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Increasing Your Speed Of Recovery And Reducing Pain From Orthopedic Procedures Starts With Physical Therapy Before Surgery
The burgeoning demand for joint replacement surgeries means that patients need to be equipped with accurate information concerning the benefits and drawbacks of surgery, the alternatives to surgery, how to prepare for surgery, and what to do in the recovery phase.
According to the American Medical Association, first-time knee replacements in the U.S. increased by 63% in only a seven-year period from 1997 to 2004 while primary hip replacements increased by 48% in the same period, and these trends are expected to continue for the foreseeable future.
Comparing Common Treatment Options
While in the most severe cases surgery is the only viable treatment option for patients suffering from joint inflammation and pain, there are always risks associated with any surgery. Recent evidence suggests that for patients with mild-moderate symptoms, surgery may be avoided for an extended period of time or even altogether. Surgeons are often eager to tell patients that surgery is their best option, but many treatments, including an extensive physical therapy program, have yielded promising results in patients with mild to moderate symptoms. Consult the chart below to see what treatments are out there for knee, hip, and shoulder pain.
|
Treatment Option |
Knee |
Hip |
Shoulder |
Benefits |
Drawbacks |
|
Medications —including aspirin, ibuprofen and prescription drugs. |
√ |
√ |
√ |
Can help to decrease inflammation in joint and provide temporary pain relief. |
Short-term fix; pain usually returns after patient stops taking medications. Can be addictive and expensive. |
|
Use of cane or walker |
√ |
√ |
|
Helps to alleviate pressure on joint |
May cause muscle deterioration and create other orthopedic problems from over compensation. Recommended for short term use whenever possible. |
|
Steroid injections |
√ |
√ |
√ |
Quick pain relief in some patients. Reduces inflammation of joint. |
Many people do not find pain relief, with potential side effects including weight gain, high blood pressure, cataracts, diabetes, "cortisone flares," and infection of joint. Recent studies also show that those treated with steroid injections have higher incidence of long –term problems compared to those who avoid steroid injections. |
|
Hyaluronan injections |
√ |
|
|
Natural substance found in knee joint; can help relieve pain and improve functionality for those suffering from osteoarthritis. |
Possible side effects include cough and problems swallowing, dizziness, and feeling feverish. Severe reactions for those with egg or poultry allergies. Pain relief may take 4 to 12 weeks. |
|
Physical Therapy |
√ |
√ |
√ |
Helps keep joint mobile, important for functionality, reduces pain, increases strength, and may help avoid surgery. Surgical patients can speed recovery with a pre-surgical course of therapy. Post-surgical physical therapy is essential. |
Minimal side effects. Takes time and commitment to see optimum results. |
|
Joint replacement surgery |
√ |
√ |
√ |
Repair of joint damage and long-term pain relief. 85% last 20 years before needing replacement, depending on activity level. |
Risk of Infection, stiffness, and other surgical side effects such as blood clots, stroke, or heart attack. Breakage of prosthesis, wear and tear. |
Already Decided To Have Joint Replacement Surgery?
Historically, physical therapy has been emphasized as a post-surgical rehabilitation activity. Today, however, we know that physical preparation and evaluation before most procedures can speed up recovery, reduce pain, and relieve while reducing the anxiety. In addition, becoming familiar with your therapist and the exercises he or she will recommend after surgery will make them easier to do.
Beginning the physical preparation and planning for all your rehabilitation needs as soon as possible in anticipation of surgery not only improves outcomes and speeds recovery, but also reduces the most common frustrations most patients face with their physical therapy and rehabilitation.
Pre-Surgical Checklist:
Pre-surgical preparation includes four general areas of orientation:
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Education to understand the anatomy and mechanics of what’s wrong.
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Evaluation of Range of Motion (ROM) - A good indicator of post-surgical progress with ROM is pre-surgical ROM.
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Review what to expect with surgery and recovery time afterwards, and what it means for your daily life.
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Physical activity to strengthen areas that will be most involved in successful rehabilitation.
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Familiarize and practice the variety of exercises you will most likely use to restore function at the appropriate time post-surgery.
Post Surgical Checklist
Post-Surgical Goals:
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Decrease pain and inflammation with medication and physical therapy.
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Restore and increase range of motion (ROM).
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Increase strength specific to functional tasks for daily living.
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Education for self management at home and work.
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Review recovery timeline and expectations for the in-clinic and at home rehabilitation plan.
At Joshua Tree Physical Therapy we would like to help you get the most out of your surgery with as little recovery time as possible.