Published on November 18, 2021

It's Your Move: Discussing Arthritis And Joint Health

Identifying and finding solutions to joint pain

We’re with orthopedic surgeon Brock Cummings, M.D., Medical Director of Enloe’s Total Joint Replacement Program, talking about arthritis and joint health. Please remember that this information is not intended to be medical advice. If you have specific questions about your well-being, please talk to your provider.

Suzie Lawry-Hall, podcast host: About 23% of adults in the U.S. — or more than 54 million people — have arthritis, according to the Centers for Disease Control and Prevention. What’s more, the condition limits the activities of about 24 million adults.

SLH: The persistent swelling, pain and limited range of motion can make daily tasks like shopping, gardening, or walking your dog challenging. But what causes arthritis, how can you prevent it and what can you do about it?

SLH: Hello, everyone, I’m Suzie Lawry-Hall, and we’re with Orthopedic Surgeon Dr. Brock Cummings, Medical Director of Enloe’s Total Joint Replacement Program. We’ll go over the signs of arthritis, what causes the condition and other joint pain, and how to manage the discomfort, and more.

SLH: With that, we’ll get started.

SLH: Thank you so much Dr. Cummings for being here.

Brock Cummings, Medical Director of Enloe's Total Joint Replacement Program: Thank you for the invitation.

SLH: So first most important question, arthritis is very common, so can you just tell us what it is?

BC: Arthritis is the wearing away of the cartilage padding that coats the ends of the bones.  So if you think about taking off a chicken leg or turkey leg it has that pearly shiny stuff on the end of the bone, that’s the cartilage that wears down with arthritis and eventually that leads to the bones grinding together resulting in pain and stiffness.

SLH: What causes arthritis?

BC: The most frequent cause of arthritis is just a wear and tear issue.  It’s called osteoarthritis and it’s essentially like the brake pads on the car wearing down.  The cartilage padding wears down and it’s just associated with  the cartilage wearing out.  There’s many other kinds of arthritis kind of the next most common one would be rheumatoid arthritis which is an autoimmune disease in which your body recognizes the cartilage as something foreign and almost like a germ.  And so your immune system attacks the cartilage and the cartilage degenerates that way rather than a wear and tear.

SLH: What would be the signs of arthritis?

BC: The most common complaint is pain that frequently stiffness goes along with that.  So people start complaining that it gets harder to put their sock on or they just can’t get in positions they used to.  They can’t cross their legs or so pain stiffness.  Particularly on startup if they’ve been sitting for a while getting going can be pretty rough. 

SLH: Who is at risk at most risk of arthritis?

BC: Well arthritis can attack anyone.  Women seem to be affected a little bit more than men.  There’s some disease processes that can put you in more risk for arthritis.  There is also seems to be a familial connection where it seems to run in families.  But nobody is free from the risk of arthritis.

SLH: So is there anything you can do to prevent arthritis or is it one of those things that essentially is at some point in your life you will probably experience it?

BC: Well there’s not a whole lot that you can definitively do to prevent arthritis.  Certainly taking care of yourself, remaining active, maintaining an ideal body weight can help reduce the risk.  Good nutrition.  But the wear and tear associated with just life’s activities that’s going to happen.  Some people seem to have inferior cartilage to other people and so that it results in symptomatic arthritis sooner than others. 

SLH: So how do we know when it’s time to come see a doctor?

BC: You should see a doctor when the pain is really starting to impact your quality of life.  You know if this is a pain that occurs occasionally and it’s a nuisance, but it doesn’t really bug you and doesn’t limit you from doing anything, you know you don’t necessarily need to seek medical attention at that point.  But if you find your world shrinking, if you find that you’re having to give up doing things that you like to do or that you want to do, or you find that you’re starting to have trouble sleeping and the simple things that we talked about are not taking care of it, then that’s the right time to seek medical attention. 

SLH: And how do we see you?  How do we get to you?

BC: That would be a referral from the primary care provider.  He or she will get an x-ray of the affected joint and see if what’s causing the pain is appropriate for our office and then they would refer you to us. 

