Dolor en las articulaciones: cuando es hora de ver a un médico

Joint pain can have a wide variety of causes. This can make it difficult to know when it is time to talk to a physician regarding pain you may be experiencing. Sometimes the joint pain can be from an acute injury. Sometimes the pain can be from a chronic ongoing condition with gradually increasing joint pain. There can also be acute flare-ups of pain with underlying chronic joint conditions. Here are some general guidelines.
 
For an acute fall or injury:

• If you’ve fallen or injured yourself and are concerned you may have broken a bone, it’s a good idea to see a physician.

• If you have an injury and have a visible deformity or severe injury, you may need to call 9-1-1 for an ambulance and to be seen in the Emergency Department. (Especially for hip fractures in the elderly)

For ongoing chronic pain that is gradually worsening:

• One of the first recommendations for pain is to try Tylenol on a consistent dosage schedule for a week. If that doesn’t work, you may try naproxen or ibuprofen on a consistent dosage schedule. If you’ve been taking these over-the-counter medications every day for a week and it’s not helping, it may be time to call a physician for further evaluation.

• If you are having trouble sleeping at night that is causing some functional disturbances in your daily life, it may be time to talk to a physician.

• For knee pain, minor non-mechanical catching or clicking is generally not a sign of a significant issue and is likely okay to observe for a while. However, if you have to twist your knee to get it to unlock so you can bend it, it is time to see an orthopedic physician for further evaluation.

• For hand pain, if it hurts to grip tools with smaller handles, but you’re fine with a larger-handled tool, then again, that’s okay to observe for a while. If changing tools enables you to continue to do the gardening, wood working or any other activities you enjoy, then that’s great. Lifestyle modifications such as these can be very effective tools to improve pain and quality of life.

• If you find yourself avoiding activities of daily living – like walking, taking the stairs or resting the affected joints too much – then it may be time to see an orthopedic physician for further evaluation. Remember that family members and loved ones may be the ones who notice you avoiding certain activities.

Keep in mind two things:

• If you’re worried about coming into a physician’s office because of the risk of contracting a virus, many initial consults can be done as a virtual visit. If it is determined that you need to come in, most providers’ offices should be among the cleanest and most disinfected of all public spaces.

• If you’re worried about having to have surgery, we do look at the whole picture – your needs as well as all the options available to you. Physical therapy and medication are also explored, as are the root causes of your specific pain. If surgery is recommended, there are so many more options for minimally invasive procedures – and drastically shorter recovery times – than were available even 20 years ago. All recommendations will be based on providing you with the least invasive option that will provide the best functional outcome.

Sometimes spouses or adult children may also feel they need to provide you with their opinion on whether it’s time for you to see a physician. While this can feel like nagging and can be difficult to hear these concerns, keep in mind that they are the ones who may have noticed changes in your activities. To you, making gradual adjustments over time, it may not be as apparent that you’re going for less frequent walks, not sleeping as well or avoiding activities. Remember that these opinions or concerns are brought up because the person cares about you.

Nicholas DeFauw, DO, has advanced training in family medicine and a fellowship in sports medicine. He treats patients of all ages, from young athletes and adult exercise enthusiasts to weekend warriors and others with muscle or bone injuries or pain.