What does your diagnosis mean?

Arthritis is a general term for a joint condition. This term is often used when people mean “Osteoarthritis.” Osteoarthritis is age-related arthritis. In other words, it is the type of arthritis we all get with time.

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Arthritis, or osteoarthritis, should not be confused with “Inflammatory arthritis.” Inflammatory arthritis is very different from osteoarthritis, and it usually requires continuous medical care from your primary care doctor and a rheumatologist. Some examples of inflammatory arthritis include Rheumatoid Arthritis, Lupus, and Ankylosing Spondylitis.

Arthritis (osteoarthritis) may contribute to your pain and stiffness. Sometimes it may even become severe, especially in the hands, hips, and knees.

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Arthritis cannot be blamed on movement; in fact, movement is helpful to manage the symptoms of arthritis.

Bursa are normal pieces of anatomy throughout our body. They are made of a tissue called “synovium.” Bursae exist at sites where a lot of movement occurs, such as the shoulder, elbow, hip, and knee.

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When a bursa becomes inflamed, the term is “Bursitis.” Some bursa exist inside of a joint. When these bursae become inflamed, the term is “Synovitis.”

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Bursitis and Synovitis most commonly cause an abrupt onset of pain and swelling. For this reason, early evaluation by your healthcare provider is appropriate.

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Bursitis and synovitis rarely cause chronic pain. This is important because the treatment for bursitis and synovitis usually involves rest and some form of anti-inflammatory treatment. This treatment approach, while helpful for the acute pain of bursitis and synovitis, will be ineffective for chronic pain.

Fibromyalgia is a chronic pain condition of unknown cause.

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People with fibromyalgia have pain in multiple parts of their bodies and associated sleep issues with fatigue. It is not life-threatening, but it can cause suffering if not managed appropriately.

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It is important you are evaluated by your medical provider to learn pain management strategies and to exclude other causes of chronic pain (for example, rheumatoid arthritis).

Low back pain is also called “Lumbago” - this is the same thing. Low back pain is defined as pain between the end of ribs and the top of the gluteal region (buttocks).

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The cause of low back pain is often related to muscle pain (also called “myalgia”) and joint irritation.

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If you had an X-ray, your doctor may have told you there was “Intervertebral disc degeneration.” This is a common age-related change that may or may not be contributing to your low back pain.

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Sometimes X-rays also show “Spondylolisthesis.” This term describes one vertebra slightly shifted in front of another. Like disc degeneration, it is more common with age and may or may not be contributing to your low back pain.

Neuropathy is a general term used to describe dysfunction of the nerves of the body.

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Any peripheral nerve can be involved in neuropathy. Some common examples include the median nerve at the wrist and hand, the ulnar nerve at the elbow, and the tibial nerve at the ankle and foot.

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If there is focal irritation or compression of these nerves, an “Entrapment Neuropathy” is diagnosed. The most common include:

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• Carpal tunnel syndrome = entrapment of the median nerve at the wrist

• Cubital tunnel syndrome = entrapment of the ulnar nerve at the elbow

• Tarsal tunnel syndrome = entrapment of the tibial nerve at the ankle

 

Certain conditions like Diabetes Mellitus or Alcohol Use Disorder can cause irritation and possibly damage to many peripheral nerves at once. This is also called “Neuropathy.” These neuropathies usually start in the toes and fingers and then progress up the legs and arms.

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Neuropathies can be very painful and can also put one at risk for falling or dropping items.

Sciatica refers to irritation of the nerves in the lower part of your back. The sciatic nerve is normal anatomy, and we have a right and left sciatic nerve.

 

This nerve forms in your gluteal region (buttocks) when the nerves of the lower part of the back come together and extends all the way to the foot.

 

If the nerves of the lower part of the back become irritated (from a disc herniation, for example), then we may feel pain along the course of this sciatic nerve. The term “Sciatica” describes this nerve irritation.

Another term for sciatica is “Lumbar Radiculopathy.” They both mean irritation of the lower back nerves.

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Sciatica is very painful, especially when it first happens. This is nerve pain, and it may feel like burning, shooting, stabbing, numbness, pins-and-needles, electrical, or aching.  

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Most cases of sciatica get better with time and do not need surgery. However, it is important you work with your doctor to make sure you receive the care you need and are recovering as expected.

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Sciatica or radiculopathy do not represent permanent “nerve damage.”

Shoulder pain is common. In adults, there are multiple potential causes of shoulder pain. The most common cause of shoulder pain is rotator cuff irritation. The rotator cuff is made up of muscles and tendons that surround the shoulder joint. Rotator cuff irritation occurs on a spectrum from “Tendinopathy/Tendinitis” to “Tear.”

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Tendinopathy means tendon degeneration, and tendinitis means tendon inflammation. Both happen with age, as well as other causes such as overuse, injury, incorrect posture, and others.

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A rotator cuff tendon tear is usually more important, and may require surgery. A thorough examination, and usually a shoulder ultrasound or MRI is needed to make the diagnosis.