Managing Hip and Knee pain at home
Advice from Consultant Orthopaedic Surgeon David Haughton, Fulwood Hall Hospital
The COVID-19 pandemic has had a huge impact on Orthopaedic surgery. Recent figures from NHS England have shown almost 40,000 patients have been waiting more than 12 months for orthopaedic elective procedures. This number is only likely to increase. A recent study investigating the quality of life in patients waiting a hip or knee replacement, has demonstrated approximately 1 fifth of those patients are in a health state worse than death!
This highlights the need for patients, now more than ever, to do everything they can to try and improve their symptoms whilst they wait. We cant turn back the clock and stop arthritis happening, the focus should be on managing the pain and prolonging the life of your joint, surgery is and always should be considered a last resort. Here’s what you should be focussing on -
- Weight loss - the hip and knee are weight bearing joints, therefore any reduction in your body weight will mean less weight being transferred to your joints and will in turn reduce pain. Having painful joints does often mean that patients find exercising difficult and we would always advise low impact exercise such as brisk walking, cycling or swimming. Start with a short distance or time period and build up what you’re doing over time. The other component of weight loss is of course diet, and this is equally as important. Find something that works for you, reduce your calorie intake and keep at it. Lockdown has introduced a lot of bad habits across the country - the importance of eating healthy and keeping active cannot be underestimated.
- Painkillers - this can often divide opinion, and we see a lot of patients that are incredibly reluctant to take strong painkillers. People are often apprehensive and worried about side effects or becoming dependent. Severe arthritis is a very painful condition! Taking regular painkillers can make the difference to you getting a full nights sleep or being able to walk the dog / get out the house. Speak to your GP about what difference types of painkillers are available to you, start with low dose and simple medication and increase as you need. There are no points for bravery!
- Aids/orthoses/Physio- Walking aids are readily available from many sources and can be invaluable in keeping patients mobile whilst they are waiting for surgery. These come in all shapes and sizes - from simple walking sticks to wheeled walking frames. A walking aid allows you to offload your body weight and reduce the forces going across your hip or knee, which in turn should reduce pain. Wearing a brace can also often help with pain and/or instability, these can be particularly useful for patients waiting a knee replacement. Physiotherapy does play an important role both before and after any hip or knee surgery. Having good muscle strength pre-operatively will generally result in a better starting point for your recovery and post-operative outcome.
- General health - it is really important to keep an eye on your general health at times like this. Having a hip or knee replacement is a major operation and carries very real risks. Patients coming to surgery will generally have other health problems such as heart or lung disease and it is vital that these medical co-morbidities are optimised. That means keeping up to date with all your relevant health checks or clinic appointments as well as taking any necessary medication you may be prescribed.
Finally I would always emphasise the importance to keep in regular contact with your surgeon, particularly if there has been any change in your condition.