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Slowed down by joint pain? Not all solutions lead to joint-replacement surgery.

By Doug Haltom, M.D.

Total joint replacement is a solution for patients with limited function and chronic pain, and for many, it’s given them the ability to walk again and return to work.

But it’s a major surgery with a long recovery, and it’s not the only route to consider when a joint disorder such as osteoarthritis becomes a problem. At West Tennessee Bone & Joint Clinic, we assess patients individually to find the best course of treatment for their condition and the lifestyle they want to achieve.

Much of the decision depends on how the joint problem has limited the patient’s activity and affected daily life. A lot depends on how much function a patient wants.

Some non-surgical options are …

Medications: Treating pain is a big part of battling osteoarthritis, and over-the-counter or prescription drugs may be all a patient needs.

Cortisone: A cortisone injection up to three or four times a year may be enough to relieve the symptoms and keep a patient ambulatory. Cortisone shots, however, lose their effectiveness if they are overused.

Viscosupplementation: Another treatment for pain caused by osteoarthritis is viscosupplementation, which is a hyaluronic acid injection that acts as a lubricant and shock absorber. It’s a substance similar to the natural fluid found in joints. It is delivered through three injections during the course of three weeks. (See box, below, for more information.)

The use of an ultrasound helps make the viscosupplementation injection and other injections more effective. It improves the accuracy of the injection, and it’s less painful. An ultrasound is often used for injections of the knee, but is also used for injections of the shoulders, hands, feet and ankles.

Activity: Another treatment for joint disorders is exercise, such as walking or swimming, which helps increase range of motion while improving function and reducing pain. Physical therapy can be very beneficial for a select group of patients with arthritis.

Other options: Sometimes, braces or shoe inserts are all a patient needs. Changing something very minor could decrease the pain enough.

The solution is different for each patient because each has different levels of pain and functionality, as well as different objectives. Some just want to be able to get around the house. Others want to get back to work and travel.