2013: Issue 27

BetterHealth Magazine by Bumrungrad International Hospital RSS Feed Follow BetterHealth by RSS

Pain Relief

Treating joint pain beats trying to live with it

 Treating joint pain

Treatments for painful joints are more effective than ever. Before deciding to grin- and-bear-it, get to know what causes painful joints, and discover the treatment advances that are helping patients enjoy a better quality life minus the pain.


If your only respite from painful joints comes when you’re asleep, it’s time to stop trying to live with pain and discover the many options for treating it.


Joint pain is one of the most common health problems. Many people deal with the pain by trying to minimize it, convincing themselves that pain is a normal part of older life that strong-willed people learn to tolerate.


Over time, you make adjustments to deal with the pain until it’s all part of your daily routine. Activities that you once enjoyed are now considered pain triggers, so you cut back on activities, you exercise less (or stop altogether). Before long, tolerating the pain takes priority, and active living is a part of your past.


The story may sound very familiar, but it doesn’t have to become your story. To understand what causes joint pain and how it can be treated, Better Health turned to Dr. Wasin Kulsomboon, a specialist in rehabilitation medicine at Bumrungrad who has spent many years helping patients re-discover pain-free living.


Why it’s painful

Aging and joint degeneration (i.e. wear-and-tear) play a role in a number of painful joint conditions. But oftentimes the blame is misplaced; according to Dr. Wasin, the majority of conditions that cause joint pain don’t involve aging or wear-and-tear. “Joint pain usually results from inflammation of the joint – a condition known generally as arthritis,”


Dr. Wasin says. “But arthritis is a very broad term; a single joint is made up of numerous bones and non-bone components such as cartilage, tendons and articular discs. And with more than 100 known types of arthritis, the diagnostic process can be very complex.”


The leading causes of joint inflammation include accident-related arthritis, rheumatoid arthritis and gout, followed by infections, allergies and skin conditions. Leaving an inflamed joint untreated for an extended period increases the amount of damage inflicted on the joint.


Earlier is better

Like all medical conditions, the sooner you seek proper medical attention for joint pain, the better it responds to treatment. “Earlier medical attention is very important for the long term health of the joint,” notes Dr. Wasin. “When a joint is painful and inflamed, many people decide to ‘wait-and-hope’ for the problem to clear up on its own without consulting a doctor. This can be a dangerous strategy, because it doesn’t address the cause of the pain.”


Obesity’s impact

Dr. Wasin notes that a growing number of younger adults are experiencing painful joints caused by obesity-related osteoarthritis. Osteoarthritis results from cartilage being damaged or chipped away from the joint as it struggles to support the excess weight. As cartilage gets progressively thinner, joints become less and less mobile.


“For patients with joint pain and inflammation, doctors typically begin the diagnostic process with a review of the patient’s medical history and a physical examination,” Dr. Wasin explains. “Lab tests and other diagnostic tools are also available to confirm the diagnosis.”


For obesity-related osteoarthritis, doctors typically consider a combination of medical treatments and lifestyle changes aimed at promoting weight loss, which by itself can relieve pain by reducing the stress placed on joints. Along with recommendations for nutrition and exercise, patients may be prescribed pain relievers, injections or antibiotics to treat an underlying condition that’s contributing to the pain.


Many types of joint pain respond well to physical therapy and rehabilitation, sometimes in conjunction with braces or other devices that help support joints. “In more severe cases that don’t respond sufficiently to non-surgical treatments,” Dr. Wasin explains, “there are a number of surgical options that are effective for relieving joint pain.” 


After surgery

Patients requiring surgery have plenty of reason for optimism. Thanks to advances in technology and improved techniques, today’s generation of joint surgery causes much less physical trauma than before, and recovery times are much shorter. “Post-surgery rehabilitation can usually begin very soon after surgery,” says Dr. Wasin. “This helps restore flexibility to joints and strengthens peripheral muscles. For patients who undergo knee or hip replacement surgery, it’s normal for rehabilitation to begin just 24 hours after surgery.”


According to Dr. Wasin, the following post-surgery guidelines are commonly applied to patients undergoing joint surgery: Moving is good. Some patients assume they have to stay still after surgery. Even when there is lingering pain or tenderness following the operation, moving the affected joint helps restore range-of-motion and promotes the rebuilding of surrounding muscles. Movement also helps the artificial joint to function properly, lowers the risk of an artery becoming blocked, and helps extend the longevity of the artificial joint.


In the first stage of recovery, light exercise is usually recommended. For example: While lying on your back, bend your knee slowly and pull your ankle back toward the hip, then slowly extend your leg back to the starting position. Do 5 to 10 repetitions for each leg 2 or 3 times per day, as directed by your doctor.


Exercises targeting leg muscles are also beneficial. For example, lie on your back, then slowly raise your foot upward, then back down. To target knee muscles:

Place a support pillow under the ankles, then tighten your knee muscles and hold for several seconds. Alleviate pain. Post-surgery pain can cause patients to stop exercising their joints, which slows the progress of rehabilitation. Try applying a cold pack to the painful area for 20 minutes, 3 to 4 times a day. Your doctor may also prescribe pain relief medication.


Protect a new joint. Joint replacement surgery can make a tremendous difference in one’s quality of life, but the artificial joint is not the same as a natural joint. Keep expectations realistic and stay mindful about the limitations of replacement joints. Treating the joint with extra care and taking sensible precautions will help extend the life of the replacement joint. Avoid damaging activities such as squatting, running up and down stairs, sitting on the floor or sitting with legs bent back to one side.


Joint pain can take all the pleasure out of everyday living. Trying to tolerate it is often the first step toward becoming more and more dependent upon others. More and better treatments are providing relief for painful joints – all the more reason to talk to your doctor about trading in the pain for a better quality of life.



“Osteoarthritis occurs when cartilages are damaged 

and chipped away until they are so thin that the

 joint can no longer move as smoothly, 

swiftly and fully as before.”

Dr. Wasin Kulsomboon

Dr. Wasin Kulsomboon Joint center Bumrungrad Bangkok Hospital Thailand



Healthy Joint and Inflamed Bangkok Thailand


What’s causing your joint pain?

There are plenty of possible causes of painful joints, including the following:

+ Osteoarthritis

+ Injury to the joint or surrounding tissue

+ Rheumatoid arthritis

+ Gout

+ Systemic lupus erythematosus

+ Psoriatic arthritis

+ Infection in a bone or joint




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