Information for Patients
What are joints?
Your joints are places where two or more bones come together. Your shoulders, elbows, hips, knees, and knuckles are all joints. Your spine has joints, too.
But joints are more than bones. They include the soft tissues around them, such as cartilage, tendons and ligaments. Cartilage is the hard slippery flexible tissue that covers the ends of your bones at a joint. Tendons are tough, flexible bands that connect your muscles to your bones so you can move your joints. Ligaments connect the bones of the joint to each other to keep them stable when you move.
What are joint disorders?
Joint disorders are diseases or injuries that affect your joints. Injuries can happen because of overuse of a joint. Or you could have a sudden injury, such as an accident or a sports injury.
What diseases can affect the joints?
Many diseases can affect the joints. They often cause joint pain and make your joints stiff, red, or swollen. Most of them are chronic. That means they last a long time. Some may never go away completely. Some of the diseases that affect the joints include:
- Arthritis. Arthritis may cause joint pain and swelling. There are many types of this disease. Osteoarthritis is the most common type. Over time, arthritis can cause severe joint damage. It can affect people of all ages. A joint injury when you're young may cause osteoarthritis later in life.
- Lupus. This autoimmune disease affects many parts of the body and can cause joint and muscle pain. Some types of lupus often cause arthritis.
- Sjögren's Syndrome. This autoimmune disease affects glands that make moisture in many parts of the body. The main symptoms are dry eyes and mouth, but it often causes joint pain, too.
Treatments are different depending on the disease. But most treatments include medicines and therapies to relieve pain and other symptoms.
What types of joint disorders happen from sudden injuries?
Joint disorders from sudden injuries include:
- Sprains and strains. Sprains are stretched or torn ligaments. Acute strains are stretched or torn muscles or tendons that happen from a sudden injury or movement, such as lifting a heavy object.
- Dislocated joints. A joint is dislocated when the bones are pushed or pulled out of position. A joint dislocation is a medical emergency.
Treatment depends on the type of injury. You can treat many sports injuries at home. But you should call your health care provider if you:
- Have a lot of joint pain, swelling or numbness
- Can't put weight on the joint
- Have pain from an old injury with more swelling, an unstable joint, or a joint that isn't normal in another way
What types of joint disorders happen from overuse?
Overuse injuries usually damage the soft tissues of the joint. They can happen when you work a joint too hard by doing the same movements over and over. For example, you could get an overuse injury from playing a musical instrument, playing sports, or doing certain jobs, such as carpentry or painting.
Joint overuse injuries include:
- Bursitis. The bursa is a small fluid-filled sac. It works as a pad between the bones of a joint and the moving parts around it, such as muscles, tendons and skin. With bursitis, the bursa becomes irritated and swollen with extra fluid. Overuse is the most common cause, but injuries, infections and other conditions, such as arthritis, can cause bursitis.
- Tendinitis. This condition happens when you overuse a tendon. It swells and makes the joint painful to move.
- Chronic strain. A strain becomes chronic when your muscles or tendons stretch or tear slowly over time from repeating the same movements.
The treatments for bursitis, tendinitis, and chronic strain are often the same. They usually include rest, keeping the injured joint higher than your heart, and taking medicine to reduce swelling. Your provider may recommend gentle exercise and other treatment. In some cases, your provider may suggest an injection (a shot) of medicine into the joint. If these do not help, you may need surgery.
How can I keep my joints healthy?
Getting enough physical activity is one of the most important things you can do to prevent or slow joint disorders. Activity strengthens the muscles around your joints and helps them work better.
When you play sports, wear the right equipment to protect your joints, such as knee pads. If you already have joint problems, ask your provider what type of activities are best for you.
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, chest, pelvis, or you may feel pain all over.
Pain can be helpful in diagnosing a problem. If you never felt pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment.
There are two types of pain: acute and chronic. Acute pain usually comes on suddenly, because of a disease, injury, or inflammation. It can often be diagnosed and treated. It usually goes away, though sometimes it can turn into chronic pain. Chronic pain lasts for a long time, and can cause severe problems.
Pain is not always curable, but there are many ways to treat it. Treatment depends on the cause and type of pain. There are drug treatments, including pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.
NIH: National Institute of Neurological Disorders and Stroke
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.