6 Tips to Help Avoid Joint Replacement Surgery
When used as a last resort, many people experience positive benefits from joint replacement surgery. However, it should only be considered as an option when osteoarthritis cannot be managed with other methods. We spoke to Dr Wendy Holden, Arthritis Action's Medical Advisor and Honorary Consultant Rheumatologist, to find out more.
What is joint replacement surgery?
Your cartilage is the tough, flexible tissue which lines the surface of joints (where two bones meet) and cushions impact, allowing the joints to move without the bones rubbing together. Osteoarthritis happens when the cartilage around a joint gets worn away, which can be very painful and limit mobility. Osteoarthritis is more common with age - 50% of those over 65 have osteoarthritis - but it can occur at any age.
If non surgical options - like medication, exercise and pain management - don’t seem to be working, some people may opt for joint replacement surgery. During surgery, the damaged cartilage and bone are removed and replaced with prosthetics made out of metal, plastic or ceramic. This artificial replacement has the same shape and movement of the original joint.
“Joint replacement or other types of orthopaedic surgery is usually used as a last resort to help manage the pain caused by arthritis,” says Dr Wendy Holden. “We usually recommend people to speak to their GP or healthcare professional about the options available to them before deciding that joint replacement surgery is right for them.”
What can people do to try to avoid joint replacement surgery?
“Surgery is one option for people living with osteoarthritis, however there are many effective ways at managing their symptoms,” says Dr Wendy. “The Arthritis Action charity encourages people to try a variety of self-management techniques to address the physical and mental impacts of living with arthritis.”
1. Self management
“Self-management strategies are vital for improving the symptoms of arthritis,” says Dr Wendy. “These include keeping to a healthy weight, exercise, eating a healthy diet and dealing with sleep problems and stresses that can both increase the pain of arthritis.”
Different things work for different people, so it’s important to settle on something which feels right for you. Some people find that meditation, mindfulness and/or talking therapy may help with stress reduction and relaxation, both of which can help with the physical pain of arthritis and improve quality of sleep.
2. Keep to a healthy weight
The heavier you are, the more pressure you put on your joints. To help avoid more extreme measures such as joint replacement therapy, it’s a good idea to keep to a healthy weight as well as strengthening the muscles around your joints to take further pressure off the cartilage and bones.
Maintaining a healthy weight doesn’t mean never eating the foods you like: it’s making sure you’re eating a balanced diet rich in the nutrients you need to keep your body healthy, while enjoying treats in moderation.
“Exercise cannot damage the joints and can make a significant difference to joint pains.,” says Dr Wendy. “If we have joint pain and reduce our levels of activity, the muscles around the joints rapidly become weak and this can then increase the level of pain in the joints. The most important self-management strategy for improving pain in arthritis is to increase your level of exercise - which can be as simple as walking or gardening - as this increases muscle strength, helps stabilise the joints and can dramatically improve both pain and function.”
Some low impact exercises which you may enjoy include swimming, yoga and walking. Anything can count as exercise as long as you’re moving around, so get creative and see what you will enjoy doing for the long term. Don’t be afraid to mix things up either - you don’t need to move in the same way every day, just as long as you’re moving! If you have any concerns about how exercise may impact your joints, speak to your doctor or physiotherapist.
4. Hot or Cold Compress
“Some people may find that an ice pack wrapped in a tea-towel can help reduce the inflammation surrounding an arthritic joint,” says Dr Wendy. “However, other people find a heat pack or hot water bottle to be more beneficial. Some may even find that both are effective. There is no single life hack that works for everyone. Experiment with the different options and see what works best for you.”
Heat therapy can help warm up joints and relieve stiffness, whereas cold therapy can reduce inflammation, swelling and pain, especially after exercising.
5. Pain Medication
“Arthritis causes pain, stiffness and swelling in the joints,” says Dr Wendy, “so the first things that many people try are medicines including simple painkillers such as paracetamol and anti-inflammatory medicines such as ibuprofen tablets, rub-on creams or gels.”
Medication can help ease the pain so you can move through your day more easily. However, recent NICE (National Institute for Health and Care Excellence) guidelines are now recommending exercise should be prescribed over painkillers. For example, FlexiSEQ is a drug free gel which, when applied to the painful joint, can lubricate the area for pain relief and joint stiffness reduction.
6. Therapy and Physical Support
An occupational therapist is a specialist who can help people with arthritis and other conditions safely participate in physical activities. It’s often a good idea to see an occupational therapist when you’re first diagnosed with osteoarthritis.
Do you have any tips for how people can manage osteoarthritis without joint replacement therapy? Let us know on Facebook.