Joint Health Program

The Joint Health Program helps people of all ages who have hip, knee, shoulder, or thumb osteoarthritis. The program may be for you if:

You want to avoid joint replacement surgery.
We’ll help you reduce your pain and maximize your function so you can delay -- or even prevent -- the need for joint replacement surgery. Research suggests people with osteoarthritis have less pain and better function -- and may keep osteoarthritis from advancing -- if they:

• Are physically active, strong, and flexible
• Eat a healthy diet and are at a healthy weight
• Sleep well
• Have good pain-coping skills and endure less emotional distress

You want to prepare your body for surgery.
Research also suggests that people who meet the characteristics listed above before joint replacement surgery have less pain and better function after surgery. The Joint Health Program can help you get ready for surgery, so you have the best chances for a good outcome.

You’re not eligible for joint replacement surgery.
If you’ve been told you’re not a candidate for joint replacement surgery, we can help you manage your pain and improve your quality of life using nonsurgical approaches. If you’re not eligible for joint replacement surgery due to diabetes or obesity, our program may help you improve those conditions so you become a candidate for surgery.

We help you achieve a better quality of life by developing a customized plan that addresses all the ways your pain affects you -- physically, mentally, and emotionally. We can help you:

• Understand your condition and your treatment options
• Learn ways to reduce and manage your pain 
• Increase and maintain your physical strength and function
• Manage anxiety, stress, and overall emotional well-being
• Lose excess weight or manage your weight
• Adopt and maintain a healthy lifestyle that includes physical activity, good nutrition, and restful sleep
• Return to activities you enjoy -- such as walking, running, hiking, biking, yoga, crafting, or gardening 
• Get around easier and perform everyday home or work functions like lifting, preparing meals, fastening buttons, or going up and down stairs with less pain

You'll have what we call a primary osteoarthritis provider to manage your care in the program. This will be a physical therapist who has extensive training in hip, knee, or shoulder osteoarthritis or an occupational therapist who has extensive training in thumb osteoarthritis, and additional training in nutrition, weight management, sleep quality, cognitive behavioral-informed therapy strategies, and drug-free pain management.

Your physical therapist or occupational therapist will also coordinate with your orthopaedic specialist or primary care doctor, who will remain involved in your care -- especially when it comes to decisions about medication, surgery, or other treatments or procedures.

In addition to visits with your physical therapist or occupational therapist, you may also choose to have appointments with:

• A dietitian or weight loss specialist, who can provide nutritional advice, meal plans, and assistance in meeting your diet and weight loss goals
• A psychologist, who can help with issues such as coping with pain; managing depression, anxiety, stress, and sleep issues; and adopting new, healthier habits

To help you achieve your goals at home and work, you and your physical therapist or occupational therapist will connect beyond the clinic via phone calls, e-mails, or Duke MyChart messages. They will also send you periodic electronic surveys to evaluate and improve your personalized program to better help you achieve success. 

The program typically provides personalized care for three to six months, more if needed, with follow-up for one year or beyond. How long you participate will depend on your health status and goals.

Clinic visits with your physical therapist or occupational therapist are billed to your health insurance as standard physical therapy or occupational therapy visits. Please check with your insurance company before your first visit to ask whether it will be covered, whether you need a referral to be seen in the program, and what deductible, copay, and/or co-insurance amounts you may be responsible for. 

Visits with your primary care provider, orthopaedic specialist, dietitian, psychologist, or other providers will be billed separately and will also depend on your individual insurance coverage.

If you have questions about insurance or costs, your physical therapist or occupational therapist can connect you with a Duke Financial Care Counselor who can assist you.