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Joint Pain: Q&A with Dr. Joseph Borrelli

If knee or hip discomfort is changing how you live, don’t accommodate it — do something about it.

Surgery isn’t your only option. Any of several conservative measures may help you find relief from joint pain, but if nonsurgical methods are insufficient, total joint replacement can be a wonderfully effective solution.

Dr. Joseph Borrelli, Jr.

Dr. Joseph Borrelli, Jr.

AreYouAWellBeing.com recently asked Joseph Borrelli Jr., M.D., orthopedic surgeon at Orthopedic Medicine Specialists, a Texas Health Physicians Group practice, and a physician on the medical staff at Texas Health Arlington Memorial Hospital, about joint problems’ common causes and symptoms, conservative treatments he typically recommends, and when joint replacement is appropriate.

Question: What is the culprit for most of the joint pain your patients report?

Dr. Borrelli: Osteoarthritis — long-term deterioration of the cartilage in the joints — is responsible for most patients’ joint symptoms. Certain individuals may develop painful joints due to post-traumatic osteoarthritis that occurs as a result of an injury, such as a fracture. Post-traumatic osteoarthritis can take quite some time to develop, depending on the amount of cartilage disruption. A small percentage of patients may experience joint discomfort due to rheumatoid arthritis, but this condition usually presents far in advance of joints wearing out.

Question: What are the most common joint symptoms you see?

Dr. Borrelli: In the knees, pain and stiffness, particularly when getting out of bed or a chair, are typical complaints. Swelling in the knees is common, too, but can be hard to discern in the hips. Patients often mention feeling a grinding sensation in the knees.

True hip pain typically presents in the groin area. Often, patients come in holding their hands on their hips, near their pants pockets, and say, ‘This is where it hurts,’ but pain in that area is usually due to bursitis or a back issue.

Question: What nonsurgical treatment options do you typically recommend for joint pain?

Dr. Borrelli: Once cartilage in the hips is gone, we can’t do much nonsurgically. The knees, whether in early or mid-stage cartilage deterioration, can benefit from physical therapy to strengthen the muscles or from reducing weight on the knees. Weight reduction can be helpful, as can engaging in weight-bearing exercise that doesn’t stress the knees, such as using an elliptical machine. Other pain-relieving options include oral medications and injections.

Question: When is joint replacement appropriate?

Dr. Borrelli: Once an individual has exhausted, within reason, all means of conservative management, he or she should consider joint replacement. This is a very good operation when performed well for the right indications. If there’s one thing artificial joints do, it’s take away pain; pain relief is where these joints make the biggest difference in patients’ lives. However, joint replacement is a big surgery that requires lots of commitment to postoperative rehabilitation, so patients should carefully weigh the decision to have the procedure in consultation with their orthopedist.

How much is knee or hip pain hurting your quality of life? To find out, take the Texas Health Knee & Hip Risk Assessment.

Physicians employed by Texas Health Physicians Group practice independently and are not employees of the hospital or Texas Health Resources.

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