Young Woman With Joint Pain In The Wrist

Is Joint Replacement the Only Option for Chronic Joint Pain?

Jenny Gartshteyn, MD Blog

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If you suffer from chronic joint pain, you likely feel desperate for a solution. The pain can make simple everyday activities like walking up the stairs or going grocery shopping unbearable. You go from doctor to doctor, trying to find someone who listens and understands, and finally you’re told that the only option left is total joint replacement. Should you move forward with the surgery?

At CORE Medical & Wellness, we offer effective alternatives to joint replacement surgery. Our integrative approach treats the pain you’re feeling now as well as the root cause, whether it’s a sports injury, an autoimmune disorder, or something else. Below, we’ll take a closer look at chronic joint pain and its various treatment options.


Types of Joint Pain


There are many reasons why your joints may hurt. Finding the underlying cause of your joint pain is critical when it comes to putting together a treatment plan. Some of the most common conditions treated by our rheumatologist, Dr. Jenny Gartshteyn, include:

  • Rheumatoid Arthritis (RA) – An immune disorder in which the body’s own immune system attacks the lining of the joints, causing chronic pain and inflammation. This typically occurs in multiple joints at the same time. As the disease progresses, joints may become deformed.
  • Psoriatic Arthritis (PsA) – Similar to rheumatoid arthritis, psoriatic arthritis occurs when the immune system attacks both the joints and the skin. In addition to joint pain, PsA sufferers have red patches and white flakes on their skin, along with pitting and ridges in the fingernails and toenails.
  • Gout – Gout is caused by an overabundance of uric acid in the body, a condition known as hyperuricemia. Gout pain often starts in the joints of the big toe, but may also affect other toe joints, ankles, and knees. While gout pain comes and goes, repeated flare ups can cause permanent joint damage.
  • Osteoarthritis – The most common form of arthritis, osteoarthritis is caused by the deterioration of cartilage in the joints. Osteoarthritis can be triggered by a joint injury, but age, weight, and genetics are risk factors as well.
  • Ankylosing Spondylitis (AS) – Ankylosing spondylitis is a type of arthritis that primarily affects the spine, but it may also cause chronic pain in the shoulders, ribs, hips, knees, and feet.
  • Systemic Lupus Erythematosus (SLE) – Lupus is an autoimmune disease that affects the entire body. Patients with lupus experience many symptoms, with joint pain being just one of them.

Joint Replacement and Other Surgical Treatment Options for Chronic Pain


There are several surgical options for treating chronic joint pain. These fall on a spectrum from the minimally invasive arthroscopy on one end to total joint replacement surgery on the other end. Some surgical treatments for chronic joint pain include:

  • Arthroscopy – Arthroscopic surgery involves making a small incision through which a camera (the arthroscope) is inserted into the joint. Then, a surgeon removes bone fragments, damaged tissue, and makes repairs to the ligaments to help reduce chronic joint pain. This is one of the more conservative surgical treatment options for injured joints.
  • Joint Resurfacing – During a joint resurfacing procedure, defects in the cartilage are repaired, recreating the smooth surface of a healthy joint. In a hip resurfacing surgery, the femoral head is trimmed and capped with a metal covering, then the damaged hip bone socket is replaced with a metal shell.
  • Osteotomy – Frequently performed on knees, osteotomy is used when a single joint is causing chronic pain, often due to injury-induced osteoarthritis. This procedure involves reshaping the tibia or femur in a way that relieves pressure on the knee joint.
  • Arthrodesis – Also known as joint fusion surgery, arthrodesis fuses together the two bones connected by the joint that is causing pain. After the surgery, you will no longer be able to move the joint in question. For this reason, the procedure is most often performed on joints in the fingers, toes, spine, wrists, and ankles, where a reduction in range of motion will not have a significant impact on overall quality of life.

When pain is severe and other options have been exhausted, doctors often recommend total joint replacement. During this procedure, a surgeon removes the damaged joint completely and replaces it with an implant. This implant may be made of metal, plastic, ceramic, or a combination of these materials. The artificial joint is designed to function like a natural joint, with the same range of motion. After surgery, physical therapy is usually needed to fully restore function.

