The 2023 National Health Interview Survey reported that nearly a quarter of adults in the U.S. experience chronic pain, with almost 10% of them suffering from high-impact pain that prevents them from doing some kind of daily activity. And as the age groups go up, so do the percentages.
By the time patients visit Dr. Matthew Morrey—a board-certified orthopedic surgeon and founder of Ortho San Antonio—they are ready to address their musculoskeletal conditions, one of the main causes of chronic pain. Most of them are active and want to remain so, but the pain has limited them, sometimes severely. “My job as a hip and knee surgeon is to say there's no reason to put up with pain if you don't have to,” Morrey says. Inevitably, one of the first things many patients say after their treatment is that they should have done it 10 years ago. So, why do people wait?
What some patients don’t realize (or admit) is that their pain diminishes their quality of life. To this end, Morrey assesses patients’ ability to sleep, drive, and complete simple tasks. With 20 years of experience, Morrey can cue in on patients wearing flip-flops, slip-on shoes, or shoes with laces knotted way off to one side. A change in patients’ gait patterns can occur as a way to compensate for their pain. Morrey says patients often feel pain in their lower back and ankles because they're trying to shift constantly and that it’s common for depression to coincide with chronic hip and knee pain.
Many patients were advised to wait as long as possible before having surgery, which Morrey acknowledges as old guidance. “Now, we start to look at it more as preemptive,” he says, “meaning at some stage they are going to need that hip and knee replaced.”
For each patient he sees, Morrey treats them conservatively until the time comes for the next step. Though surgery is not always required, he says it should be considered once physical therapy and pain management have run their course. Because of the remarkable advancements in surgical techniques, longer-lasting implants, and post-operative pain management, Morrey says that recoveries are more often accelerated than in the past.
While the standard recovery time for hip and knee surgery is still one year, Morrey says patients experience the biggest gains in pain reduction and increased movement during the first three months. He refers to the following nine months as “fine-tuning,” particularly for active patients. Morrey says, “For every few steps forward they take, they might take a half step back because they're using muscles that they haven't used in a while… But as long as you're making progress, that's okay.”
There are other factors to consider in recovery that can reinforce the advice not to wait. Morrey says younger patients are more likely to be in good health and have more reserve capacity to recover sooner. For older patients, he says, “Their medical comorbidities catch up with them a little bit, so sometimes recovery from that is a little more onerous, a little more daunting for them.” Underlying health conditions, including diabetes, smoking, and obesity, can also impact a patient’s recovery time.
Surgeons at Ortho San Antonio spend an extensive amount of time counseling, managing expectations, and ensuring patients can make an informed decision, including which physician best meets their needs. Morrey likens the patient-doctor relationship to a marriage. He says, “You need to find the right person. If it’s not working out, that might be a bad situation.”
Morrey recognizes that people have different perspectives on what healthcare means to them. He warns against relying solely on the internet or hearsay because patients can incorrectly self-diagnose. Morrey says, “It never hurts to just see someone and get an idea, a baseline, of what's going on because not all pain requires surgery…The more informed the patient is, the easier it is to start making decisions moving forward.”
ortho-sa.com | 210-705-5060 | 138 Old San Antonio Rd., Ste. 302
“My job as a hip and knee surgeon is to say there's no reason to put up with pain if you don't have to.”