Ask The Expert: Robert Sterling on Maintaining Healthy Joints

As we get older, our knees, hips, ankles and other joints begin to wear down from years of use and stress - sometimes causing great pain. What causes joint pain and what can be done to help prevent and alleviate joint pain? Assistant professor of orthopaedic surgery Robert Sterling answers some questions about best practices for keeping our joints healthy in today's Ask The Expert.

What are some variables that lead to joint pain?

SterlingThere are numerous potential causes of joint pain, including pain from ligaments, tendons, bones and sources within the joint itself, such as the cartilage and joint lining. Overuse injury is a very common cause of joint pain, as is repetitive trauma. For example, jackhammer operators have an increased incidence of wrist and elbow pain.

The most common cause of joint pain in adults is osteoarthritis. Being overweight has been shown to be a risk factor for development of arthritis in the knee. Arthritis becomes more common as people age, and arthritis is more common in women than men. Trauma, genetics, hormones and nutrition are other contributors to the development of joint pain and arthritis.


How can highly active people help preserve their joints though the added strain?

Maintaining a healthy lifestyle is critical to joint health. Highly active people can preserve their joints best by avoiding injury. Many sports have been tied to knee injuries, including soccer and competitive basketball. Proper preparation before participating in sports and proper muscle recovery after activity can help prevent injury and preserve joint function.


What can people do to alleviate pain from arthritis if they have it?

Unfortunately, there is no way to “cure” osteoarthritis. However, people can do some simple things to slow the progression and limit the pain.

Weight control is one factor that can help ease arthritis pain. In the knee joint, for each pound of weight, the joint can feel 1.5 to 3 pounds of pressure when climbing a step. Maintaining a healthy weight can help slow the progression of osteoarthritis.

An exercise program for the muscle around the knee and hip will improve strength and often decreases joint pain from arthritis. The use of a simple knee sleeve can also improve pain by providing compression at the joint. Over-the-counter medications, such as acetaminophen or anti-inflammatory medications, are also commonly used to relieve arthritis pain.


What are the best supplements available for joint pain relief?

There are numerous supplements available that are advertised for relief of joint pain—glucosamine, chondroitin sulfate, ginger, methylsulfonylmethane, etc. However, there are no rigorous clinical research trials that consistently demonstrate positive effects of supplements.

The clinical practice guideline on treatment of osteoarthritis of the knee published by the American Association of Orthopaedic Surgeons does not recommend use of glucosamine and chondroitin sulfate due to a lack of evidence. That said, many individuals do feel relief from taking supplements, and the effect in an individual cannot be discounted.

Supplements can have side effects—for example, ginger can cause blood thinning—or interact with prescription medications. Anyone interested in adding supplements to a health regimen should be aware of this and make sure that the supplement will not interfere with any prescription medications.


Some food and drinks, such as fish and milk, are thought to help prevent wear on bones and joints. Is this true? If so, are there any others?

The risk of developing rheumatoid arthritis, an autoimmune disorder affecting the joint lining, has been show to be lower in people who consumed higher levels of vitamin D, Vitamin C and omega-3 fatty acids.

A study from one center found that eating cruciferous vegetables, such as broccoli and cauliflower, had a protective effect on the development of arthritis. There are numerous other foods that may help ease joint pains due to their natural anti-inflammatory properties, such as onions, leeks, extra-virgin olive oil, fatty fish, walnuts and soy beans.


What are the most common joints that require replacement?

The knee is the most commonly replaced joint, followed by the hip, shoulder and ankle. In 2010, there were more than 700,000 total knee replacements and more than 300,000 total hip replacements performed in the U.S.


If joint replacement is necessary, what recovery tips do you have for people who have received replacement surgery?

Proper presurgical preparation is critical to making the recovery easy. Ask questions. Patients who are better informed and participate in the development of their treatment plan have better outcomes.

Losing weight before surgery is critical for obese patients, both to ease the recovery and reduce the risks of surgery. A preoperative exercise program involving the arthritis joint helps improve postoperative recovery. A simple program of stretching and gentle strengthening can go a long way postoperatively.

If you are having surgery on your hip, knee, or ankle, find out how to prepare your home before surgery to prevent falls. Find a “coach” who will be available to assist you after surgery, and who can help you at home with both your personal care and home exercises.

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{ 3 comments… read them below or add one }


Martha Seay December 10, 2014 at 10:06 am

How does compressing a joint by a sleeve relieve pain? I came across stretchy terry cloth finger sleeves that relieve the stiffness in my finger joints. If I wear them overnight, in the morning my fingers feel fine with no stiffness, but if I leave them off, the stiffness returns big time!


Robert Sterling December 10, 2014 at 5:57 pm

This is a great question with no real good answer. There are several studies with rheuamtoid arthritis patients demonstrating that the use of compression gloves at night reduce morning stiffness, but we do not know exactly why this is the case. Some believe that the compression may limit swelling in the joints. For knees, the compression sleeves are thought to provide neural feedback that is protective and thereby improves joint stability. The exact mechanism by which joint compression helps is not yet known.


Deidra Kelly December 10, 2014 at 8:02 am

A concise overview of the topic. I have had an hip joint replacement, and I can vouch for the benefits of exercise. The specifics on the effect of excess weight, diet and supplements were useful to me going forward with my osteoarthritis issues.


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