Understanding Chronic Joint Pain

Chronic joint pain is common in the United States, where 30 to 50 percent of adults suffer from severe arthritis, nerve trauma, injuries, and inflammation affecting the joints. Joints are present everywhere in your body where two skeletal bones meet. However, joint pain is usually felt in the hands, wrists, feet, knees, hips, or spine. 

In chronic or severe cases, the discomfort caused by joint pain is enough to interfere with basic day-to-day activities and overall quality of life. If you or someone you know suffers from chronic joint pain, schedule a consultation with a joint pain doctor, such as a rheumatologist, with specialized training in conditions that involve bones, muscles, and joints.

Joint pain symptoms can vary from person to person, depending on the root cause. For some people, joint pain may be constant, while for others, it may be intermittent. Your joints may feel mildly achy, sore, or stiff, or your pain may feel like a burning, throbbing, or grating sensation. In some cases, joint pain or stiffness is worse in the morning but eases with activity and movement. In other cases, pain can worsen with activity.  

Nerve-related joint pain is different from orthopedic joint pain. If you have nerve pain in your joints, you may experience:

• Burning
• “Electric shock”
• Zinging radiating pain that moves away from the joint
• Joint pain that wakes you up at night
• Skin sensitivity over the joint

The most common cause of joint pain is osteoarthritis (arthritis). Osteoarthritis is when the cartilage that provides a protective cushion between two bones wears away over time. Chronic joint pain can also result from numerous other conditions, such as:

• Rheumatoid arthritis (RA): a chronic disease that can cause joint swelling, pain, and deformity.
• Gout: a condition where crystals from the body collect in a joint such as the big toe, causing severe swelling and pain.
• Viral infection: such as hepatitis B or C.
• Trauma: such as overuse, injury, or surgery.
• Nerve damage: caused by trauma or surgery.

Nerve-Related Joint Pain

When nerves are directly injured by trauma or surgery, the affected nerve can send pain signals to the brain, even if there is no apparent reason for the pain – for example, structural damage to the joint. Nerve-related joint pain can be either acute (appearing suddenly) or chronic and long-lasting. 

In most cases, joint pain occurs when a joint is injured by trauma or overuse. In the case of nerve-related joint pain, orthopedic surgery or trauma can increase the risk of an occurrence. Joint pain is more common in individuals who:

• Have previous or recurring joint injuries
• Repeatedly use or overuse a muscle or motion
• Have been diagnosed with arthritis or rheumatoid arthritis
• Are overweight
• Are aging

To ensure a proper diagnosis, your doctor will perform a physical examination, ask about your medical history, and may request additional tests. They will also look for signs of injury to the muscles, tendons, and ligaments surrounding the affected area.

Additional testing may include imaging, which will allow your doctor to see joint deterioration, bone spurs, fluid, and other possible causes of your pain, or minimally-invasive procedures. Some of the most commonly used methods for diagnosing joint pain or nerve-related joint pain include:

• EMGs: Electromyography (EMG) measures the health of muscles and the nerve cells, known as motor neurons, that control them.
• X-Rays and/ or MRI: magnetic resonance imaging uses magnetic fields and radio waves to create an image.
• Tinel’s sign test: a test where the nerve is gently tapped to assess nerve damage.
• Nerve block: an injection around a nerve to block pain. If a nerve block is successful, it indicates that the pain is nerve-related.
• Blood test: to rule out viral infections or other diseases that may be causing pain.

Your joint pain doctor may first recommend conservative treatment for alleviating pain before moving on to more aggressive treatment options. Common conservative treatments for joint pain may include:

• Heat or ice
• Changes to exercise routine
• Anti-inflammatory and/ or pain medications
• Weight loss
• Dietary supplements, such as glucosamine
• Topical medicines such as creams or gels (over-the-counter or prescription)
• Braces, canes, or other supportive aides
• Physical therapy
• Steroid injections

If the pain does not respond to conservative forms of treatment, your doctor may recommend surgery. At the Institute for Advanced Reconstruction, we offer multiple surgical procedures to address chronic joint pain, including:

Arthroscopy: a procedure wherein your surgeon will use microsurgical instruments to repair cartilage or remove bone chips near the affected joint.

Joint replacement: typically done on hip, knee, and shoulder joints and involves removing part of your bone and implanting an artificial joint.

Nerve reconstruction: a surgical procedure that works to eliminate pain signals from affected joints. During a denervation or nerve reconstruction surgery, a surgeon will remove or redirect the nerves that are sending pain signals to your joints.

Nerve decompression: a surgical procedure that either removes the bone or tissue causing pressure on a nerve or opens up any narrow space around the nerve to provide more room.

The Institute for Advanced Reconstruction participates in a wide range of insurance plans, including those listed below. However, each physician has their own accepted insurance and hospital affiliations. Before scheduling an appointment, please contact your insurance carrier to confirm that your provider is in-network.

If we are not an in-network provider, our friendly insurance specialists will help you find the most coverage available for your treatment. 

• Horizon Blue Cross Blue Shield of New Jersey
• Medicare
• Railroad Medicare
• Aetna
• Cigna
• United Healthcare
• Oxford (Freedom, Liberty)
• MagnaCare

If your joint pain is persistent, lasting longer than 3 months, and has not responded to conservative forms of treatment, you may be a candidate for advanced chronic joint pain treatments, such as nerve reconstruction or decompression surgery.