Why do I hurt?

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Q: What is arthritis?

A: Definition of arthritis is an inflammatory reaction involving a joint.

Q:  What is inflammation?

A: Inflammation is the process by which our body, heals injuries, fights infection. However chronic inflammation or uncontrolled inflammation can lead to harmful consequences including excessive wear and tear on the joints and body. Therefore inflammation is a necessary mechanism to promote good health and function. Injured ligaments, tendons, joint capsules require inflammation to repair themselves. Blocking inflammation with anti-inflammatory medications may not be the best approach long-term for our bodies.

Q:  What is Bursitis?

A: First what is a bursa? A bursa is a thin fluid-filled sac that separates a muscle from a bone to reduce friction. There are multiple bursae throughout the body. Some large, some small. Normally, they have a minimal amount of fluid. Sometimes overuse or injury can result in fluid accumulation and sometimes infection, leads to bursitis. This can be quite painful.
Locations of common bursa:

Outer hip (greater trochanteric bursa)
Shoulder (subacromial bursa)
Elbow (olecranon bursa)
Front of the knee (prepatellar bursa)
About the knee (suprapatellar bursa)
Under the shoulder blade (subscapular bursa)

Q:  What is tendinitis?

A: What is a tendon? Tendons attach muscle to bone. They are fibrous tissue with a poor blood supply, therefore prone to injury. Injury to a tendon is called an enthesopathy. Tendinitis is an inflammatory reaction involving an injury to the tendon. The pain resulting from an enthesopathy can mimic arthritis.
Common locations for tendinopathy:

Outer shoulder (rotator cuff tendinopathy)
Lateral elbow (lateral epicondylitis-i.e. tennis elbow)
Medial elbow (medial epicondylitis, i.e. golfers elbow)
Wrist and thumb (dequervain’s tenosynovitis)
Outer hip (gluteal or piriformis tendinopathy)
Top front of the knee (quadriceps tendinopathy)
Bottom front of the knee (patellar tendinopathy)
Ankle (posterior tibialis tendinopathy)

Q: What is sciatica?

A: Sciatica means leg pain. When pain from the lower back goes into the leg, this is termed sciatica. Sciatica usually denotes a pinched sciatic nerve, most commonly due to a herniated disk in the lower back. However, it is still possible to have sciatica without a slipped disk. Sciatic pain can arise outside the spinal region. A careful history and physical examination, including possibly additional tests such as a CT scan or MRI may be needed to confirm the diagnosis. Most people with back pain recover spontaneously with a tincture of time usually within 6 months. When pain does not resolve, nonsurgical methods of treatment, can usually resolve the pain. Rarely should one need to have surgical intervention.

As you can see, there are many reasons why someone can be in pain. Sciatica does not automatically translate to a pinched nerve. Joint pain does not always equate to arthritis.  A careful history and physical examination is required to arrive at a diagnosis. Even then, there may not be a clear cut cause of the pain.

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