Joint pain — especially in the knees and hips — is a common complaint as people grow older.
By Brian M. Vannozzi, M.D. Princeton HealthCare System
While arthritis is often the culprit, joint pain can also be caused by other conditions and injuries that lead to aching hips and sore knees. That’s why it’s important not to jump to conclusions and to see your doctor for proper diagnosis and treatment.
Arthritis is the breakdown of the protective cartilage between the joints. This cartilage prevents bones from rubbing against each other when you move. When the cartilage deteriorates, the bones grind together, causing the pain associated with arthritis.
An estimated 37 million people suffer from some form of arthritis, according to the Centers for Disease Control and Prevention, with women more at risk for developing the condition than men. Additionally, the chances of developing arthritis increase with age.
Symptoms of arthritis include:
• Pain in the joint, typically described as an ache, burning or soreness.
• Pain and stiffness that is worse in the morning or when you first start moving.
• Decreased range of motion of the joint.
• Pain that eases with anti-inflammatory medicine.
Yet not all hip and knee pain is arthritis. Other common causes include:
Meniscus Tear. Located in the knee, the meniscus is a separate piece of soft cartilage between the femur and the tibia that acts as a shock absorber during motion. This cartilage is subject to tears, normally as a result of twisting or over-flexing the knee.
A meniscus tear will often cause sharp pain when the injury occurs and may cause the knee to lock or catch. The knee can also become swollen with fluid because of the injury. Unfortunately, both arthritis pain and the pain associated with a meniscus tear usually occur on the inside or center of the knee, sometimes making it difficult to differentiate between the two.
Bursitis. Often mistaken for arthritis, bursitis is an inflammation of the bursa, the soft sac that cushions the hip joint. Unlike arthritis pain, which almost universally affects the groin area, bursitis pain is felt in the outer area of the hip.
Other signs of bursitis may include pain that radiates from the hip to thigh, pain that gets worse at night or when you lie on the bad hip, and pain that worsens with prolonged activity.
Pinched Nerve. In addition to bursitis, pain thought to be from your hip joint can actually be a result of a pinched nerve in the lower back. This pain radiates down the buttock and the back of the leg and causes tingling and numbness or a pins-and- needles sensation.
If you experience this type of pain, see your doctor right away. Ignoring it could result in lasting nerve damage.
Sorting out the symptoms and causes of hip and knee pain can be confusing and takes time.
The first step is to visit your doctor, who will ask you to describe your symptoms. Here are some of the questions you should be prepared to answer:
• When do you experience the pain?
• Where is the pain located?
• What does the pain feel like?
• Did the pain begin suddenly or slowly? Severely or mildly?
• Does the pain come and go, or is it constant?
• How long have you been experiencing the pain?
• Does resting the joint ease the pain or make it worse?
• Do medications, massage or applying heat reduce the pain?
Your doctor may then order X-rays and an MRI to evaluate the relationship of the bones to one another and the condition of the tendons, muscles and tissues surrounding the bones.
Treatment depends on the condition and its severity.
Some patients can live with small meniscus tears, while larger tears may need to be removed with minimally invasive arthroscopic surgery. Bursitis is usually treated with rest, ice and medicine to reduce swelling.
If, in fact, you do have arthritis, the condition can often be successfully managed with pain-relieving medication and lifestyle changes such as exercise and weight loss. If the pain is more severe, doctors may recommend injecting anti-inflammatory drugs or synthetic lubricants into the joint.
For some patients, these measures may fail to bring relief and doctors may recommend joint replacement surgery. At University Medical Center at Princeton, orthopedic specialists offer the latest options in total joint replacement, including gender-smart knee replacement for women.
If you are experiencing joint pain and worried it might be arthritis, don’t assume. Visit your doctor and find out for sure, so you can take the right steps to ease the pain.
Princeton HealthCare System, through its Community Education & Outreach Program, will host a discussion on “Hip and Knee Pain: Is It Arthritis?” from 7 to 8:30 p.m. on Wednesday, Oct. 13, at the Ewing Branch Library, 61 Scotch Library, Ewing. To register for the free session or for more information, visit www.princetonhcs.org/ calendar.
For more information about University Medical Center at Princeton’s Orthopedics Program or to find an orthopedic surgeon on staff at Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org/ orthopedics.
Brian M. Vannozzi, M.D., specializes in orthopedic surgery and is a member of the medical staff at University Medical Center at Princeton.

