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nonsurgical joint treatments

NONSURGICAL JOINT TREATMENTS

Relieving Hip and Knee Pain without Surgery

Hip and knee pain can keep you from the activities you love, as well as make routine tasks difficult. There are many ways to get you moving again pain-free, without surgery. If your doctor is not recommending surgery for your hip or knee joints at this time, there are some other ways to alleviate pain and improve mobility

Medications

Pain relievers are usually the first choice of therapy for osteoarthritis of the hip and knee. Simple pain relievers, such as acetaminophen (Tylenol) are available without a prescription and can be effective in reducing pain. There are additioinal non-steroidal, anti-inflammatory medications available over-the-counter including aspirin, ibuprofen (Motrin or Advil), or naproxen (Aleve) designed to help reduce pain and swelling in the joints. More aggressive therapy sometimes includes stronger prescription-strength, non-steroidal, anti-inflammatory drugs (NSAIDs) that can be prescribed by your doctor.

Another category of medication treatment includes "disease-modifying anti-rheumatic drugs" (DMARDs). These medications, such as methotrexate (Rheumatrex, Trexall) and etanercept (Enbrel) can help slow down the progress of certain types of inflammatory arthritis including rheumatoid arthritis. While NSAIDs are typically effective soon after you take the medicain, the DMARDs have an extended onset of action, often not providing optimal pain relief for weeks or months.
osteoarthritis and rheumatoid arthritis diagram

Joint injections

Cortisone injections administered by a healthcare professional can provide you with pain relief and reduce inflammation within a joint. These types of injections can be very useful if there is significant swelling, but often offer very limited relief if the arthritis affects movement of your joint. How long the injection works before it wears off is variable, and there is a limit to how often and how many steroid injections you should receive per year.

Viscosupplementation is a treatment in which hyaluronic acid (HA) is injected into the hip or knee joint. Hyaluronic Acid based injections can help joints work properly by essentially acting like a lubricant within the joint. There are several different types that your doctor can offer to provide in various treatment regimes. Due to anatomy around the hip joint, injections into the hip are more complicated and therefore much less frequently prescribed. Some brand-name examples of such medications include Synvisc, Orthovisc, Supartz, and Hyalgan.
hip joint injection infographic

Weight Loss

Many people with osteoarthritis are overweight. Simple weight loss can reduce stress on your weight-bearing joints, such as the hip or knee. Based upon the physics of the hip and knee joints, you put three to five times your body weight across these joints throughout the day – especially during stair climbing and getting in and out of a chair.Every ten pounds of extra weight that you carry can result in fifty pounds of weight-bearing pressure across your hips and knees. Losing weight can result in reduced pain and increased function, particularly in walking.

exercise

An exercise routine can help increase your range of motion and flexibility as well as help strengthen the muscles in your legs. Exercise is often effective in reducing pain and improving function. Unfortunately, in the setting of advanced arthritis (bone-on-bone), exercise can sometimes increase pain in your hip and knee joints. Your physician or a physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.

exercises for hip arthritis

Physical Therapy

Physical therapy to strengthen the muscles around your joint may help absorb some of the shock imparted to the joint. Physical therapy can help to reduce the pain, swelling, and stiffness of osteoarthritis, and it can help improve joint function. It can also make it easier for you to walk, bend, kneel, squat, and sit.

Braces and Splints

Braces may be especially helpful in knee arthritis if the arthritis is centered on one side or the other. A brace can assist with stability and function. Braces are not for everyone and they can be difficult to fit for certain people.

Alternative and biologic Therapies

Examples of alternative therapies include the use of acupuncture and magnetic pulse therapy. Acupuncture uses fine needles to stimulate specific body areas to relieve pain or temporarily numb an area. It is used in many parts of the world, and evidence suggests that it can help ease the pain of arthritis. Magnetic pulse therapy is painless and works by applying a pulsed signal to the knee, which is placed in an electromagnetic field. Data on this is somewhat inconclusive. It’s the position of the American Association of Hip and Knee Surgeons that biologic therapies, including stem cell and PRP injections, cannot currently be recommended for the treatment of advanced hip or knee arthritis.
Source: American Academy of Orthopaedic Surgeons, https://orthoinfo.aaos.org/; American Association of Hip and Knee Surgeons,https://hipknee.aahks.org/total-hip-replacement/; EverydayHealth.com
Cory Calendine, MD is an Orthopedic Surgeon and founding partner of the Bone and Joint Institute of Tennessee at Williamson County Hospital in Franklin, TN. Dr. Calendine is an expert in Joint Replacement, specializing in Hip and Knee Surgery. From diagnosis through treatment, the Orthopedic Surgical experts at the Bone and Joint Institute use the latest techniques and technology to improve care for people with musculoskeletal problems. For more information, please contact our office or schedule your appointment today.
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