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Had Joint Replacement and Still in Pain? Physical Therapists in Denver Can Help

December 20, 2017

Total joint replacement is a surgery that has provided pain relief for many people who have suffered with hip, knee or shoulder discomfort and pain.  Ads often times show patients who have undergone total joint replacement mid-run, smiling and--for all intent and purposes-- enjoying life again. The decision to undergo a complex procedure is not one to take lightly, but as physical therapists in Denver, we are happy to see someone make that decision to have the surgery when all signs are pointing toward a life limiting disability without the replacement.

Reasons for Replacement

Dealing with pain associated with joint movement is a symptom that could be the indication of something far more serious. Causes of joint pain can be anything from arthritis to infection even cancer in extremely rare cases.

For those who are experiencing chronic pain that is not caused by illness or infection, the most likely cause of said pain is essential the joint wearing down which has caused the bones to rub against one another.
The bones of the joint are typically covered in a substance called articular cartilage near their ends that allow them to easily glide against each other. In between the bones is another substance called synovial fluid which acts like oil in a car to lubricate the joint further. If either the cartilage, or fluid is damaged or diminished, problems can develop and lead to stiff and painful joint movement.

What Happens When a Joint is Replaced

Typically when people think of joint replacement, the knee and hip are what come to mind, but there are other less common areas where replacement surgery can help. The shoulder, ankle and even the finger joints can all be replaced to better help the patient live a regular, functional life.

When a joint is replaced by a surgeon, what essentially happens is the worn or damaged parts are removed and replaced with prosthesis that are fitted to the area and allow the joint to behave as it normally would in a healthy individual.
  • Before
    • Since joint replacement involves anesthesia, except for finger joint replacement which can be done as an outpatient procedure, your surgeon will require a physical examination. In some cases they may require more examinations to be performed such as blood tests, X-rays, and MRIs.
  • During
    • Depending on the area which is being replaced, you will be placed either under general anesthesia or have a spinal block, which numbs the lower half of your body and is typically for knee and hip replacements. During the procedure, your surgeon will remove the infected or damaged areas and fit your bone to the prosthesis which will replace the joint.
  • After
    • Once your surgery is complete, you’ll be taken to a recovery room where you’ll be monitored as the effects of the anesthesia wear off. From there you’ll be placed in a hospital room where you’ll be under supervision for the first few days afterwards to ensure no complications arise. Complications include:
      • Infection
      • Blood clots
      • Joint Stiffness or further pain if your body rejects the prosthesis
      • Dislocation
      • Loosening
One of the biggest risks after surgery is blood clots developing. In order to combat this you’ll be required to walk or move the area the day of, or after your surgery. You may also be required to take blood thinners and have a compress on the area to further deter clots from forming.

Physical Therapy to Ensure Your Back to 100% Functionality

The overall objective of the surgery is to help return the recipient to full activity without the underlying joint pain they have experienced for so long by ensuring that the bones connected to the joint in question don’t rub against each other.  

So the question is, if it is such a wonderful procedure, then why do some people still have pain and dysfunction after going through the discomfort of the surgery? The answer sometimes can be that something needs to be addressed by the surgeon, but more often than not, the answer tends to be a little more simple.  There is generally still work that the patient has to do post-operatively to make the joint replacement a total success.  

In physical therapy, we see the end result of many years of limited use of the limb in question; decreased range of motion, decreased muscle tone and strength, and an overall loss of ability to balance.  When a joint is painful, we just do not use it fully anymore, leading to all of these issues.  The replacement of the joint surfaces takes away the pain of bone rubbing against bone, which generally is the most direct cause of the pain, inflammation and swelling.  Once the new joint is in, now attention has to be turned to regaining all that was lost over the time when the joint was used on a limited basis.  

Unfortunately, just walking, riding a bike or swimming will not get back full motion, strength, or full functional capability.  Some people are just glad to have the majority of the pain resolved with the surgery, and simple functional capability returned, and really are not interested in anything beyond that.  
A much larger number of people, however, want to regain what they have lost over the years of joint dysfunction.  Your physical therapist is trained to test for loss of not only muscle strength, but also joint mobility and balance.  A program is then designed for each individual, taking into consideration what they personally have lost along the way.  

The lesson here is this….You may not be stuck with whatever you were left with post operatively, no matter what the surgery.  There are exercises specifically aimed at functional return for every body part, including those areas you thought were going to be an issue forever.  Not sure? The physical therapists in Denver at Body Image PT can discuss your issues and compile information and a schedule for you to regain more function in your limbs. Whether it’s knee pain or your experiencing chronic pain associated with your surgery, the skilled team at Body Image PT can help. Call today at 720-870-8900.