4 Ways to Treat Joint Pain Without Surgery

If joint pain is interfering with your daily life, there are options to try that don't include surgery. I explore all of the options with my patients to determine what is the best treatment plan for each person.

1. Medication

Over-the-counter pain medications, such as NSAIDs or Tylenol, can help with pain and inflammation. It is not uncommon for patients to have already tried these. If they have not tried them, they can play a role in treating pain and helping patients maintain their activity. Even with over-the-counter medications, I use caution and consider a patient's pre-existing medical conditions when recommending these.

2. Bracing

Bracing is often an option particularly if there has been an injury. Certain joints such as the wrist, elbow, knee and ankle are amenable to bracing. Treating with a brace over a short time allows the joint to be protected while it heals. Typically, we try to strengthen and stabilize the patients' joints with their own muscles to gradually wean them out of the brace.

3. Physical Therapy

As a non-operative sports medicine physician, I am routinely recommending physical therapy to help patients strengthen and stabilize their painful joints. Therapy is not easy and takes a lot of hard work, but often helps patients stay functional and have less pain. One example is degenerative rotator cuff tears. Most people are surprised when I tell them that 85% of partial-thickness rotator cuff tears can be treated with physical therapy.

4. Injections

For certain patients we consider injections. I typically use an ultrasound to help guide the injection to the perfect spot. The three types of injections routinely utilized to help with joint pain are:

• Corticosteroid injections, also called steroid or cortisone shots. These are potent anti-inflammatories that decrease inflammation and help conditions such as flares of osteoarthritis and sometimes tendinitis. They also are used at times to help us diagnose where pain is or is not originating.
• Hyaluronic acid injections, also called gel injections and sometimes called rooster comb shots. These are approved for use only in knees and typically are used for patients that have mild to moderate osteoarthritis of the knees. They restore the viscous properties of the patient's joint fluid and typically last around 6 months.
• Platelet rich plasma, also called PRP. This is a procedure where we draw the patient's blood, separate the components of the blood in a centrifuge and concentrate the platelets into the plasma. This can be used to treat tendon injuries, ligament injuries and mild joint osteoarthritis. It is typically not covered by insurance. Data continues to emerge on the efficacy of PRP for each of these conditions, so I always have an extensive and very transparent discussion about risks, benefits and alternatives each time we consider a PRP injection.

Finally, the last option is surgery. As a non-operative sports medicine physician, my goal is to do treat you without the use of surgery. However, there are certain conditions that require a surgical discussion. Whether we have tried non-operative measures that were unsuccessful or I can tell from the start that your condition will not respond to nonoperative measures, I will help you find a surgeon who can help and will collaborate your care with the surgeon.

Of course, not all of the options listed above are appropriate for all patients and some conditions have even more treatment options. I always like to discuss all of the paths available to patients as we get them back on the road to recovery.