More than half of adults will end up with osteoarthritis at some point in their lives regardless of their age, though it generally sets in after age 50. While it may affect various joints, like your spine, hips, or hands, it most commonly shows up in your knees. What begins as a nagging but minor soreness gradually progresses in stages to a debilitating pain that limits your mobility and lifestyle. Regardless of what degree of osteoarthritis you have, it’s important to maintain a healthy weight in order to keep as much pressure off your joints as possible.
If you have osteoarthritis (OA), the sooner you begin treatment to manage your symptoms the better. Dr. Jay M. Shah at the Samwell Institute for Pain Management is renowned for his treatment of osteoarthritis and his expertise in the field of interventional pain management. That means he specializes in pain-blocking techniques that can make your day-to-day life less painful. Depending on how far your OA has progressed, Dr. Shah recommends different treatments and lifestyle adjustments.
The beginning stages of OA are often so mild you might not even feel it. At this stage, it's unlikely it will show up on an X-ray, which makes it hard to diagnose. The primary characteristic of OA is the wearing down of your cartilage, the slippery tissue that cushions the bones in your joints and allows them to slide against one another smoothly.
When that cartilage is damaged or missing, your bones start to rub against each other with no protection in between, which causes the signature OA pain. But in phase 1, the damage is still minor, so the pain is minor as well. Over-the-counter, nonsteroidal anti-inflammatory drugs (NSAIDs) are often all that’s needed to relieve the discomfort.
Once you’ve begun to develop little bone growths in your joint (called osteophytes), you’re well into phase 2. Dr. Shah can now detect the thinning of your cartilage on an X-ray and see that your bones have begun to thicken and develop osteophytes. This is the reason you’ve started feeling stiffness in addition to increased pain.
Dr. Shah may start you on a physical therapy regimen to make sure the supporting structures around your knee remain strong and stable. NSAIDs can also help on days when the pain is worse. In some cases, he might offer a knee brace or a shoe insert to ease your discomfort.
When your cartilage loss progresses, and you’ve lost most of the cushion between your bones, you’re in phase 3. Your bones get thicker and thicker, and those osteophytes begin to grow outward. Naturally, inflammation becomes a problem, causing swelling and more pain. The synovial fluid that once lubricated your joint now revs up production, increasing the swelling as well.
If your pain is intense at this phase, Dr. Shah may prescribe medication to alleviate it as you work toward adopting physical therapy and daily activity routines that increase your mobility and decrease your pain, including corticosteroid or hyaluronic acid (“gel”) injections. These are designed to calm down the swelling and bring you significant pain relief.
At its worst, OA completely wears out your cartilage so you have nothing left but bone on bone. This is the most advanced stage of the disease and it becomes difficult for you to walk or stand at all. The stiffness and inflammation are constant now, and the friction is worse than ever.
To help manage your pain at this severe stage, Dr. Shah can give you a nerve block around the knee, an injection of anesthetic and anti-inflammatory medications that stops your nerves’ impulses from sending pain messages to your brain and central nervous system. To provide long term pain relief for up to one year, Dr. Shah may perform a radiofrequency rhizotomy procedure to these nerves around the knee, and when used in conjunction with other methods such as physical therapy or acupuncture, it can be a great tool in your treatment plan. Radiofrequency rhizotomy is also an effective treatment for persistent knee pain after knee surgery or replacement.
Whether you’re just beginning to notice symptoms of OA or have been dealing with it for years, Dr. Shah can help you manage and overcome the pain in your knees. Call us to set up a consultation or book an appointment online at either of our New Jersey locations.
