– Arthritis Pain – Do I need Surgery? Part 2

Last month’s blog discussed a number of first line, non-operative treatments for arthritis.  Another important factor, especially in lower extremity arthritis, is weight.  The progressive obesity in America has been a hot topic in the news.  Even recently, New York City banned supersized sugary soft drinks in an attempt to deal with the epidemic.  The many health risks associated with obesity are well publicized.

It is perhaps intuitive that being overweight would add undue stress on our joints.  For perspective, your knee experiences about 6 times your body weight of force through it when you bend your knee like squatting and climbing/descending stairs.  So, if you are 150 pounds, your knee feels about 900 pounds when you sit down on a chair or get back up!  Your hip experiences 2-3 times your body weight with a straight leg raise when lying down and 3-6 times walking/jogging.  Now do the math if you weigh 250 pounds.  Six times your body weight is 1500 pounds, or ¾ ton.

So, needless to say, controlling your weight is extremely helpful in managing your arthritis pain.  I remember as specific patient even saying that a ten pound swing in their weight makes a huge difference in their arthritis symptoms.  Obviously, managing your weight is a two-headed problem.  One is your caloric intake and the other is your caloric expenditure.  Increasing your activity level can be extremely difficult if your joints hurt.  I have seen patients lose over 100 pounds with extremely bad arthritis.  Lower impact activities like walking, swimming, and bicycling tend to be less stressful than running.  Intense weight training is also helpful to burn calories and create more muscle which, in turn, uses more calories as well.

Watching your diet, portions, and types of food can help with your caloric intake.  The problem is, your body does require a basic level of calories for normal function.  Fad diets can be helpful but tend to be hard to maintain.  Slow, steady weight loss of 1-2 pounds every 1-2 weeks seems to be the most reliable and maintainable.

For those people who have struggled with weight loss and morbid obesity for a number of years, they may be candidates for surgical intervention.  Newer procedures are less invasive with less morbidity.  Find a local bariatric surgeon to see if you’re a good candidate.  It is still important to change your eating lifestyle after a surgery.

Finally, many people propose they would lose a lot more weight if they had their arthritic joints replaced.  Unfortunately, most studies show minimal weight loss, at best, in most patients after total joint replacement.

For those who have failed non-operative treatment for arthritis, their next option is surgery.  We will discuss that topic next time.

Written by Sean Brimacombe, MD

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