The Best Non-Surgical Orthopedic Treatments in the Era of COVID-19

Are you struggling with joint pain and had your orthopedic surgery delayed during the pandemic? You are not alone! Across the nation, countless orthopedic surgeries have been rescheduled due to the COVID-19 crisis, leaving many wondering how to cope with their pain. If you are one of these patients, here is a list of the best non-surgical treatments to help manage your symptoms until your surgery can proceed. 

MAKE SOME LIFESTYLE MODIFICATIONS:


The simplest changes in your daily life can help to minimize the damage done to your joint, slow the progression of any arthritis which may be present, and calm any flare-up of symptoms. The most common lifestyle changes include:

  • Change your exercise routing from high impact activities (such as running and jumping) to low impact activities (such as biking, walking, or elliptical)
  • Limit any activities which produce pain (such as climbing up/down stairs)
  • If a lower extremity is the source of your pain, attempt to lose weight to limit the stress placed upon your legs. According to Arthritis-health, every pound you lose takes 3lbs of pressure off of your knees. That means that even if you lose only 5lbs, you will be taking 15lbs of pressure off your knees!

BEGIN PHYSICAL THERAPY OR A HOME EXERCISE PROGRAM:

Establishing a good exercise plan which focuses on strength, endurance and flexibility is vital to preserving your joint’s health. If you find yourself lacking the motivation to exercise at home, or need extra help pushing your range of motion and/or controlling swelling, attending formal physical therapy sessions can really make the difference. 

BEGIN USING AN ASSISTIVE WALKING DEVICE:

Use of a cane, walker or brace can be very helpful for those struggling with instability. Falls can be detrimental to one’s health, so if you feel at all unstable while walking, you may want to discuss using a cane or walker with your doctor or physical therapist. If you are struggling with knee arthritis, you may also want to discuss use of an unloader brace or support brace with your doctor. Unloader braces are great for those whose knee arthritis is concentrated in just one half of the knee, as they can help to take pressure off of that side, while support braces are helpful for those who have arthritis throughout the entire knee joint. 

TAKE MEASURES TO CONTROL SWELLING:

Swelling can be a major source of pain, so it is important to try and keep it under control. Simple measures such as ice or elevation several times a day can be very effective in controlling swelling. Try icing your injured/painful joint 20 minutes at a time, 3-4 times a day to begin with. However, be careful not to ice your joint for too long, as ice constricts blood vessels and can limit blood flow to the area, slowing your body’s healing process. If your swelling is concentrated to one of the lower extremities, consider use of compression stockings as an extra measure to control it. 

TRY ORAL MEDICATIONS:

There are several types of oral medications which can be helpful in treating orthopedic pain. Below is a list of the most common medications prescribed and their purpose. *** It is important to discuss all medications with you doctor before beginning use ***

  • Over-the-counter pain medications: medications such as acetaminophen, naproxen and ibuprofen are commonly the first choice in treating pain. These medications are sold over-the-counter, but higher doses can be prescribed by your doctor. 
  • Non-steroidal anti-inflammatory drugs (NSAIDs): these medications are commonly prescribed to help with both pain and swelling. Common prescription strength NSAID’s include Meloxicam and Indomethacin. 
  • Steroids: a short course of steroids is commonly prescribed for painful arthritic flare-ups or persistent swelling. A common example of a short course steroids is a Medrol Dose Pak. 
  • Daily supplements: glucosamine and chondroitin sulfate are two substances found naturally in joint cartilage which may be taken as dietary supplements. Although patient reports indicate that these supplements may relieve pain, there is no evidence to support the use of either to decrease or reverse the progression of arthritis. 

TRY AN INJECTION:

If your surgery has been postponed by several months, you may wish to discuss an injection with your doctor. Injections directly into the joint are a common treatment for decreasing joint pain and swelling, especially in those with arthritis. There are several different types of injections which are designed to help with pain, inflammation, or lubrication of the joint. The most common injectable options include:

  • Short-acting corticosteroid injections (aka cortisone injections): Corticosteroids are powerful anti-inflammatory agents which can provide pain relief and reduce inflammation. These injections can be given in most joints and typically last between 1-3 months. Your doctor may recommend limiting the number of these injections to 3-4 per year, per joint, due to possible side effects. 
  • Long-acting steroid injections: like their short-acting counterparts, long-acting steroid injections help to reduce inflammation and relieve joint pain. However, these injections are given only in the knee and designed to be “slow-release”. They commonly give patients a 50% reduction in pain or symptoms for 4-6 months. 
  • Hyaluronic Acid injections (HA injections): Hyaluronic acid is similar to the substance that occurs naturally in the joints and can act as both a lubricant and shock absorber. These injections are designed only for knees. Some HA injections are given as a one-time injection, while others are done in a series. 

If you are planning to have a total joint replacement in the near future, injections may not be the solution for you. Most surgeons require a minimum of 3-6 months between an injection and surgery, due to an increase in the risk of infection. Talk to your doctor about your surgery timeframe to decide if an injection is appropriate. 

As you can see, there are many conservative treatment methods to help you cope with your symptoms until it is safe to proceed with surgery. Try out any combination of the tips above and talk to your doctor about what conservative treatments they suggest to help get you through this difficult time. 

Sources:

https://www.arthritis-health.com/blog/why-losing-weight-best-treatment-knee-arthritis

https://orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-knee/

How to Stay Active After Orthopedic Surgery

For a patient recovering from orthopedic surgery, no phrase is truer than if you rest, you rust.” Orthopedic surgery can be a life altering event, and in order to regain the strength, endurance and flexibility needed for independent living, exercise and therapy must be a top priority. 

When it comes to getting the most out of an orthopedic surgery, a lot of the responsibility falls upon the patient and their compliance with post-operative therapy, not on the surgery itself. 

Padraic Obma, MD, founder and president of Strive, likes to compare the role of the surgeon to that of a quarterback in football.

 “Orthopedic surgeons are like quarterbacks. They get too much credit and too much blame.” 

That is to say, if a patient has an excellent outcome, they often credit their surgeon, when in fact it was their own hard work in therapy that led to their results. Conversely, it has been shown that patients who are not compliant in completing their therapy exercises as prescribed, tend to report the worst results. 

So, how can you make sure you stay active at home and continue to recover after your orthopedic surgery? We’ve got some tips that you can write down and follow for post-operative success. 

 

1. Stick to your physical therapy homework. 

 

Rebuilding your strength and restoring your endurance is a huge part in the post-operative recovery process. That’s why it’s extremely important to complete your assigned at-home physical therapy exercises to ensure a successful recovery. 

 

2. Keep moving! 

 

Exercise does not necessarily mean going to the gym or lifting weights. Activities such as gardening, cooking, cleaning, and the like can all count towards a daily exercise routine. Getting back to these types of activities is important in preventing joint stiffness and improving the overall result of an orthopedic surgery

 

3. Don’t overdo it. 

 

Too much exercise can have a negative effect on your post-operative recovery. If you overdo it by participating in strenuous activities, it can easily lead to re-injury. So always consult your doctor before starting any exercise. (Trust us, your doctors know what they’re doing!)

It is very important to stay active after orthopedic surgery. Following post-operative therapy instructions and completing therapy exercises daily can be the largest determining factor in a patient’s recovery time and outcome. So, the next time you are tempted to skip out on your therapy exercises, just remember, if you rest, you rust.