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The Journal of the American Board of Family Practice 17:S32-S42 (2004)
© 2004 American Board of Family Practice

Article

Managing Joint Pain in Primary Care

Trish Palmer, MD and James D. Toombs, MD

Pisacano Leadership Foundation and the Department of Family and Preventive Medicine, University of Utah, Salt Lake City (TP)
Department of Anesthesia, University of Iowa Hospitals & Clinics, Iowa City (JDT)

Correspondence: Address correspondence to Trish Palmer, MD, Department of Family and Preventive Medicine University of Utah, 1138 E Wilmington, Salt Lake City, UT 84106 (e-mail: trish.palmer{at}hsc.utah.edu)

Joint pain is a common problem seen by family physicians. Although many pain complaints arise from self-limited conditions, a substantial number require immediate and ongoing care. Prompt appropriate treatment can help limit symptoms, prevent disability, and improve outcomes. The differential diagnosis is varied, with both laboratory studies and diagnostic imaging available to help evaluate the joint. At the initial evaluation and at each subsequent re-evaluation, there should be efforts to identify dangerous conditions and distinguish conditions with a disease-specific pathogenesis. Treatment of joint pain consists of both pharmacologic and nonpharmacologic modalities. Pharmacologic therapies may include medications specific for pain, inflammation, and adjuncts specific to the diagnosis. Treatment of pain should proceed in a step-wise fashion providing medications appropriate for treating the level of pain. Inflammation is treated with physical modalities and nonsteroidal anti-inflammatory or cyclo-oxygenase-2 inhibitors. Nonpharmacologic therapies may include protection, rest, ice, compression, elevation, and simple office procedures. Physical therapy and education can assist in the recovery process, and prevent recurrence.


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Copyright © 2004 by the American Board of Family Medicine.