Sunday, October 24, 2021

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Prairie Doc Perspectives: Return to wellness

I recently saw a patient I hadn’t seen in more than 18 months. This patient had previously come to me somewhat routinely for arthritic knees. Together, we constructed a conservative treatment plan to help increase activity and prolong the life of those knees. Unfortunately, the Covid-19 pandemic put a dent in our plan. Prior to the pandemic, this patient had been a borderline diabetic with some other medical comorbidities. Upon their return, we found a lot had changed. The patient had gained 30 pounds, decreased activity, and could not move about very well. We had to revise our plan based upon the patient’s current condition. I have observed, over the last few months, this scenario is not unusual. 

With the pandemic, many people simply stopped moving and as a result their joint related complaints skyrocketed. This inactivity created a significant increase in pain and discomfort in those with underlying arthritis. As patients continue to return to society and have a difficult time picking up where they left off, what do we do to help them get back to their normal? 

First, identifying the significance of their medical and orthopedic issues is key. Those with more combined orthopedic and medical issues may require a multidisciplinary approach amongst physicians. Success is more likely if the patient and orthopedic surgeon work together with the primary care physician to assist in management of weight, diabetes, cardiac and other issues that need specific attention. Great communication amongst providers is essential to maximize the benefit for the patient.

Second, developing a plan that will assist in overcoming these issues is the next goal. This may involve cautious use of anti-inflammatories or corticosteroid injections to help decrease inflammation. It may involve viscosupplementation or “gel” injections to assist with lubrication. Physical therapy to focus on getting specific muscle groups to unload the joint while also allowing increased movement may be a great place to begin. Walking, water walking, water aerobics, elliptical machine, bike riding, or hiking are great examples of low impact activities that promote good joint health. The overall goal is to get patients that stopped moving back to an active lifestyle. As many of my patients and colleagues say, “motion is the lotion”. 

We all know the pandemic has been difficult and affected us all in different ways. Getting outside, increasing activity, and developing goals to help people get moving again is paramount for overall health. A good conversation and developing a plan with your local health care team is a great way to begin your return to wellness.

Luke Mortimer, M.D. is a contributing Prairie Doc® columnist. He practices as a board-certified orthopedic surgeon in Rapid City and Spearfish, South Dakota and Gillette, Wyoming. For free and easy access to the entire Prairie Doc® library, visit and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPB most Thursdays at 7 p.m. central.

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