A Patient’s Guide to Chronic Joint Inflammation

Pain and inflammation in or around your joints is fairly common and usually quickly resolved. But chronic inflammation can permanently damage your joints and affect your mobility. Unsurprisingly, there’s a lot of things that can cause chronic inflammation in joints, and most people are at risk of developing one or more of these issues, so it’s important to understand what they are and how they’re different.

Let’s start with defining what a “joint” is in your body, as inflammation is often rooted in a particular part of the joint. A joint is: “the connection made between bones in the body which link the skeletal system into a functional whole.” Joints include the structures surrounding the bones, like supporting muscles, tendons that attach muscle to bone, cartilage padding between bone surfaces, and synovial cavities, which are fluid-filled spaces between bones. Not all joints in our bodies have all of these structures, but each of these structures can be damaged, irritated, and consequently, inflamed.

What is Inflammation?

Inflammation has a bad reputation, but it’s actually part of the body’s immune response. The inflammatory response, under regular conditions, is an increase in white blood cells to an area of the body that’s damaged, stressed, or infected. The white blood cells are sent to protect the body from infection, remove damaged cells, and initiate repair. So, in most cases, like a scrape or cut, inflammation is necessary and helpful to the body, and then goes away when the body’s healed.

The problem with inflammation is when it’s long-lasting or caused by an auto-immune condition where the body is attacking healthy cells. Not resolving inflammation in the joints results in permanent damage.

Main Causes of Chronic Joint Inflammation

Two common culprits of chronic joint inflammation are arthritis and tendonitis. These conditions primarily affect the same joints, such as the knees, hips, elbows, wrists, and fingers, and they both cause painful inflammation that can limit movement. Arthritis and tendonitis are also both umbrella terms for a wide array of specific conditions. But they’re very different.

Arthritis

Arthritis isn’t actually one disease. It’s a category of over 100 joint conditions, and the combination of these conditions is the leading cause of disability in America. In general, arthritis is the progressive wearing away or loss of joint structures like cartilage and synovial fluid that, if unchecked, causes bone to rub on bone. There’s four categories of arthritis: degenerative, inflammatory, infectious, and metabolic.

• Degenerative: The kind people are usually familiar with when they hear “arthritis” is degenerative, or osteoarthritis. This type is simply caused by age, but other factors like gender, weight, and prior injury can cause earlier onset. Osteoarthritis is the loss of cartilage between bones that normally helps the joint to glide and provides shock absorption. The loss of cartilage causes pain, swelling, and joint stiffness.
• Inflammatory: Conditions such as rheumatoid and psoriatic arthritis are types of inflammatory arthritis that are auto-immune diseases. They cause deterioration of joint tissue by an overactive immune system that attacks healthy cells. These kinds of arthritis can also damage the eyes, skin, and internal organs, so early detection is key to slowing the disease.
• Metabolic: Better known as gout, this condition causes a build up of excess uric acid in the body and forms crystals in one or more joints. These crystals cause sudden painful inflammation in the affected joint, known as a “gout attack.”
• Infectious: A bacteria or virus infects the joint. This arthritis is usually resolved with antibiotics but can sometimes become chronic.

There is no cure for arthritis, and treatment is targeted at reducing pain and inflammation, strengthening surrounding muscles for more support, retaining range of motion, and slowing joint damage. While arthritis mostly affects older individuals, it can happen at any age, and early detection for all forms of arthritis is helpful to retaining mobility and reducing pain.

Tendonitis

Tendonitis is inflammation in the tendons, which connect muscle to bone. The inflammation can be a result of irritation or microscopic tearing of the tendon. Since tendons are part of the joint structure, tendonitis can happen in any joint with a tendon, often times for no discernible cause. However, most tendonitis you’re likely familiar with are caused by overuse (repetitive motions with the joint) or overloading (increased level of activity too quickly).

Tendonitis is a general term, and there are a number of specific types of tendonitis, depending on which joint they’re affecting.

