Is joint pain just part of ageing? What to know about osteoarthritis

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Five minutes. That was about as long as Mrs Jenny Soh* could walk before the pain in her knees forced her to stop. 

For more than a decade, the 56-year-old homemaker had lived with worsening pain in both knees, which began after a knee injury in her late 30s. 

She suffered from osteoarthritis, a progressive condition where the cartilage that cushions the joint gradually breaks down, leading to pain, stiffness and reduced function. Mrs Soh had put up with the pain for years and tried to manage the symptoms herself, including by taking supplements.

“I was hesitant to seek medical advice because I had heard mixed opinions from people,” she said.

By the time she saw a specialist, even standing for several minutes or leaving the house had become difficult. “I was scared to go anywhere alone. I could barely stand for five to seven minutes,” she said.

FEAR AND MISCONCEPTION CAN DELAY TREATMENT

Such hesitation is not uncommon, said Dr Kelvin Tan, senior consultant and specialist orthopaedic surgeon at Singapore Sports and Orthopaedic Clinic. Uncertainty about treatment, as well as misconceptions about joint health, can sometimes lead people to delay seeking medical advice. 

One misconception is that arthritis and joint pain are simply part of ageing and something people live with.

“Persistent joint pain is not something people should simply accept as ageing. When pain starts to affect daily activities, mobility, independence or quality of life, it is important to seek medical assessment,” said Dr Tan. 

While occasional aches and pains can occur with age, Dr Tan said osteoarthritis should not simply be dismissed as normal “wear and tear”. Because symptoms can worsen gradually, patients may adapt without realising how much their mobility has declined, he added.

The prospect of surgery may also put some off seeing a specialist, while information on social media can add to the uncertainty around treatment and make it difficult to distinguish evidence-based advice from anecdotal claims. “Medical professionals generally rely on established clinical guidelines when recommending treatment,” said Dr Tan. 

FROM CONSERVATIVE CARE TO SURGERY

Seeing a specialist does not necessarily mean surgery.

According to Dr Tan, osteoarthritis treatment usually begins with measures such as weight management, physiotherapy and strengthening exercises, depending on a patient’s symptoms and needs. Pain medication and, where appropriate, injections may also help relieve symptoms and maintain function. 

“Arthritis management is usually a progression. We start with conservative measures and adjust treatment according to how symptoms evolve and how patients respond,” said Dr Tan. 

These approaches can help patients manage symptoms and remain active, but they do not reverse the underlying joint degeneration, said Dr Tan. 

For some patients whose symptoms continue to significantly affect mobility and daily life, surgery may be one of the treatment options considered, depending on individual circumstances and clinical assessment.

In Mrs Soh’s case, after discussing the available treatment options with her doctor, she underwent total knee replacement surgery.

WHERE ROBOTIC ASSISTANCE FITS IN

Knee replacement can be carried out using different surgical approaches and tools. These include robotic-assisted systems, which can help surgeons plan and carry out the procedure based on a patient’s anatomy. Their use does not mean the robot performs the operation, said Dr Tan.

“The surgeon remains in control throughout. These systems are human-controlled, robot-guided and human-executed,” he said. The technology can provide information to assist with implant positioning and alignment, but surgical judgment, decision-making and execution remain the responsibility of the surgeon, he explained.

Robotic assistance is also not necessarily appropriate for every patient.

“Conventional joint replacement remains a well-established and appropriate option for many patients. The choice of technique depends on multiple factors, including the patient’s needs and the surgeon’s assessment,” said Dr Tan.

STAYING ACTIVE WITH OSTEOARTHRITIS

For people with osteoarthritis, staying active can help maintain mobility, although the type and intensity of activity must be appropriate for the individual. 

For some people, previous injuries may be a more significant risk factor. “The bigger issue is often previous ligament, meniscus or cartilage injuries, which can contribute to earlier osteoarthritis,” said Dr Tan.

There is also no single exercise approach that suits everyone with osteoarthritis. Dr Tan advised patients to stay active in ways they can manage comfortably and consistently. Strength training can help support the joints by building the surrounding muscles, while lower-impact activities may be better tolerated by some people, he said.

Some discomfort during activity can occur, but changes in pain and function are important to pay attention to. “Mild discomfort during activity can occur, but persistent pain, worsening symptoms or pain that significantly limits function should not be ignored,” said Dr Tan. 

Looking back, Mrs Soh said she wished she had sought medical advice earlier rather than trying to manage her symptoms on her own for more than a decade.

Dr Tan said it is important to recognise when joint pain begins to affect daily life. “If you find yourself avoiding activities you previously enjoyed, needing to rest more frequently because of joint pain, or struggling with routine tasks, it is worth seeing a doctor to understand the cause and discuss appropriate treatment options,” he said. 

*Name has been changed to protect her privacy. 

This article is intended for general educational purposes only and does not constitute medical advice or an endorsement of any specific treatment approach, healthcare provider or medical device. Treatment options and suitability vary according to individual clinical circumstances. Individuals should consult a healthcare professional for diagnosis and treatment recommendations.