Non-Operative Treatments
Many women and men with hip and knee pain never pursue treatment because of fear about surgery. In the end we are treating your pain and pain is subjective, so our treatment plans are customized to a patient’s needs and goals in life.
At the Bone and Joint Center, we offer both nonsurgical and surgical treatment options.
We know that how you're cared for greatly affects how you heal. By using this inclusive approach to care, we treat the whole person.
At the Bone and Joint Center, we offer both nonsurgical and surgical treatment options.
We know that how you're cared for greatly affects how you heal. By using this inclusive approach to care, we treat the whole person.
IMPORTANT:
It’s important that if you are suffering from knee and/or hip pain but not had a recent evaluation and up to date diagnosis, then it is recommended that you come into the office for a complete evaluation and a customized treatment plan before you try to self-treat.
Non-Operative Treatments
Injections
How to Manage Your Pain From Arthritis
Recommended Medications
- Acetaminophen (Tylenol) has an anti-inflammatory effect, if you take it within the ranges of the recommended daily dosage it’s very safe.
- NSAIDs (Advil, Ibuprofen, Motrin etc.) reduces inflammation which causes the pain. If you take it within the ranges of the recommended daily dosage, it’s very safe. Side effects may include GI system irritation and kidney issues.
- Cox 2 Inhibitors (Celebrex) is also an anti-inflammatory medication. It is part of BJC’s pre-surgery pain management program, as it is the only inflammatory that you can take up to around your surgery date because it does not affect your bleeding time.
Supplements
- Remember, the FDA views these as nutritional supplements (ie like vitamins) NOT as a form of medicine. The advertising of these supplements is not screened by the FDA so be careful with the claims in their advertisements.
- Glucosamine/Cosamine and Chondroitin Sulfate: Has an anti-inflammatory effect. It is sugar based so those with diabetes should use with caution. It has NEVER been proved to replace cartilage that’s gone, but it is falsely advertised that way.
- Fish Oil and Vitamin E are potent and safe-to-use anti-inflammatories. However, the downside is that many of these vitamins can be quite costly and should be discontinued before any surgery since they can affect your bleeding.
- When choosing what supplements to take, consult your doctor and weigh the effect versus the cost. Be aware of what they claim.
Joint Injections
Joint injections are potent anti-inflammatories that stay inside your knee or hip joints which can be very effective in relieving pain, and many times for several weeks and months. There are several types of joint injections that can help manage the pain caused by arthritis.
REMEMBER: Injections won’t make joint degeneration worse and won’t accelerate joint degeneration and no injections of any kind can replace cartilage if it’s already worn away
REMEMBER: Injections won’t make joint degeneration worse and won’t accelerate joint degeneration and no injections of any kind can replace cartilage if it’s already worn away
1. Cortisone/Corticosteroid injection works by treating the inflammation that can cause pain and swelling.
- The effects of a cortisone injection can last from 3 to 12 months, and occasionally longer.
- All insurances cover this injection.
- Since this injection is a steroid medicine, it has a higher efficacy for bone on bone (end stage) joints.
2. Hyaluronic acid injection delivers lubricating fluid into the joint. The goal is to temporarily lubricate the joint, thereby decreasing inflammation and plain, and improve function.
- For this injection to have any anti-inflammatory effect, at least some cartilage must still be present in the joint.
- When the joint is bone on bone there is little to no effect in relieving pain from these lubricating injections.
When injections don’t work in controlling pain for even 3 months, and your quality of life is affected, then you may be a candidate for joint replacement surgery.
REMEMBER:
- Injections will NOT make the degeneration worse. Injections treat inflammation which causes pain and won’t accelerate the inflammation.
- Contrary to what is advertised in the media, there are NO treatments that can replace or rebuild your cartilage. That is why early evaluations are so important to delay the progression of arthritis.
New Treatment Options at the BJC
1. PRP (platelet-rich plasma) injections are now offered by the BJC as an additional non-operative treatment for the pain caused by knee and hip arthritis and hip bursitis. This is a “biologic” and “natural”anti-inflammatory treatment that adds to our one stop shop approach to treating hip and knee disorders.
2. Cryoanalgesia Treatment (Knee Only)
This treatment uses “cryoanalgesia” technology that implements freezing cold to disrupt the pain transmitting portion of nerves to produce immediate, longer lasting “block” of those pain sensors. This is only for the sensory nerves and leaves muscle function intact.
Learn More about Cryoanalgesia Treatment
This treatment uses “cryoanalgesia” technology that implements freezing cold to disrupt the pain transmitting portion of nerves to produce immediate, longer lasting “block” of those pain sensors. This is only for the sensory nerves and leaves muscle function intact.
