Arthritis is a normal part of aging. I often refer to it as the gift we get for living past age 50. Though it is nothing concerning, that doesn’t mean it’s something you can’t treat.
Many times, people receive injections
Over the years the approach to injections seems to have mostly (thankfully) evolved. Many providers used to just give (usually cortisone) injections on an as needed basis, without any other intervention. I strongly recommend against this. Here’s why: The injections mask the symptoms (mainly – pain) of arthritis. Over time, these injections (mainly cortisone, though there are others) may actually damage the tissues of a joint.
To combat arthritis, we prescribe strength training
Enter: physical therapy! In PT we strengthen the muscles supporting the arthritic joint in order to improve its function. Some of you may be reading this while panicking. “Oh, my gosh. Are they going to have to do squats?! Or heavy lifting?! That sounds unbearable!”
Relax, take a deep breath. No, we don’t do that. When I give someone strength work, I give them non-painful things to start with. If we are working on their knees or hips, I might start with a mini squat (think: not a full depth squat), balance work, and stretches. I typically do hands-on work to reduce joint stiffness as well.
Does this mean I should avoid an injection?
The answer is, it depends! If you haven’t already had injections but are having pain, then a shot COMBINED with physical therapy is an excellent combination. This helps you tolerate physical therapy (think: less pain!) while also addressing the issues you have. When my patients reach a plateau or are struggling with pain during therapy, I usually send them to their physician for an injection to help them along.
Injections as a stand alone treatment have short-lived results. Usually, pain relief from an injection starts by lasting a few years. Over time injections provide pain relief for progressively shorter periods, or they stop working altogether. Use of injections alongside physical therapy can be an excellent combination.
Arthritis typically gets worse with prolonged inactivity.
When you remain inactive, your muscles gradually become weaker and weaker. This makes the body put more force through the joints when we move instead of using the muscles to offload the joints. Stay active! If you’re not sure where to start, a great exercise for individuals with arthritis is walking in a pool. The pressure of the water combined with buoyancy makes movement in the pool very comfortable for arthritic joints. Try to stick with exercise that isn’t painful if you can.
Sometimes physical therapy isn’t enough, and surgery may be necessary.
The need for a joint replacement depends on your age, your goals, and your overall function. Many people prefer to avoid surgery, which I support and completely understand. It is always worthwhile to try physical therapy to see if your pain and function are able to improve enough to avoid surgery. If you aren’t able to avoid it, I have a post about expectations after a knee replacement which you can find here.
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