Creaky, achy joints, a twinge in the knee, a sharp shooting pain from the shoulder to the elbow, No big deal, right?

Wrong. All too often, we assume joint pain is a normal part of aging that we just have to learn to live with. Nothing could be further from the truth.

"Many people in India know very little about joint pain," Contrary to what many may think, joint pain is not an inevitable part of aging. Unless someone has suffered an injury such as breaking a leg, joint pain in the 50-plus age group usually means osteoarthritis, a degenerative disease in which the joints' natural shock absorber -- Cartilage -- begins to break down. Without their protective layer, bones begin to scrape against one other, causing joint pain and thwarting movement.

But never make a diagnosis by yourself. "The average person may not be able tell if it's the joint, a torn tendon or ligament, or pain in the area of the joint. An orthopaedic surgeon needs to evaluate you to make sure you do in fact have joint pain and why."

X-rays can sometimes show changes that indicate cartilage breakdown, but often, the images are inconclusive. "Physical exam, MRI, and bone scans can all be helpful in establishing a diagnosis that is not evident on X-ray."

While there is no conservative cure for joint pain, you can find relief. Treatments range from lifestyle changes to medications to surgery -- and should usually be tried in that order.

Lifestyle Changes

If you are overweight, the first step is to loose weight. A recent study shows that losing as little as 11 pounds (5 kilos) can decrease the risk of osteoarthritis of the knee by 50%. The next step is to work with a physical therapist to develop an exercise program that's right for you. Walking, and other low-impact exercises that don't put pounding pressure on the joints are helpful but high impact exercises such as jogging should usually be avoided. "Exercise is a lifetime commitment," I recommend that patients work out for 40 minutes at a time, three or four days a week. Wearing the correct footwear is also important. A regular and brisk morning walk for one hour (recent recommendation) will usher in a feeling of well being and is excellent all-round exercise. Putting all your joints through a full range of movement will go a long way in preventing stiffness.

Medications

If lifestyle changes don't ease your pain, medication is often prescribed. For mild pain, a simple painkiller can often help. Heat or cold therapy can often provide temporary pain relief. For more prolonged pain which is not amenable to simple drugs, your orthopedician in India will write you up for an anti- inflammatory drug. Although this latest generation of drugs has come under fire recently in the US, their capacity to alleviate pain in the elderly for short durations is welcome. If Knee pain is due to osteoarthritis, Glucosamine could be useful in the early stages. An orthopedic surgeon may choose to supplement the fluid in your knee with a synthetic substance which improves the viscosity of the joint fluid and ameliorates pain.

Surgery including Joint Replacement-

Joint replacements are advised for the elderly person with severe knee or other joint pain. For the young person, I perform some form of cartilage surgery in which the focal damaged areas of cartilage are repaired by surgery. This is an alternative available for young patients as they need not wait to attain the senior citizen's age (> 70) to get a joint replacement. Meniscal suture and Ligament reconstruction in the knee help to restore the mechanical stability for those sportspersons with knee injuries. These will postpone the advent of osteoarthritis. In those unlucky to have had a complete Menisectomy (complete removal of the semi- lunar cartilage) of the knee, Meniscal transplant will be available in Chennai soon. At present this surgery is confined to a few centres in the US and Europe.

For senior citizens if all else fails to relieve your pain and disability, your doctor may recommend surgery in which an arthritic or damaged joint is removed and replaced with an artificial joint called prosthesis.

The artificial joints, fashioned out of metal and plastic, can be as good as the real thing, restoring movement and function. "Joint replacement is extremely successful, lasting over 20 years for more than 90% of patients," The procedure is becoming increasingly safer and less invasive.

In summary, prompt consultation with your orthopedic surgeon will lead to earlier diagnosis and effective treatment of joint pain and improve the quality of many lives affected by this common malady.