(Health.com) -- Knee and hip replacement operations can result in a lot of pain, but surgical techniques have improved significantly in the past 20 years.
Risks such as infection, blood clots, and extreme postsurgical pain have been reduced, refinements in technique and anesthesia have cut recovery time, and implants work better.
Still, recovery can be a long, difficult road for which patients should be mentally and physically prepared.
Pick your pain relief option
New pain relief techniques mean patients can have painkillers delivered efficiently and with greater success. When Judy Street, 67, from Fort Lauderdale, Florida, opted for knee replacement because she couldn't do anything with her grandchildren, she was nervous.
A friend had told her the post-operative pain would be excruciating. But her anesthesiologist gave her two pain control options: a patient-controlled infusion pump delivering pain medicine or a two-day epidural implant that automatically delivers pain relief. She opted for the implant and was pleased that her leg felt pretty much numb in the days after surgery.
Glenn, 54, of Chappaqua, New York, who had a double hip replacement remembers the importance of post-op narcotics: "Everybody including my macho football-playing friend who had a knee replacement said, 'Don't be a brave guy. Take as much painkiller as you need. Don't be macho, don't let the pain get in front of you. Just keep taking it.'"
Jump right into rehab
For Street, gentle physical therapy began the day after surgery. "It didn't hurt because my leg was numb from the epidural anyway," says Street. "I pretty much got up after the third day when they took the epidural out." Therapy then intensified to twice a day, for about an hour.
Twelve days later Street was able to leave the hospital walking with a cane. She decided against taking Percocet, which she regrets. "You have to take the Percocet," she says.
Glenn was surprised by the wallop that surgery dealt his fit body: "I have run three marathons, but nothing compared with how hard trying to sit up in bed was. I pretty much fainted or they sort of caught me."
Still, Glenn was "kicked out" of the hospital after less than three days because he was progressing so rapidly -- remarkable for a double-hip replacement. Four weeks after the operation Glenn was able to walk a mile and bike for 50 minutes.
Your recovery plan begins before surgery
Eight months before his hip replacement, Charles, 66, from Grantham, New Hampshire, started going to the gym three times a week, using a treadmill and strengthening his leg and abdominal muscles. His surgeon credited the regimen for optimizing his recovery time.
Before her surgery, Street did eight weeks of strength training. "This is a service that Medicare will provide if you can get a doctor's prescription. I think it made a big difference in my recovery," says Street who was playing golf three months after surgery.
Don't expect miracles
The amount of time it takes to get back to normal life varies for each patient. For Charles, it took six months to get back 100 percent. In part it was his fault, he says. "I went back to work way too fast. You've got to listen to your doctor and have common sense. Next time I do this I'll be in a better frame of mind and I'll have had more experience."
Copyright Health Magazine 2011