Where the Pain Begins

The knee joint. Click to open larger size.

As we age, cartilage, the tissue in our joints that acts as a cushion between bone surfaces, grows brittle and begins to wear away until we have bone rubbing against bone. This loss of cartilage, which results in inflammation, pain, and stiffness in the joints, is known as arthritis.

Because the knee, hip and ankle are weight-bearing joints, the stresses and strains of living, such as injuries, weight, occupation, and genetics affect how much and how fast the cartilage wears away. The shoulder and hand, although non-weight bearing joints, also are frequently affected by arthritis and cartilage wear, and have their own set of stresses that can lead to problems.

The degree to which cartilage in a joint wears away varies from person to person. Moderate degrees of wear can cause intermittent or mild pain, which may be managed with treatments ranging from over-the-counter (or prescription medications) to exercise, weight loss and physical therapy.

If, however, cartilage wear and the accompanying pain reach a point where the normal functions of everyday life become difficult, joint replacement surgery — specifically knee, hip, shoulder or ankle — may be the appropriate option.