Living With Multiple Joint Problems: What Are My Options?

Facing issues with more than one joint—say your hips, knees, and even shoulders—can feel overwhelming. It’s a complex journey, but with careful planning and support, you can maintain your mobility, manage pain, and improve your quality of life. Let’s explore the options.

What does "living with multiple joints" involve?

Depending on the joints affected and the severity of symptoms, you might experience:

• Ongoing pain at rest or with activity
• Difficulty with basic daily routines like getting out of chairs or climbing stairs
• Fatigue or mood changes from chronic discomfort
• Fear or hesitation about committing to major surgery

The key is a comprehensive strategy that balances staying active with protecting vulnerable joints, while keeping your long-term goals in mind—whether it’s walking your kids to school, playing tennis, or returning to work.

A Three-Pronged Approach: Conservative, Surgical Staging, Long-Term Care

1. Conservative (Non-Surgical) Care

Before considering surgery, or as a way to delay it, start here:

a. Individualised Exercise Plans

• Low-impact cardio (like swimming, cycling, or walking) boosts strength without aggravating joints
• Strength training—focusing on muscles around your hips, knees, and shoulders—provides additional support
• Balance and posture exercises (yoga, Tai Chi) help protect vulnerable joints

b. Pain & Inflammation Management

• Simple analgesics (e.g. paracetamol) or non-steroidal anti-inflammatories can reduce pain and stiffness
• Applying heat or cold packs can relieve symptoms before or after activities

c. Physical Therapy & Joint Protection

• A physiotherapist can help you learn soft-tissue release, joint mobilisation, and taping or bracing techniques
• Tips to adjust your daily routine—like using a shower stool, raised toilet seats, or adaptive kitchen gadgets—can reduce stress on multiple joints

d. Lifestyle & Support

• Maintaining a healthy weight minimizes load on joints
• Using walking aids (e.g. cane, rollator) can improve stability and relieve pressure
• Pain education and cognitive support help you understand flare-ups and pacing strategies

Conservative care is essential—even after surgery—to preserve function and delay or avoid surgical intervention altogether.

2. Staging Surgeries Wisely

When conservative measures are no longer enough, surgery may be the best next step. Here’s how to manage multiple joints:

a. Prioritise by Pain & Impact

Focus first on the joint that’s most painful or limiting—whether that’s a hip keeping you from walking or a shoulder affecting your ability to get dressed. Start with the joint that will most improve quality of life.

b. Interval Between Procedures

• Usually, surgeons wait at least 8–12 weeks before converting to a second joint replacement.
• This spacing allows for healing, mobilisation, and strengthening—reducing complication risks.

c. Consider the Sequence

• Rehabilitate the first joint—regain muscle strength and confidence—before replacing the next.
• If multiple joints are severely affected, simultaneous unilateral procedures (e.g., a hip and a shoulder) may be possible in carefully selected patients.

d. Team-Based Planning

• Working with your surgeon, anaesthetist, and physio ensures a coordinated plan—especially important for anaesthetic risks and pain management tailored across multiple operations.

3. Long-Term Maintenance After Surgery Continuum

a. Ongoing Physiotherapy & Reinforcement

Even after full recovery, regimens like home exercises and gym routines with guidance help maintain joint and muscle health.

b. Monitoring Secondary Joints

Hypertrophy in nearby joints—like increased wear in a knee after a hip replacement—means regular check-ins are vital. Early detection of changes can guide timely interventions.

c. Lifestyle Adjustments Post-Recovery

• Continue low-impact activities to preserve fitness and prevent stress on other joints
• Incorporate strength and balance workouts to support your surgical joints
• Healthy eating and weight management remain essential

d. Long-Term Safety Net

Routine follow-up appointments—typically at 1-, 2-, 5-, and 10-year marks—ensure your artificial joints stay healthy. Regular X-rays may be required to check alignment and wear.

4. Putting This Into Practice: A Sample Roadmap

Step 1: Conservative Care

Begin with non-surgical treatments such as personalised exercise plans, appropriate pain medication, and physiotherapy. Focus on improving mobility and minimising discomfort while preserving joint function.

Step 2: First Surgery

Once conservative measures are no longer sufficient, proceed with the most functionally limiting joint. Complete the operation and dedicate time to structured post-operative rehabilitation.

Step 3: Second Surgery

After full recovery from the first procedure—usually 8–12 weeks or longer depending on your progress—address the next joint. Ensure your strength, balance, and confidence are restored before moving on.

Step 4: Recovery & Maintenance

Post-surgery, continue strengthening exercises and maintain healthy habits. Reinforce the results of each surgery through long-term rehabilitation, and avoid high-impact activities that could strain your other joints.

Step 5: Ongoing Care

Stay engaged with your care team through regular follow-up appointments. Monitor joint health proactively with imaging and clinical reviews, and adjust your lifestyle to support lasting joint function.

Frequently Asked Questions (FAQ)

Q1: Can I have surgeries on two joints at once?

It depends. For example, combining hip and shoulder surgery in one anaesthetic is rare and complex, usually reserved for medically fit individuals under strict protocols. Most of the time, sequential operations spaced apart leads to better outcomes.

Q2: If I do a hip replacement, will my knee get worse faster?

Not necessarily—but often correcting one joint changes your gait, shifting forces. Good rehab, regular follow-ups, and physiotherapy help manage stress on secondary joints and delay any deterioration.

Q3: How do I stay safe between surgeries?

Use well-designed walking aids and brace solutions taught by a physiotherapist, stick to exercise plans tailored for you, practice joint protections like chair rises, and avoid aggravating activities.

Q4: Will I need long-term pain medication after surgery?

Typically, pain improves significantly after complete surgical and rehab phases. In some cases, short-term analgesics or occasional anti-inflammatories are used, always under medical guidance.

Q5: I’m worried about taking multiple pain meds—is that okay?

Combining simple analgesics (like paracetamol) with occasional anti-inflammatories is usually fine if used short-term. Long-term reliance on strong medications is rare in well-managed surgical pathways.