Joint pain, a common complaint among older adults, warrants careful evaluation rather than dismissal as a simple consequence of aging, according to medical specialists at Sunway Medical Centre Damansara (SMCD). Consultant rheumatologist Dr. Lee Kar Hoo emphasized that the term “arthritis” encompasses a variety of conditions affecting joints, characterized by pain, stiffness, and swelling.
Arthritis is generally classified into two main types: inflammatory arthritis and mechanical arthritis, or osteoarthritis. Inflammatory arthritis results from various causes such as infections, autoimmune diseases, chemical or drug reactions, and certain metabolic or hormonal disorders. This type of arthritis features swollen and painful joints resulting from inflammation and often affects multiple joints. Furthermore, it can involve other organs including the skin, eyes, lungs, heart, and kidneys, along with symptoms like persistent fatigue.
Mechanical arthritis, on the other hand, develops from wear and tear of joint cartilage and bone. While aging is a significant risk factor, previous joint injuries, excess weight, joint alignment issues, genetics, and repetitive stress also contribute. Unlike inflammatory arthritis, mechanical arthritis symptoms typically worsen with activity and improve with rest.
Diagnosis relies on a combination of clinical evaluation, blood tests to identify inflammatory markers and autoimmune antibodies, uric acid levels for gout detection, and imaging techniques such as X-rays, ultrasound, or MRI to assess joint damage or inflammation. Early and accurate diagnosis is critical for preventing permanent joint damage, with treatments focused on controlling inflammation, pain relief, and improving joint function.
Treatment strategies vary according to the arthritis type. For inflammatory arthritis, early control of inflammation is key to limiting joint damage. Mechanical arthritis treatment generally emphasizes symptom relief, functional improvement, and addressing underlying mechanical issues.
Surgical intervention is considered a last resort when conservative measures such as medication, physical therapy, weight management, and pain control do not sufficiently relieve symptoms. Consultant orthopaedic trauma, arthroplasty, and robotic surgeon Dr. Juzaily Fekry Leong notes that surgery aims to reduce pain and correct deformities, enabling patients to return to daily activities. Surgical options include joint-preserving procedures like osteotomy, which can redistribute joint forces and delay the need for replacement, particularly in younger patients. When joint damage is extensive, arthroplasty or joint replacement—commonly performed on hips and knees—provides reliable pain relief and functional restoration.
Advances in surgical technology, including robotic-assisted and artificial intelligence-guided navigation, have enhanced precision in implant placement, although these tools complement rather than replace surgical expertise. Age is not a disqualifying factor for surgery; suitability depends on the severity of joint damage, overall health, activity level, and previous responses to non-surgical treatment.
Both clinicians stress the importance of obtaining an accurate diagnosis instead of self-medicating persistent joint pain. Dr. Lee warns that improper treatment of assumed osteoarthritis or gout may lead to irreversible joint damage or other complications. Dr. Juzaily also advises patients not to fear surgery, highlighting that modern techniques often allow for shorter hospital stays, and select patients may even undergo same-day joint replacement procedures.
The overarching goal in arthritis management remains to preserve mobility and quality of life for as long as possible through a combination of timely diagnosis, appropriate medical care, and when necessary, advanced surgical intervention.