If you have chronic joint pain and stiffness, it could be osteoarthritis, which means that the cartilage of your joint is starting to break down. It’s more common as you age and can be accelerated by injuries, repetitive motion, obesity, genetics or structural issues.
Some people with joint pain don’t think it’s worth it to meet with an orthopedic doctor because they assume that their only option is surgery, but that’s not true.
“Surgery isn’t the only way to manage arthritis, and usually shouldn’t be the first option,” says UNC Health orthopedic surgeon Zachary Bloom, MD. “I see many patients everyday who may never need a joint replacement. Ultimately, the goal is to feel better and there are many ways to get there.”
Dr. Bloom explains some nonsurgical options, as well as how to know it’s time for surgery.
Treatment Options To Try Before Joint Replacement Surgery
While the specific options will vary depending on your situation, here are some common approaches to pain relief:
- Physical therapy.
When your joint hurts or you can’t trust its stability, you tend to stop using it. That makes the joint weak, which actually worsens the pain. A physical therapist can give you exercises that are safe and helpful for your situation, as well as exercise modifications that keep you moving for your overall health.
“Motion is important for joints,” Dr. Bloom says. “Physical therapy helps by building strength and mobility.”
In addition to building strength, working with a physical therapist will likely give you confidence about how much you can actually do, even with osteoarthritis. If you’ve stopped exercising or doing things you love, such as gardening, physical therapy is a great first step back.
- Pain relievers and braces.
Your doctor or physical therapist can help you understand how to best treat flares of pain or chronic pain. You may benefit from ice or heat at certain times, such as after exercise or before bed.
You can also use over-the-counter oral pain relievers, such as acetaminophen or ibuprofen, but talk to your doctor if you’re taking them multiple times a day.
“With something like Motrin (ibuprofen), the effect wears off after eight hours. Other medications can give relief all day with just a single dose,” Dr. Bloom says.
An over-the-counter brace can provide pain relief and stability, but talk to your doctor about the right one for you or if you notice you’re using it more and more.
- Injections.
Depending on the joint that’s affected, you may benefit from certain injections.
Your doctor may recommend corticosteroid injections that provide short-term pain relief by decreasing inflammation. Most people can get these shots every three months.
For some people, shots of hyaluronic acid (sometimes called gel shots) reduce knee pain by adding lubrication to the joint, giving your knee a better cushion. Eventually, your body will absorb that fluid, so relief is usually not permanent. These injections can be given every six months if they work for you.
Platelet-rich plasma injections use the healing factors in your blood to stimulate healing for the joint, but right now, these injections are not covered by insurance, and not all types of injuries respond to this therapy.
- Lifestyle changes.
If you’ve been dealing with joint pain, you may have let some healthy habits such as exercise fall by the wayside. It can be hard to sleep when you’re in pain, so you may feel more stressed or lack the energy to make healthy meals.
Getting back on track with regular movement, a balanced diet, prioritizing sleep and minimizing stress will help you feel better overall. If overweight or obesity has contributed to pain in your knees and hips, losing weight will help.
“When it comes to your knee, every pound you lose from your body can take four pounds of pressure off your knee, which can be really helpful,” Dr. Bloom says.
How to Know It’s Time to Consider Joint Replacement Surgery
How will you know when it’s time for joint replacement surgery? Here are some things you can expect to discuss with your doctor:
1. Your quality of life.
Only you will be able to tell your doctor when you can no longer handle the pain in your joint.
“If you’ve tried other things and you’re still hurting, then we can talk about surgery,” Dr. Bloom says. “It really comes down to your quality of life, what you want to do and how you feel.”
Your doctor will perform imaging and see the extent of your arthritis. Some people are able to live with a high degree of arthritis, while others need surgery with only a little bit of damage, so only you can tell your doctor when it’s time.
“Everyone is different, so a personal approach is important when dealing with joint pain,” Dr. Bloom says.
2. Your medical history and health status.
You may know that you’re on the road to a joint replacement, but it might not be your top health priority—maybe you need to be focused on your blood pressure or your mental health right now. Talk to your doctor about how you can be at your healthiest before surgery.
3. Your readiness to participate in recovery.
Because joint replacement is elective surgery, you should try to find a period of time when you can really focus on your recovery. Be honest with your doctor about personal commitments that might hinder that.
“A joint replacement is a team effort, and you’ll get out what you put in,” Dr. Bloom says. “Post-operative therapy plays a big part in recovery.”
If you watched a loved one have a joint replacement 20 or 30 years ago, you might be surprised by how quickly you start recovering.
“We used to keep people in the hospital for days after surgery, but now the majority of patients go home the same day or the day after,” Dr. Bloom says. “Physical therapists may come to your house to help you get up and back to your life. It’s hard work, but with time, you feel better and better.”
Questions about joint pain? Talk to your doctor or find one near you.