Hip and Knee Pain: When is it Time to Consider Surgery?

Take measures to relieve joint pain before surgery is necessary.

(NewsUSA) - Chronic joint aches and pains caused by arthritis can interfere with everyday life, limiting mobility and function.

In early stages of arthritis, pain relief can be obtained from acetaminophen and anti-inflammatory drugs like aspirin, naproxen and ibuprofen or, for some, injections into the joint (intra-articular injections). However, when arthritis progresses, the cartilage between the bones disappears, and the joint is "bone on bone." At this stage, these conservative measures may not be enough.

"As the progression of arthritis cannot be stopped, patients should consider joint replacement surgery when the pain in an arthritic joint is severe and disabling," says Alejandro González Della Valle, M.D., orthopaedic surgeon at Hospital for Special Surgery in New York.

The criteria used for recommending joint replacement surgery include disabling pain associated with limp, loss of function and mobility. The best candidates for surgery are people who have seen deterioration in their quality of life or impairment in their activities of daily living due to arthritic pain. Activities such as going for a walk or performing some non-impact recreational sports should not be difficult for people without major health problems.

Before arthritic pain is severe enough to consider surgery, some simple measures can be implemented to diminish pain and promote joint health.

* Respect the pain you feel. Perform activities only to the point of discomfort.

* Plan ahead and be realistic about what you can do.

* Learn how to pick things up properly. Bend from the knees when lifting and carrying weights more than 30-40 pounds.

* Reduce repetitive impact on joints, and distribute weight among them to protect joints.

* When walking more than four or five miles, wear well-padded shoes with rubber soles.

* Think about your weight. The impact on your joints will be less detrimental if you are not carrying extra weight.

"No one is too young or too old for joint replacement," says Douglas E. Padgett, M.D., chief of the Adult Reconstruction and Joint Replacement Service at Hospital for Special Surgery. "Every condition can be addressed, even when compounded by other medical conditions."

The Adult Reconstruction and Joint Replacement Service at Hospital for Special Surgery is the world leader in hip, knee and surgical arthritis patient treatment, education, innovation and research. For more information, visit www.hss.edu.

How to Be a Prepared Patient

Be prepared to ask your doctor for written explanations and instructions.

(NewsUSA) - Aches and pains aren't always readily attributable to a particular disease, and receiving a medical diagnosis often takes more than one doctor's visit. Doctor-patient teamwork can help facilitate an efficient and proper diagnosis. Becoming an advocate for your own health and knowing the right questions to ask your doctor can help.

How can you take a more active role in helping your doctor understand your health condition? One simple solution provided by the Arthritis Foundation is to "Take P.A.R.T."

P - Prepare a list of questions, concerns and symptoms to discuss. Keep a detailed journal of your symptoms, including the times they occurred and associated environmental factors. For example, was a particular pain triggered by a certain food or activity?

A - Ask questions during your appointment. It's a good idea to bring a list of questions with you, as well as a friend or family member to ask questions you may not have identified.

R - Repeat what your doctor recommends so you can be sure you understand. Ask for written instructions.

T - Take action. Inform your doctor of your lifestyle and habits, as well as any concerns and preferences, so a treatment plan can be customized to your specific needs.

"Patients who track their symptoms are better prepared to communicate effectively with their doctors," said Dr. John Klippel, CEO of the Arthritis Foundation. "Accurate information helps both parties work together to determine the best possible treatment options."

Fostering open communication with one's doctor is particularly important for patients with hard-to-diagnose diseases like the autoimmune disorder rheumatoid arthritis (RA), as symptoms can be attributed to other medical conditions. Furthermore, there is no single diagnostic test for RA.

There are programs that help patients and doctors work together to manage health conditions by communicating openly. The Arthritis Foundation's Let's Talk RA program, sponsored by Bristol-Myers Squibb, offers national meetings, educational podcasts and a communication kit that includes step-by-step discussion tips, as well as a symptom tracker that RA patients can use with their rheumatologists -; all at no cost.

The Let's Talk RA communication kit can be ordered at no charge through the Arthritis Foundation's Web site, www.arthritis.org/letstalkra