Surgical & Non-Surgical Treatment for Joint Pain

Thank you for visiting the Institute for Orthopaedic Surgery and Sports Medicine! You’ve now had an orthopaedic evaluation with one of our Fort Myers orthopaedic specialists inquiring about your joint pain and are waiting for your results. Many different types of treatments are available to you depending on your diagnosis.

Non-Surgical Options

Diet & Exercise

Did you know that the average American is 20-40 lbs overweight, and takes around 5000-7000 steps a day? Light exercise like walking and a balanced diet are recommended to help manage your weight and keep you healthy. Otherwise, if you suffer from arthritis, you should also try and reduce stress on your weight-bearing joints as the extra pressure on your diagnosed joint may aggravate your condition.

ROM Exercises

Range of motion exercises are exercises that promote joint function and help maintain normal joint movement. They can also increase flexibility and relieve stiffness, in conditions like arthritis.

Strengthening Exercises

Try strengthening exercises to increase your muscle strength, thereby supporting and protecting joints that are affected by arthritis. Regular exercise and strength building is integral to managing joint conditions.

Aerobic Exercise

Aerobic exercise improves cardiovascular fitness, can help maintain a proper weight and may play a part in reducing joint inflammation.

Rest & Joint Care

You may be advised for short-term bed rest to reduce your joint inflammation and pain. Rest is especially important when multiple joints are affected and if you are suffering from lethargy and fatigue due to joint pain. If only one or few joints are affected by pain, you can rest your joints independently while still using your other body parts. Heat therapy for joints can be done to increase blood flow and pain tolerance/flexibility, while cold therapy like ice packs/massages, sprays and ointments can reduce your pain by numbing nerves surrounding the joints.

Physical Therapy

Physical therapy is prescribed in order to restore your function and perform everyday tasks, so you can go back to your everyday routine. Your physical therapist at Hicksville PT will provide exercises intended to preserve your joint strength and usage, reteaching you how to walk or use your muscles as well as use any aids you may be provided with. In physical therapy, you will focus on range of motion, as these exercises are key for your muscles to return to everyday use.

Walking Aids

Depending on your condition, your doctor may suggest a walking aid like crutches, a walker, a brace or a cane.

Medications

Analgesics, or pain relievers, may help relieve arthritis pain. Traditional pain relievers like Aspirin, ibuprofen, and naproxen may also be taken, though they are only temporary solutions.

Topical pain relievers, like over-the-counter patches, rubs, and ointments also provide quick pain relief for conditions that aren’t too severe, or for arthritis that encompasses few joints like the hand.

Glucosamine

Glucosamine and chondroitin are naturally-occurring compounds found in your body, that both are part of your cartilage and help cushion the joints. Researchers are currently studying chondroitin for use in medicines and helping to prevent blood clots in anticoagulants. However, further research needs to be done for their safety and effectiveness, and they are not FDA approved, but they are thought to help joint pain, osteoarthritis pain and improve functions (1,2). Some studies perceive that glucosamine will be able to relieve osteoarthritis pain similarly to ibuprofen medications, especially pain in the knee, and will produce fewer side effects (3).

Side Effects

Arthritis supplements and treatments like cortisone injections may provide temporary relief. They are generally well-tolerated, but side effects may still occur. These side effects may include:

●      Nausea

●      Diarrhea or constipation

●      Heartburn

●      Increased intestinal gas

Your doctor will provide you with the full information if you are recommended an injection or supplement.

Visco-Supplementation

A hyaluronic acid injection is taken from the fleshy growth on a rooster’s head, which is why they are also called “rooster comb injections”. They are FDA approved treatments for osteoarthritis, especially in the knee. Their effectiveness will show in around 5-13 weeks, so their relief is not as instant as cortisone injections, and benefits usually last at least 6 months. However, they do not prevent progression and may be expensive if administered.

Arthroscopy

Arthroscopy is a minimally invasive joint procedure in which a small incision is made in the joint so a small instrument with a camera lens can be inserted to diagnose and treat the problem. Compared to open surgery and a joint replacement, you will have fewer complications and a shorter recovery time but not every case can have an arthroscopy.

Joint Fluid Supplements

If your pain does not improve with medications or physical therapy, your doctor may suggest a "joint grease" injection. Like a viscosupplement and cortisone injection, the joint is injected with a fluid. In this case, the joint grease acts as a lubricant for the painful joint. Joint inections and relief vary with the patient’s condition, but they will usually be every few months. These injections will not cure the joint, and only provide temporary relief; eventually, the joint may still need to be replaced.

Joint Replacement

If your condition is more severe and non-surgical options do not fix your pain, your doctor may recommend joint replacement surgery. Your doctor will provide you with all the information you need, such as the type of artificial joint they will use, what you need to do to prepare for joint surgery, how the surgery will be performed, and how your joint will progress when recovering from joint replacement surgery.

Total joint replacement is a type of surgery where parts of an arthritic or damaged joint (such as the hip or knee) are replaced with a plastic or metal device called a prosthesis. A prosthesis helps your artificial joint mimic the actions of a healthy joint.

In hip replacement, your doctor will replace your thigh bone (femur) and hip socket (acetabulum), with an artificial ball made of a strong metal and an artificial socket made of polyethylene, a resilient and wear-resistant plastic. Meanwhile, in total knee replacement, the artificial joint is also composed of metal and polyethylene to replace the diseased knee. The prosthesis is held in place with bone cement or covered with material that lets bone tissue grow into it.

References:

1. Dieppe P, et al. (2002). Osteoarthritis. Clinical Evidence (7): 1071–1090.
2. McAlindon TE, et al. (2000). Glucosamine and chondroitin for treatment of osteoarthritis. A systematic quality assessment and meta-analysis. JAMA, 283(11): 1469–1475.
3. Update on glucosamine for osteoarthritis (2001). Medical Letter on Drugs and Therapeutics, 43(1120): 111–112.

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