Learn More About Your Pain and Alternative Therapies
Controlling pain is the hardest part of managing osteoarthritis (OA) and degenerative joint disease (DJD). Pain can lead to a vicious circle of inactivity, which leads to greater pain and muscle weakness, and thus greater inactivity. Pain may affect your ability to do daily tasks and can also lead to depression.
Most people feel their symptoms get better with physical activity and exercise. Your doctor may also recommend medications to help control your pain enough to start an exercise program. However, the complex nature of pain and its unique interpretation by the brain of each patient means that complementary and alternative pain management strategies should be explored and incorporated into your personal pain management plan.
Most people feel their symptoms get better with physical activity and exercise. Your doctor may also recommend medications to help control your pain enough to start an exercise program. However, the complex nature of pain and its unique interpretation by the brain of each patient means that complementary and alternative pain management strategies should be explored and incorporated into your personal pain management plan.
Weight Management
The Role of Weight Management in Arthritis
One factor you will have the most control over that will have the biggest impact on your progression of arthritis is your weight.
Your hips and knees work in a way such that for every one pound of body weight, your hips and knees thinks is six pounds of pressure.
Let’s say you gained 10 pounds, that means your hips and knees senses that as an extra 60 pounds of pressure daily on everything you do. Vice versa for decreasing weight, which would have a significant impact on prolonging joint cartilage, and why we focus so much on weight management both for non-operative treatment as well as for preparing for surgery. We have found that excess weight adversely affects the outcomes of patients.
Not only does weight management slow the progression of arthritis, but also better prepares a patient when it comes time for surgery.
Learn More about Weight ManagementYour hips and knees work in a way such that for every one pound of body weight, your hips and knees thinks is six pounds of pressure.
Let’s say you gained 10 pounds, that means your hips and knees senses that as an extra 60 pounds of pressure daily on everything you do. Vice versa for decreasing weight, which would have a significant impact on prolonging joint cartilage, and why we focus so much on weight management both for non-operative treatment as well as for preparing for surgery. We have found that excess weight adversely affects the outcomes of patients.
Not only does weight management slow the progression of arthritis, but also better prepares a patient when it comes time for surgery.
Nutrition Assistance
Nutritional support provided by a registered dietitian nutritionist (RDN) can enhance your quality of life and overall health. You may benefit from working with an RDN.
The Wellness Center for Bone and Joint Health developed a Recipe Book that helps you learn how changes in your nutrition can help you gain relief from bone and joint conditions.
Learn about:
Learn about:
- How the anti-inflammatory style of eating can help reduce pain caused by osteoarthritis.
- How calcium and vitamin D are important to improve bone density and reduce the risk of osteopenia, osteoporosis and fractures.
- Tips and helpful hints about the differences in fresh, canned, and frozen produce, healthy cooking, and portion control.
Exercises
Exercise is always important as part of the non-op treatment for patients with degeneration and prepares you for surgery if it is ever needed down the road.
There are usually 3 types of exercises: Cardiovascular, Stretching, Strengthening. Remember your muscles act as shock absorbers for your joints so it is very important to not only have good strength but also good endurance.
There are usually 3 types of exercises: Cardiovascular, Stretching, Strengthening. Remember your muscles act as shock absorbers for your joints so it is very important to not only have good strength but also good endurance.
Watch and follow our videos and exercise books below for Arthritis friendly exercises:
Assistive Devices
Using a cane is a good option to help take the stress off the joint. Remember to use the cane on the OPPOSITE side of the joint that has pain and arthritis.
We do not recommend using crutches or walkers. If you get to this point where it’s necessary to use a crutch or walker, it’s probably time to consider surgery!
We do not recommend using crutches or walkers. If you get to this point where it’s necessary to use a crutch or walker, it’s probably time to consider surgery!
Smoking Cessation
Knee and hip joint replacements are more likely to fail in smokers than nonsmokers. Studies showed that joint replacements failed 10 times more in smokers than nonsmokers.
How can you quit smoking? To give up smoking, your body must stop craving nicotine. It is hard to quit, but most people can do it. Keep in mind there are many health benefits to quitting smoking.
How can you quit smoking? To give up smoking, your body must stop craving nicotine. It is hard to quit, but most people can do it. Keep in mind there are many health benefits to quitting smoking.
The Wellness Center for Bone and Joint health
The Wellness Center for Bone and Joint Health is a BJC affiliated non-operative treatment program. We offer services on all the treatments listed above, and work closely with you to follow a personalized treatment plan that is tailored to your needs and functional goals.
Contact Us at 412-641-8594 for a Self-Referral!It was created to transform the care experience of patients by identifying health disparities, creating programs based on patient feedback, and coordinating services based on what matters most to patients. The Wellness Center aims to help fight the growing epidemic of arthritis and help patients to live a pain-free, active life.
