The number of hip and knee replacements has greatly increased in recent years but why do so many people need these operations? What has happened to joints to render them so fragile or prone to damage as to require a prosthesis, sometimes at quite a young age? Are these operations always necessary? Is the pain actually caused by the wearing away of a joint or could there be another reason?
DIAGNOSIS NOT ALWAYS CORRECT
In his Florida practice, Dr Mitchell Yass, who has a PhD in physical therapy, has put forward some revolutionary ideas concerning hip and knee pain, especially for people who continue to suffer pain after joint replacement. In the hip for instance, he has found that very often the pain stems not from the joint but from the muscle surrounding the hip. He explains ‘If a muscle around the hip region were strained and elicited your pain, how would it be diagnosed? It won’t show up on a diagnostic test and certainly the medical specialists you seek a diagnosis from cannot identify this.’ He describes how, all too often, the medical approach to the problem is to use their very specialized training assuming that it is the joint giving pain; the possibility that it might be referred pain from a muscle just never occurs to them.
MRI MAY LEAD TO FALSE DIAGNOSES
Yass claims that the failure rate for joint replacement has led to the meteoric rise in joint replacement revision surgery. More than 22 million people are now addicted to prescription pain medication because their pain could not be resolved through the existing medical approach. The number of people suffering from chronic pain has continued to rise since MRI (magnetic resonance imaging) began to be used as the primary mechanism for identifying the cause of the pain. However, Yass is convinced that the existing system is flawed because MRI often reveals minor abnormalities that would never cause a problem but can lead to diagnoses that indicate medical care is required to resolve the symptoms when, in fact, ‘the real cause of pain in more than 98% of cases is muscular and requires a solution that can be found in a gym; not a physician’s office.’
WAYS TO RELIEVE PAIN
As a young man, Yass had a great interest in physics and the biomechanics of weight lifting. This knowledge became a key component to his understanding of how to resolve pain through what he calls 'targeted strength training'. He believes ‘the overriding reason people suffer from pain is because there is a force requirement in performing our activities due to gravity and our muscles must create a certain force output to allow us to perform these activities. If the force output is less than the force requirement, the muscles strain and elicit pain, or they refer pain and other symptoms, or they can impinge on a nerve and the nerve refers a symptom. Most people can connect their symptoms to performing an activity which basically is saying that the tissue in distress eliciting the symptoms is muscle.’
Where knees are concerned, there are indeed some people whose joints have been so degraded by wear and tear that replacement is the only current option to provide them with normal use of the knee, but Yass suggests those people are actually few and far between. He observed “Joints are nothing more than ‘pivot points’ that exist solely to allow range of motion, when a joint has undergone arthritic changes severe enough to prevent motion, then and only then is surgery warranted.”
EXERCISE INSTEAD OF SURGERY
Because of the pain people are willing to commit themselves to an expensive operation that can take a year for full recovery and is certainly not without serious risks from fatal blood clots and infection. Rather than knee-replacement surgery, Yass, with his twenty years of experience, believes most people with knee pain need exercise to keep leg and knee muscles balanced and toned. He has designed exercises to strengthen muscles and claims that sometimes results can be spectacular, especially for people who have suffered for years with what they always thought was joint pain. For more information and a description of some of the exercises read this excerpt from Dr. Yass’s book, The Pain Cure, published by Hay House. https://www.wddty.com/magazine/2016/august/the-true-cause-of-back-pain-1.html
Unfortunately, joint replacement has now become a thriving industry; so successful in fact that there is a real risk that some patients may be operated on unnecessarily. According to the National Joint Registry, there are approximately 160,000 total hip and knee replacement procedures performed each year in England and Wales at eye-watering costs to the NHS. Each hip replacement costs on average £10,000 and the knee replacement £12.000. In the United States total knee replacements number about 700,000 a year and total hip replacements about 400,000 a year.
HOW TO AVOID KNEE PROBLEMS
Nicholas Sgaglione, MD, director of the Northwell Health Orthopaedic Institute, who has spent 30 years caring for patients’ knees, says that a lot of damage to the knees can be prevented by avoiding common lifestyle mistakes especially putting on weight. ‘With every step, skip and jump you take, your knees absorb the force of your body’s weight. Each pound you gain adds exponentially to the amount of pressure exerted on your knees. In fact, each extra pound adds about four pounds of pressure. So if you’ve gained 20 pounds over the last few years, they feel more like 80 pounds to your knees.’ Other causes of knee problems are injuries, breakdown of cartilage and other tissues and the loss of strength in the muscles surrounding the joint. Being overweight puts you at risk of all three.
So think twice before you are persuaded to have surgery; there may be a simpler way to relieve your pain.