Treating Joint Pain – What To Do And When To See A Doctor

Jared Kiernicki, Physicians Assistant

If you’re experiencing pain in any joint—your knee, ankle, shoulder, hip, etc.—you need to know how to best treat it at home. It’s also important to know when it’s time to see a doctor.

Each day at Orthopaedic Associates, I help patients with joint pain. In most cases, it’s been going on for a while and the patient or caregiver has been trying to manage it for some time.

Below are tips for managing your symptoms at home. I also give guidance on when it’s time to see one of our experts.

Chronic joint pain vs. Acute joint pain

Chronic joint pain is something that’s been nagging for months to years. It has a predictable pattern, such as painful in the morning, after standing on your feet all day, etc.

Acute joint pain is from something sudden. For example, you’re playing a sport and you feel a “pop” or tearing feeling. Or acute injuries can result for a fall or other accident.

RICE treatment, medications at home

The methods below can be relevant and helpful for managing both types of pain at home, as nearly all joint pain benefits from the RICE method of treatment.

RICE is an acronym standing for Rest, Ice, Compression and Elevation. Each part helps in a different way.

• Rest: Not only helps the injury heal, but prevents further irritation or injury from ongoing activity.
• Ice: Ice stops the formation of new inflammation (swelling, pain, pressure), and helps with pain control. (More details on how to properly use ice below)
• Compression: Helps minimize swelling and can also provide some stability.
• Elevation: Elevating the irritated or injured body part above the level of the heart can help decrease swelling and pressure.

Also, some consider the “I” to “anti-inflammatory medications.” Anti-inflammatory medications not only reduce pain, but can help reduce the body’s inflammatory response to injury or irritation.

The most common OTC anti-inflammatory medication is ibuprofen, under brand names such as Advil and Motrin. Naproxen (brand name Aleve) is also an OTC anti-inflammatory medication.

Naproxen is typically taken twice per day, and ibuprofen is taken up to 4 times per day. Both work to reduce pain and address inflammation. Trying them for 7-10 days (in addition to other RICE methods) often works to reduce joint pain.

Also, acetaminophen (brand name Tylenol) helps treat pain, but doesn’t work to minimize inflammation. However, especially in combination with naproxen or ibuprofen, it can help with pain control.  It’s important to avoid any alcohol while taking acetaminophen.

If you find that you’re taking pain medication for a length of time, or you are at risk for stomach or kidney problems or other side effects, you should check with your primary care doctor.

When to see a doctor

Overall, if RICE and OTC medications don’t seem to help, it’s time to see a doctor.

It’s also time to see doctor when you experience the following:

• Symptoms don’t improve, or even worsen with treatment. That means that the ankle or knee that was aching or sore is now throbbing and you can’t put weight on it.
• Your pain has evolved to the point that it’s affecting your activities of daily living. Perhaps you now can’t go up or down stairs, or you can’t carry your child or bring in the groceries. If your life is impacted by joint pain that has become unmanageable on your own, it’s time to get help.
• New symptoms, such as swelling that wasn’t there before, a “clicking” inside the joint, or a feeling that it’s locking up.
• Signs of infection, such as heat and redness in the joint accompanied by a fever.

If you’re having these symptoms, you should see your primary care doctor. However, you can also visit a Deaconess Urgent Care or the Orthopaedic Associates Walk-In Urgent Care.

Visiting a doctor or other provider for severe or worsening joint pain can lead to a variety of treatment options, depending on the cause and type of pain.

• Medication options may be considered, including oral or injected steroids, or prescription strength anti-inflammatory or pain medications.
• Physical therapy—for strengthening, stretching, etc.—is important to help overcome many types of joint pain, and to teach self-care methods for the future, including a personalized therapy/exercise program.
• Advanced imaging may be required. Some injuries may need to be diagnosed with the help of MRI, CT, x-ray, etc.
• Equipment or supportive devices. This could include a brace, sling, crutches, or a “boot.” There are lots of options depending on type of injury.
• Further referrals to an orthopaedic specialist may be needed. Joint injuries sometimes need surgery, and chronic conditions, such as arthritis, may lead to joint replacement. To learn more about what to expect from joint replacement, my colleague Brooke Kline has written an excellent Q&A article.

Tips for using ice and heat

I want to give some tips on effective use of ice for the most benefit.

• Ice the entire joint. For example, applying ice all the way around the knee is more beneficial than just putting an ice pack on the front.
• Applying compression WITH the ice is more beneficial than just placing an ice pack. Wrapping an elastic or compression wrap around the ice pack can give double benefit.
• Always have a layer of some type of fabric between ice and skin. A hand towel, sock, etc. is fine—you just don’t want to damage your skin with direct contact.
• Use ice multiple times throughout the day, 20-30 minutes at a time. Let your joint re-warm back to normal temperature between times of icing.

Now let’s talk about using heat. Some people report that using a heating pad can help with joint pain before going shopping, golfing, or other types of activity. With chronic joint pain, sometimes applying heat can help “loosen up” the joint and surrounding muscles. A few minutes with a heating pad or similar heat can help reduce pain during activity. I would still recommend icing afterwards to help with inflammation and swelling.
Note: For acute joint pain, such as from an injury (an ankle sprain is a good example), heat can increase swelling and inflammation, so avoid heat for the first 48 hours after an injury.