Our knees and hips work hard every day, carrying us out of bed, up and down stairs, through thousands of steps at home and work. 

Most of us don’t feel the full force of those movements because of the cushion between our joints called cartilage, which keeps our bones from rubbing together. But if that cartilage starts to wear away, joints can feel stiff and painful, limiting how well you can move. This can lead to osteoarthritis. 

If you have pain in your knees and hips, there are ways you can feel better. Talk to your doctor to see if one or more of these steps is right for you.

Lose weight if needed. 
Carrying extra weight puts greater strain on your joints, which can cause osteoarthritis at a younger age. Losing weight is never easy, but even a smaller weight loss can make a big difference. Plus, you don’t have to go it alone. Ask your doctor or a dietitian for help. If your doctor recommends nutritional counseling from a registered dietitian, nutritionist, or certified diabetes outpatient educator—for high blood sugar, weight loss, or other health issues—those visits are covered in full by your BCBSRI health plan. (No copays, deductibles, or other costs apply.)

Walk, bike, swim, and do other low-impact exercises.
If it hurts when you move, it may seem like you should move less. But regular exercise actually helps relieve pain and stops your joints from getting worse. Studies suggest that cardio, muscle strengthening, and stretching exercises all have benefits. Ask your doctor what they recommend.

Consider physical therapy.
If your pain is limiting what you can do, a physical therapist can show you specific exercises that help and how to do them safely and most effectively. Some physical therapy programs even include water therapy and anti-gravity treadmills to help you get stronger while taking weight off the joints. 

Try over-the-counter pain relievers.
 Most doctors recommend using acetaminophen (Tylenol^®) first— no more than 3,000 mg per day— because it has fewer side effects than other drugs. Some other medications you are taking may also contain acetaminophen, so talk to your PCP about the right dose for you. If your pain continues, your PCP may suggest aspirin, ibuprofen, or naproxen, which relieve swelling. If you’re taking pain relievers on most days, tell your PCP, as you need to be watched for side effects. 

Ask about steroid shots if your pain is severe.
Medicine called corticosteroids can be injected into the joint to help with swelling and pain. It’s important to know that relief only lasts for a short time and more than two or three shots a year may be harmful. 

What about knee and hip replacements?

These surgeries are important options for those with serious cases of osteoarthritis, many people experience relief from treatment besides surgery. However, if you do need a knee or hip replacement, it’s better to wait until after age 65 whenever possible. The average life expectancy of a total knee replacement is 20 years (with hips lasting a little longer), so you’ll likely need the surgery twice if you have it earlier in life. 

If you and your doctor decide that surgery is the best option, it’s still important to take good care of your joints beforehand—as well as your overall health. As Dr. Michelle Collie, physical therapist and CEO of Performance Physical Therapy, says, “The better shape you are in before your surgery, the better results you will have afterwards.” 

The people who do best after surgery:

• Don’t smoke.
• Are at a healthy weight.
• Have any existing chronic conditions under control.
• Complete physical therapy as recommended.

The 12 weeks following surgery are the most crucial to rehabbing the joint and are the most intense. As Dr. Collie says, “People need to understand that surgery represents the beginning of a journey to get better. It’s hard work.” Following through with a physical therapy program and at-home exercises is a must and it’s best to avoid opioid pain relievers whenever possible.

Have a post-surgery plan in place 

Most surgeons and/or physical therapists will talk with you about what to expect after surgery and what you can do in advance to prepare. This includes changes you can make at home to ensure you recover in a safe environment. If the discussion doesn’t come up, here are some important points for you to bring up so you can get ready, mentally and physically, and improve your outcomes.

• What kind of house you live in can affect how mobile you will be and how you are going to get around once you’re home. Make sure to bring up whether you live on a single floor or have multiple floors or stairs to climb.
•  Animals may unintentionally knock you over or cause you to trip, so be sure to mention it in case you need to find temporary care for your furry loved ones. 
• Ask how long it will be before you can drive and the frequency of physical therapy and follow-up appointments. This will help you make the necessary arrangements. 

Joint replacement statistics

1/3 
Knee replacements found to be unnecessary.

$26,000–$33,000
Cost range in RI for knee and hip replacements

6 to 12 months
For full recovery from a knee replacement

20 years
Average life expectancy of a knee replacement

Sources: Arthritis and Rheumatology Journal, Blue Cross and Blue Shield Association, Journal of Bone and Joint Surgery, American Association of Knee and Hip Surgeons