Total joint replacement can be an effective treatment for chronic joint pain, particularly when pain is localized to one joint or caused by injury, as is often the case with osteoarthritis. But even when a patient is a great fit for the procedure, there are many risks and there is no guarantee that the surgery will be a success.


The Risks of Joint Replacement


There are risks involved with any surgical procedure; these include infection, bleeding, blood clots, and complications from anesthesia. With total joint replacement, there is a risk that the artificial joint could fail. This can lead to immobility and the need for a surgical joint revision, a complex procedure that has a lower success rate than first-time joint replacement surgeries.

Artificial joints may wear out over time; particularly if you are young, you should expect that you’ll need your joint replaced again at some point in the future. Metal-on-metal implants, which are frequently used in hip replacements, may release metal ions into the bloodstream. It’s believed that this can damage the bone and cause other health issues.

While the vast majority of joint replacement surgeries are successful, it’s an invasive procedure and should be considered as a last resort when all other treatments have failed. Researchers and doctors are beginning to believe that total joint replacement surgery is over-prescribed; if it’s been recommended to you, seek out a second opinion before moving forward with the surgery.


Non-Surgical Alternatives to Total Joint Replacement


Before resorting to total joint replacement surgery, it’s important to first explore all of the alternatives. Dr. Gartshteyn and our team at CORE Medical & Wellness can put together a customized treatment plan to help you avoid surgery. Our objective is to reduce chronic pain and minimize joint damage to improve physical function and your overall quality of life. We take an integrative approach to treating joint pain, which may include one or more of the following:

  • Physical Therapy – This often involves a combination of hot and cold therapy, exercises to increase mobility, and electrical nerve stimulation.
  • Medication – Anti-inflammatory medications like nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to reduce pain, stiffness, and swelling around the joints. We may also recommend research-backed over-the-counter supplements that have been shown to help minimize arthritis symptoms, like hyaluronic acid and glucosamine sulfate. Hyaluronic acid can also be injected directly into the joint to help lubricate it.
  • Steroid Injections – Corticosteroid injections are a common treatment for arthritic joints. They work to reduce inflammation, pain, and swelling.
  • Disease-Modifying Antirheumatic Drugs – When joint pain is caused by rheumatoid arthritis, we often prescribe disease-modifying antirheumatic drugs (DMARDs) to slow the progression of the disease.
  • Platelet-Rich Plasma Injections – One of the most exciting new treatments for chronic joint pain is platelet-rich plasma (PRP) injections. This procedure uses your own concentrated platelets to promote healing in the joints. Learn more about PRP injections at CORE Medical & Wellness. 
  • Bone Marrow Concentrate Injections – Like PRP injections, BMC injections use the patient’s own concentrated stem cells to promote the growth of healthy new cartilage to repair the damaged joint. Learn more about BMC injections and other regenerative medicine offerings at CORE Medical & Wellness.
  • Acupuncture – Many patients experience symptom relief from acupuncture. During this procedure, small needles are inserted into the skin to reduce inflammation and chronic pain. There is conflicting research on the efficacy of acupuncture treatment; some doctors argue that any benefits are a result of a placebo effect, while others point to research showing improvements in arthritis symptoms after acupuncture sessions. 
  • Lifestyle Changes – Our entire team is here to support you in making lifestyle changes to help alleviate your chronic joint pain. Weight loss, low impact exercise, and a diet rich in anti-inflammatory foods may be used in conjunction with other therapies to help reduce the pain, swelling, and stiffness associated with arthritis and similar joint conditions.

Chronic Joint Pain Treatment at CORE Medical & Wellness


We understand the impact that chronic pain has on our patients’ lives. Our goal is to partner with you in your treatment; we are committed to making sure you feel heard and respected. If you’re looking for a compassionate rheumatologist in NJ with experience treating chronic joint pain without surgery, call us today at 888-521-0688 to schedule an appointment with Dr. Jenny Gartshteyn.