SLH: So what does treatment look like for arthritis?

BC: Treatment for arthritis is basically two extremes.  One extreme is we do things to reduce the pain or minimize the pain that don’t solve the problem.  Those things would include various kinds of over-the-counter medications like ibuprofen or Tylenol.  Physical therapy can be beneficial.  It seems a little counterintuitive that moving the joint would be something you want to do if the joint’s painful.  But arthritic joints are less painful if they’re worked in a low-impact way than if they’re just left alone. There’s also some injection options.  Cortisone-like injections can be quite helpful. There’s also an injection for knees that is a thick jelly-like lubricant that puts a little lubrication in the joint that can be can be helpful.  If those kinds of things are not are not working then the other extreme becomes worthwhile and that’s surgery to replace the joint.

SLH: And that’s where you come in?

BC: That’s what I do.

SLH: Yeah, so tell us a little bit about that.

BC: So joint replacement is something that should be done when you’re when your pain is really impacting your quality of life and those simpler measures have failed.  And the joint replacement just involves resurfacing the ends of the bones and using artificial surfaces so the bones are no longer grinding together you’ve got artificial joints moving.

SLH: What joints is arthritis effect most often are most common?  Is there a certain type of person or is it a specific joint that it tends to affect more than others?

BC: The knees are traditionally more common than other joints.  You know the weight-bearing joints are the biggest issues.  In terms of joint replacements, most joint surgeons do about two-thirds of their cases as knee replacements and one-third about one-third of them are hip replacements.  Any joint can be involved.  The joint at the base of the thumb is a common joint to become problematic with arthritis.  We just do hip and knee replacements in our office.

SLH: So what does the surgery look like if someone decides that they’d like to do surgery?  Is it an overnight type of thing?  Is it in and out, can you tell us more about that?

BC: Traditionally it’s been and overnight sort of thing.  When I came out of training we would do the surgeries on a Monday and we were happy if people were home on Thursday or Friday.  Over my career that time has been reduced steadily.  We’re now doing these surgeries in the appropriate patient as an outpatient.  We just recently did our 100th outpatient joint replacement here at Enloe and those are my happiest patients.  People like not having to spend the night in the hospital and go directly home.  And if their general health is such that we don’t have concerns for them not spending the night and they’ve got an appropriate support at home, this can be done as an outpatient nowadays. 

SLH: Wow, that’s incredible so start in the morning and back home in the evening.

BC: Yep, the people going home the same day are typically done in the first two or three cases of the of the morning.  And they’re usually leaving the hospital between two and four in the afternoon. 

SLH: That’s great, so what does recovery look like once they go home?  What does that look like for a patient?

BC: So initially they’re using a walker.  We allow full weight bearing right out of the gate but most people don’t feel like putting all of their weight on it immediately.  So they’re using a walker to start out with but they can transition to a cane and then nothing as quickly as they feel like it.  The lion’s share of the recovery is the first six weeks.  During that time every day is better than the day before.  You can do stuff today you couldn’t do yesterday.  By three months you’re probably 75 to 80 % recovered.  It takes a year to get truly as good as you’re going to get.  Those last nine months though it’s hard to perceive the improvement like you were earlier on.  It’s kind of like watching the hour hand on the clock move.  You know there’s stuff happening but it’ not so dramatic as the first six weeks.

SLH: Nice, well those are all the questions I have is there anything else you’d like to share before we sign off for today?

BC: I would say don’t let arthritis control your life.  You know we do have options whether they’re non-surgical or surgical.  Arthritis pain doesn’t have to ruin your quality of life or control your life.  So, you know get it checked out if it’s interrupting you with your quality of life.

SLH: Thank you so much Dr. Cummings for being here. And thank you all for watching.

SLH: We hope you found this information helpful. If you want to hear more about life after replacement surgery, check out Enloe’s new podcast, Health Matters. We’ve placed a link to it in the comments field.

SLH: And remember, being active and doing what you love shouldn’t hurt. Having healthy joints can help you live a happy life.

SLH: See you next time. Take care.