By Dr. Winifred Bragg, published by The Wellness Network
Many people come to me with osteoarthritis of their knees. When they ask about joint replacements, I remind them that pain is the primary reason for joint replacements of both the hip and knee.
It is important to pay attention to your knees and hips. By paying attention to your joints, you can avoid joint replacement surgery.
If we can get rid of the pain, we can get rid of the need to have joint replacement surgery.
Osteoarthritis can cause your joints to become stiff and can result in significant pain, thus limiting your function. By restricting one’s mobility, it is often difficult to perform your activities of daily living. Sometimes joints can become so painful that negotiating stairs and getting into and out of the bathtub can become very difficult.
Unfortunately, joint replacement surgeries can also be taxing on the body. There is no guarantee that you will regain the mobility you once had following a joint replacement. Your pain may also persist after surgical intervention.
Most of the time, surgery for joint pain is elective and can be avoided.
Here are five tips to help you avoid a total knee replacement:
1. Get Rid of Excess Weight. Obesity is considered one of the top causes of damage to the joints in the lower extremity. Being overweight puts excess stress on the joints which can cause the cartilage to break down more quickly than normal. Before joint replacement surgery, you might want to consider losing weight.
A recent study of more than 38,000 patients in Australia found that there was a direct correlation between weight loss and the need for joint replacement. The correlation was especially strong for knees.
Excess weight puts extra pressure on the painful joint. There is also evidence that excess weight increases the rate at which cartilage is lost from the knee. Extra weight can make a person more prone to develop osteoarthritis. This can cause the disease to progress more rapidly.
Even a small weight loss can be beneficial. Being 50 pounds overweight puts 250 pounds of additional pressure on the joints. Therefore, losing 3 pounds can subtract 6 pounds of pressure. Losing as little as 5 percent of your body weight can relieve some of this pressure. The weight loss will help patients to reduce arthritic symptoms.
Some physicians say it is estimated that six to eight times your body weight is experienced through the knee. Therefore, every 10 pounds loss means 60 to 80 pounds less pressure. Additional weight can lead to a greater risk of developing arthritis.
To avoid joint replacement surgery focuses on weight loss. Losing weight will not replace cartilage; but it will help to reduce the stress on the joints.
2. Exercise Regularly. Stay as active as possible. Limiting physical activity can actually make joint damage worse. The less you move, the stiffer you get. When you get stiff, it hurts more to move.
Inactivity leads to loss in the cartilage between your bones. Without cartilage, you get bone-on-bone and this is very painful.
Exercise also helps because it stimulates the release of synovial fluid. Synovial fluid is released the more you move your joints. Synovial fluid bathes the cartilage and helps to loosen the joints.
Physical therapy is often recommended to facilitate a good exercise program. Doing aerobic exercises at least 3 times a week can be helpful. Strength training is also helpful in maintaining joint health.
With regular exercise, one should be able to maintain a healthy weight which can prevent further joint damage. Low-impact workouts such as using the elliptical trainer, a recumbent bicycle, walking and swimming are best. These exercises help to provide cardiovascular benefits without loading the joints.
Maintaining your range of motion is very important. Therefore, remember to work on extending and flexing your knees regularly. Daily stretching of your quadriceps and hamstrings is important.
A well-trained physical therapist can perform deep tissue massage to help relax the muscles to increase blood flow to the joints. This will supply the joints with more nutrients and can help to reduce swelling thereby reducing pain.
3. Joint Injections. Injections with cortisone or hyaluronic acid are other non-operative treatments to help reduce knee pain. Knee pain may also be treated with regenerative medicine treatments such as platelet rich plasma therapy. Platelet rich plasma therapy may protect existing cartilage and possibly help to produce more cartilage.
Cortisone injections may also be effective for hip pain. These injections are best done under fluoroscopy.
4. A Knee Unloader Brace. An unloader brace unloads the painful side of the knee, and shifts the stresses to the side with minimal arthritis. These can be used very effectively in treating patients with osteoarthritis of the knee. Unloader braces will help to reduce pain and therefore increases mobility. I prescribe these often to patients who want to consider an effective non-surgical solution to treatment osteoarthritis of the knee. These braces help to increase mobility and can help you to perform your activities of daily living. Many patients use these braces to participate in sporting activities as well.
I have patients who use these braces to play racquetball and to golf.
5. Medications and Supplements. The use of supplements like glucosamine and chondroitin can have beneficial effects on osteoarthritis. Opioid analgesics can be given for severe pain if there is no response to other treatments.
These non-surgical options depend on your commitment to make behavioral modifications through weight loss and exercise.
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