The first step in any arthritic problem is non-surgical or conservative treatment measures. The first question many patients have in the office is do I need surgery? The answer is most of the time not. Many, many arthritic problems can be treated without surgery. The simple, conservative, or non-surgical approaches that may help the patient, may start out simply with exercising the joint. Exercising motion of the joint nourishes the cartilage, helps strengthen the joint, increases the flexibility of the joint. And even though there might be arthritis on the x-ray, we treat the patient not the x-ray. So even though your x-ray may show arthritis, if you do simple exercises, weight loss, take an anti-inflammatory such as Tylenol or Motrin or Aleve, those simple measures may go a great – give you a great amount of relief. Following that, if you continue to have pain or discomfort, a joint injection in other words placing a needle in the joint and injecting a steroid and painkiller, may give pain relief to the patient for either a short time or very long time. Each patient is different in how they respond to the cortisone injection. The other type of injection that may be helpful is a gel injection in which a thick gel is injected typically into the knee to help cushion the knee. So these simple approaches such as medication, exercise, therapy, injections may relieve a great deal of pain for great many patients and avoid the need for any sort of surgery. Beyond that, the other options that may help without involving surgery could include ultrasound-guided injections for some of the deeper joints such as the hip, such as the spine which are often done under C-arm or under x-ray magnification.
