Joint pain is a huge burden for those affected. Orthopedist Dr. Heribert Konvalin answers the most important questions about causes and therapy.
With age, the shock absorber in the body hinges wears out. Fortunately, there is help. The renowned orthopedist and sports medicine specialist Dr. Heribert Konvalin practices in the MVZ Helios Munich and answers the most important questions.
Interview with Dr. Heribert Konvalin
Why are joints so vulnerable?
Because they are so flexible and at the same time resilient. The joints that bear the weight, such as the knees, hips and ankles, are particularly stressed and are therefore the most vulnerable. The problems usually begin after 40: The hyaline (glassy) cartilage, which acts like a shock absorber, wears out and becomes thinner. On the one hand, age is to blame, but obesity, malpositions and one-sided posture also cause problems for the joints.
What are warning signs?
Typical signs are a feeling of tension and stiffness in the affected joint in the morning. Likewise, the so-called start-up pain: At the beginning of a movement, the symptoms are still severe, but they decrease with further stress. They come back at intervals. In addition, the joint is often swollen and reddened. As the osteoarthritis progresses , movements become increasingly difficult.
How does the diagnosis work?
The orthopedic surgeon feels the joint and moves it. Ultrasound can determine inflammation and swelling, but also the thickness of the cartilage. The doctor can determine the stage of the osteoarthritis on an X-ray. Sometimes an MRI scan is also necessary.
How is osteoarthritis treated?
The development of the muscles is important, because the muscle mantle is the most active joint protection. During physiotherapy, the patient is shown the exercises (the health insurance company pays). Obesity should be reduced. Anti-inflammatory drugs, in the form of tablets or injections, relieve symptoms. Orally ingestible basic cartilage substances and autologous blood therapy are also helpful.
How does therapy with autologous blood work?
This involves isolating a substance from the patient’s blood that inhibits the further breakdown of cartilage. The substance is multiplied in the laboratory and injected back into the joint (approx. $420 to $720, the cash register does not pay). It is usually sufficient to do this procedure once a year. However: this method cannot form new cartilage, it can only stop and delay further wear and tear. Therapy on the knee is particularly suitable, as the syringe can be placed precisely in the joint.
What is the most common shoulder ailment?
The so-called bottleneck syndrome or impingement. There is no longer enough space under the shoulder roof for the muscles and tendons. The reason is bony constrictions or tension in the muscles. This leads to pain when lifting the arm or when putting on a jacket. In the long run, it can lead to chronic bursa irritation between the tendon and bones, or to tendon wear or tear. Pain medication and physiotherapy often help. If none of this brings anything, the shoulder roof has to be expanded during surgery.
When is a joint replacement necessary?
This is often the case with the knee or hip – if there is constant start-up pain, for example after sitting for a long time, if the symptoms are also present at rest, e.g. at night, and if conservative methods such as physiotherapy, medication or injections no longer help. The condition of the joint, which the doctor can assess using X-rays and magnetic resonance imaging, is also decisive. A hip operation takes half an hour to an hour and a half and the joint lasts for around 20 years.
Prevent complaints and treat them yourself
Many joint problems arise from poor posture, for example when sitting for a long time. This can, for example, shorten the front shoulder area. This promotes joint diseases and a narrowing of the distance between the humerus and the roof of the shoulder.
Effective prevention can be achieved with simple exercises that stretch the pectoral muscles and the front shoulder area and strengthen the muscles. For example, raise and lower full one-liter water bottles or two-kilo dumbbells. Moderate circling with arms straight forward and back is also good. Doing push-ups on your knees every day also work wonders.
Just don’t overdo it. For example, jogging five to six times a week overloads your joints. Running on soft surfaces, swimming and cycling twice a week are ideal. People with weak connective tissue and sensitive, soft cartilage should avoid all extreme sports such as marathons or triathlons. You can increase the abrasion of the cartilage mass.
If a joint is swollen and the pain is not very severe, home remedies can also help: a quark compress, an ointment bandage and local application of cold and heat. If the pain does not improve despite immobilization, you should see a doctor, preferably an orthopedic surgeon.