Experience relief from persistent joint pain with Bergen Medical Associates’ expert diagnosis, treatment

Experience relief from persistent joint pain with Bergen Medical Associates’ expert diagnosis, treatment

One in four American adults grapple with a chronic condition that causes stiff and painful joints — a reality that can impair one’s quality of life and ability to conduct activities of daily living, notes the Centers for Disease Control and Prevention. But when is a joint condition categorized as an autoimmune disease, and how are different joint conditions treated?

In the following interview, Jeff Chung, MD, rheumatologist at Bergen Medical Associates, which has six offices throughout Bergen County, explains some of the most common joint-related conditions and their treatments:

Jeff Chung, M.D. Rheumatology, Sports Medicine

Please discuss some of the conditions that cause joint pain?

Dr. Chung: Sources of chronic joint pain include osteoarthritis, which is extremely common among older people, as well as occupational injuries, sports injuries and falls. Other major conditions causing joint/musculoskeletal pain include autoimmune diseases such as lupus and rheumatoid arthritis, which, while less common, still affect millions of people.

How do physicians determine if a patient’s joint pain is caused by an autoimmune disease?

Dr. Chung: Patients with autoimmune-driven joint pain may experience the standard symptoms of joint pain, stiffness and swelling, but the presence of such additional “cross-system” symptoms as fever, stomach issues, swollen glands and unusual skin rashes may indicate that an autoimmune disorder is at play. Risk factors for autoimmune-driven joint pain and its underlying inflammation include smoking, excessive stress, frequent infections, obesity, chronic use of medication and a family history of autoimmune disorders. A patient with any symptoms or risk factors can be referred to a rheumatologist for a full medical history, evaluation and blood and/or imaging tests to diagnose the presence of an autoimmune disorder.

Osteoarthritis frequently causes chronic joint pain. What are the symptoms of osteoarthritis and how is it treated?

Dr. Chung: A patient’s age, occupation, lifestyle, injury history and weight all play a role in the development of osteoarthritis, which, while not necessarily an autoimmune condition, can be associated with a lot of inflammation. Often affecting individuals who are middle-aged and older, symptoms include joint stiffness and/or limited use of certain joints, often in the hands, knees, hips, shoulders, feet, neck and lower back. Knee or hip replacement surgeries are popular options, but there are more non-invasive approaches that can help reduce pain, improve joint function and maintain quality of life. These include physical therapy, chiropractic, acupuncture, massage, infrared treatment (for arthritis), stretching and targeted range-of-motion exercises to help strengthen muscles and enhance flexibility. Over-the-counter treatments like muscle rubs, heat patches, braces or assistive devices such as canes or walkers can also bring relief and/or stability.

Rheumatoid arthritis (RA) is another common cause of chronic joint pain. What are the symptoms of RA and how is it treated?

Dr. Chung: RA is a long-term kind of arthritis that causes pain, swelling and stiffness in the joints with a distribution that’s widespread. Blood testing, imaging and/or testing of joint fluid can enable a more definitive diagnosis. Patients with RA often experience swelling, pain, throbbing and aching in their fingers, wrists, ankles and toes that make it hard for them to get going in the morning. While those with osteoarthritis may also experience those symptoms in the morning, it can take someone with RA one to two hours to warm up. RA is caused by the immune system attacking the joints and joint lining. Thus, the goal of treatment is not only to alleviate pain, but also to calm down the immune system and counteract that over-activity. When treating RA, holistic/alternative approaches are still in play, but treatment typically involves medication — known as “DMARDS” and “Biologics.” These medications prevent further joint damage and allow people to maintain their independence and range of motion.

Gout is another frequent cause of chronic joint pain. What are the symptoms of gout and how is it treated?

Dr. Chung: Often mistaken for an autoimmune disease, gout is caused by a buildup of uric acid crystals in the joints of the foot, toe, ankle or knee that becomes so severely inflamed that even a breeze blowing across those areas or the weight of a blanket on them can cause intense pain. Gout is treatable — it starts by first getting the acute flare(s) under control and then addressing lifelong control. This entails getting excess uric acid out of the body, because too many uric acid deposits in the joints and organs can lead to long-term organ failure, cardiovascular disease, kidney disease, arthritis and more. Dietary recommendations, such as drinking tart cherry juice and consuming less red meat, deli meat, shellfish and alcohol, can somewhat help manage uric acid levels and prevent an attack of gout or its complications. Most essentially, however, uric acid-lowering medication is necessary to ensure that a gout sufferer’s uric acid always stays below a certain physiologic level; these medicines are the main way to control gout and prevent complications.

What final information can you share with individuals experiencing joint pain?

Dr. Chung: Joint pain can be associated with a broad range of conditions, so proper diagnosis is critical. Conversations with the patient, their family, and/or their primary care doctor regarding their pain and an assessment by a rheumatologist can help determine if their symptoms are within or outside of the autoimmune realm. On a positive note, having a good team and a strong rheumatologist on your side can help you through your pain or disability. While we may not be able to cure these chronic joint issues completely, there are many treatments that can help patients manage day-to-day and restore their livelihoods, independence and quality of life.

For More Information

With offices in Emerson, Paramus (two), Ridgewood, Northvale and Montvale, Bergen Medical Associates offers primary care and 12 areas of specialized care. Patients enjoy the “one-stop shopping” approach where so many medical services are provided under one umbrella. The multispecialty group fosters an environment of collaboration among the physicians, which results in a seamless continuum of care for patients. For more information, contact us today or call 201-967-8221.