Why See an Orthopedist Before You Need Surgery?

Knowing you have arthritis within a hip or knee joint does not automatically mean that you will need joint replacement surgery.  This decision is based on several factors such as:  X-ray and physical exam findings, conservative treatments tried, pain, sleep issues, as well as the extent of limitations in activities of daily living that you are experiencing.  Based on the degree of the above factors, one may or may not qualify for joint replacement surgery.

Joint replacement surgery is a very good surgery that can permanently help alleviate pain and allow a patient to get their quality of life back.  It is the endpoint when reasonable conservative treatments have failed.  Let’s go through some of these conservative measures that can help manage arthritic pain.

Weight loss, or maintaining a more average weight is critical to slowing the arthritic process.  Every pound of weight gained or loss correlates to three to six pounds of stress or force across various areas of a joint.  One can understand then, maintaining a healthy weight can slow the arthritic process and control pain.  Exercise as well as a healthy diet (food choices) can aid in weight loss.

Strengthening the muscles around your arthritic joint can aid in pain relief by helping to absorb the forces that cross the joint surfaces.  Various activities such as weight lifting, swimming, biking, and elliptical raining can help accomplish pain relief.  A physical therapist or your doctor can help guide you to which exercises may be right for you.

Bracing may be an option, especially for knee arthritis.  Various knee sleeves all the way to more rigid unloader braces can be used for symptomatic relief.  A cane also help take some weight-bearing load off the affected joint.

Icing or heat treatment about the affected joint can help alleviate symptomatic arthritic pain.  Consult your doctor or therapist as to the appropriate amount of time to use this therapy to avoid skin damage.

Over-the-counter medications such as Tylenol, Ibuprofen, Motrin, Advil and Aleve can help control the pain symptoms of arthritis.  Various topical creams are available.   Additionally, oral medications such as glucosamine, chondroitin sulfate, hyaluronic acid, and turmeric can also help.  Be sure to consult your doctor to see if these medications are right for you based on health conditions you may have.

Prescription medications taken on a more regular basis as directed by your physician may be a step in aiding arthritic symptoms. These can provide more therapeutic levels of medication in your bloodstream that can combat the inflammation process and subsequent pain caused by arthritis.

Various types of injections can be given to combat arthritic joint pain.  The most common type is cortisone.  It is a concentrated anti-inflammatory that can more directly act on the arthritic components causing pain in the joint.  After injection, it can take anywhere from two to five days to work.  Approximately 70% of people receive various degrees of relief from the injection that can last from days to months.  These injections can be given roughly three times a year.  Visco-supplementation (Hyaluronic acid) injections are another source of arthritic pain relief.  How it works is not fully understood, but approximately 70% of patients gain some relief.  It tends to work better on those with less severe arthritis.  Out-of-pocket treatment such as platelet-rich plasma (PRP) injections is an option, but less well studied regarding arthritic benefit.

If the above conservative measures to control pain have been exhausted, X-ray physical exam findings warrant, and activities of daily living are significantly impacted, a joint replacement may be offered by an orthopedic surgeon as a way for more permanent pain relief.

Joint replacement surgery is a very good surgery that can allow a patient to get their function and quality of life back.  The longevity of replacements these days have evolved and are life-long for most patients undergoing these surgeries.  Certainly, there are pain and risks to undergoing surgical intervention, but these risks and pain management are discussed with your orthopedic provider prior to undergoing joint replacement. OrthoNebraska offers many options that are customized to you and your surgeon, from opioid-sparing to robotic and same day discharge protocols.

In summary, there are several different treatment options to slow and control arthritic pain prior to total joint replacement. Treatment combinations are unique to each patient. Seeing an orthopedic expert before you reach the point where surgery might feel inevitable is helpful so we can help tailor the right plan for you.

Ready to discuss your pain with an expert? Schedule an appointment today.

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