritis and Arthritis-Attributable Activity Limitation - United States, 2016-2018.. MMWR Morb Mortal Wkly Rep, 2021. DOI: 10.15585/mmwr.mm7040a2.

2. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-efficacy and self-management programmes, tai chi, cane use, hand orthoses for first-CMC joint OA, tibiofemoral bracing, topical NSAIDs for the knee, oral NSAIDs and intra-articular glucocorticoid injections for the knee; acupuncture, thermal modalities, radiofrequency ablation, acetaminophen, duloxetine and tramadol are only conditional.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis Rheumatol, 2020. DOI: 10.1002/art.41142.

3. OARSI designates arthritis education plus structured land-based exercise (with dietary weight management for the knee) as CORE treatments for knee, hip and polyarticular OA. Topical NSAIDs are Level 1A for knee OA. Intra-articular corticosteroids, intra-articular hyaluronic acid and aquatic exercise are Level 1B/2 for the KNEE only and are NOT recommended for hip or polyarticular OA. Acetaminophen is conditionally not recommended, and no oral NSAID is recommended for people with cardiovascular comorbidity or frailty.

   Bannuru RR, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.. Osteoarthritis Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

4. In a randomized trial of 156 US Military Health System primary-care patients with knee osteoarthritis, physical therapy beat glucocorticoid injection at one year: mean WOMAC total scores were 37.0 with physical therapy versus 55.8 with injection (mean between-group difference 18.8 points, 95% CI 5.0 to 32.6, lower is better), with secondary outcomes in the same direction.

   Deyle GD, et al. — Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee.. N Engl J Med, 2020. DOI: 10.1056/NEJMoa1905877.

5. CMS covers autologous platelet-rich plasma ONLY for patients with chronic non-healing diabetic, pressure and/or venous wounds, and only when the patient is enrolled in an approved clinical research study under the coverage-with-evidence-development National Coverage Determination. There is no national Medicare coverage for PRP in osteoarthritis of any joint.

   Centers for Medicare & Medicaid Services — Autologous Platelet-rich Plasma (Coverage with Evidence Development). CMS Coverage with Evidence Development, 2014.