• Plantar Fasciitis: Inflammation in the tendon that connects the heel to the toe bones. This type of tendonitis is common in runners and those who wear shoes without adequate support.
• Achilles Tendonitis: Inflammation of the Achilles tendon that connects the calf muscles to the heel. This is common in runners as well, and recreational sports players.
• Patellar Tendonitis: Inflammation of the patellar tendon, which connects the kneecap to the shin. This type of tendonitis is common among jumping athletes, like basketball and volleyball players.
• De Quervain’s Tenosynovitis: Inflammation of the tendons around the back of the wrist and the base of the thumb. This type is common in those who do small, repetitive tasks with their hands, like needlework or video gaming with a controller.
• Lateral or Medial Epicondylitis: Inflammation of tendons on the outer (lateral) or inner (medial) side of the elbow. Lateral Epicondylitis is common in racquet sports players, while Medial Epicondylitis is common in professions like construction.
• Impingement Syndrome: Inflammation of the tendons that make up the rotator cuff, which attaches muscles to the shoulder. This is common in swimmers and baseball pitchers, but it can also result from repetitive lifting of a briefcase or shopping bags.

Tendonitis, unlike arthritis, is generally curable. Stretching and strengthening exercises along with rest and remedies for inflammation can relieve the irritation and prevent joint damage. Inflamed tendons that are not treated can suffer from deterioration and result in permanent damage.

However, those who’ve experienced tendonitis are at a higher risk for developing arthritis in the same joint later on in life. Inflamed tendons are also sensitive and more prone to tearing and other serious injuries that would require surgery to regain mobility.

Other Causes of Joint Inflammation

While arthritis and tendonitis are the major causes of inflammation in joints, two other common causes are acute injury and infection. When treated properly, these don’t become chronic issues, but continuing regular activity without treatment can cause damage. Those who’ve had acute joint issues can also have a higher risk of developing tendonitis or arthritis.

• Infection: As mentioned previously, inflammation can be caused by an infection in part of the joint. Sudden onset of inflammation without a known cause for injury could be an infection, and it’s important to identify the cause as soon as possible.
• Acute Injury: Since inflammation is part of the body’s immune system, it’ll happen when there’s an injury to the area, such as a muscle strain or fractured bone. Anyone can be injured by a fall or an awkward movement, but athletic individuals are at a higher risk for an acute injury.

Laser Therapy for Joint Pain & Inflammation

Pain and inflammation associated with these conditions are commonly treated with non-steroidal anti-inflammatories (NSAIDS) and corticosteroid injections. For acute injury and tendonitis, the practice of RICE (rest, ice, compression, elevation) is used to help reduce inflammation. Treatment like physical or occupational therapy, braces, and assistive devices offer support by strengthening muscles, stretching, and modifying movement to reduce pain.

Another option for reducing chronic or acute inflammation in the joints is laser therapy, a type of photobiomodulation therapy that uses near-infrared light to reduce pain and inflammation. These specific wavelengths of light, combined with the power and concentration of a laser, can project into deep tissue to cause a metabolic change by targeting the mitochondria of cells. The energy delivered by the laser light boosts cellular energy.

• Pain Reduction: Laser therapy treatments reduce levels of bradykinin, a pain-eliciting chemical and release endorphins and enkephalins that help relieve pain. Laser therapy also has shown to decrease nerve sensitivity in certain nerve fibers, reducing pain.
• Anti-Inflammatory: Laser therapy increases inflammatory-mediating white blood cells that help to quickly resolve inflammation.
• Vasodilation: Laser therapy causes blood and lymphatic vessels to widen, called vasodilation, that allows more activity to happen at the site of inflammation, such as the delivery of nutrients and removal of waste and dead cells, resolving inflammation faster.

Is Laser Therapy Safe?

Laser therapy is safe and painless. The lasers used in therapeutic applications do not have beams that are concentrated or powerful enough to cause harm to the body. Both patient and technician must wear protective eyewear while the laser is in operation, but this is no different than wearing protective gear like a lead vest for an x-ray (although much lighter).

Laser therapy treatments are painless and have no serious, lasting side effects like over-the-counter pain relievers can have. The treatments can be used in combination with RICE therapy as well as physical or occupational therapy, and there is no downtime following laser therapy treatments. You can be in and out of the doctor’s office and back to your daily schedule in 30 minutes.

There’s a lot of things that can make joints inflamed and painful. If you experience chronic joint inflammation, it’s important to identify the cause and begin treatment as soon as possible. If you’re interested in laser therapy as an option for pain and inflammation management, click below to find an Aspen Laser Systems healthcare provider near you.