Bone and Joint: The Complete Guide

Key numbers at a glance

How your bones and joints work

Your skeleton is living tissue, not scaffolding. Bone is constantly being broken down and rebuilt by specialized cells, a process called remodeling that replaces most of your skeleton over a period of years. Through childhood and adolescence, building outpaces breakdown, and bone mass peaks somewhere in early adulthood. After that, the balance slowly tips the other way, and for women it tips faster in the years around menopause, when falling estrogen speeds up bone loss.

Joints are where bones meet. In the joints that move most, such as the knee, hip and shoulder, the bone ends are capped with smooth cartilage and enclosed in a capsule lined with a membrane that produces lubricating fluid. Ligaments hold bone to bone and keep the joint stable; tendons attach muscle to bone and transmit the force that moves it. Cartilage has no blood supply of its own, and it depends partly on the squeeze and release of movement to stay nourished.

That last point explains a great deal of modern advice. Bone, cartilage, tendon and muscle all respond to load. Put them to work regularly and progressively, and they adapt by becoming stronger; leave them idle, and they weaken. This is why so much of what follows comes back to movement, even for conditions that hurt, and why rest — the instinctive response to joint pain — so often makes things worse in the long run.

Muscles are part of the joint

The muscles around a joint act as its shock absorbers and stabilizers. Strong thigh muscles, for example, take a large share of the load off the knee with every step. When muscle weakens through inactivity or after an injury, more stress passes through cartilage and ligaments, and the joint tends to feel less stable and more painful. Strengthening the muscles is therefore one of the most direct ways to protect a joint, whatever its X-ray looks like.

Why bone and joint health matters

Arthritis is one of the most common chronic conditions in the United States, and the CDC counts it among the leading causes of work disability. Back pain is one of the most common reasons people see a doctor at all. These conditions rarely shorten life directly, but they shape it: they decide whether you can climb stairs, lift a grandchild, keep working, or keep walking far enough to stay well in other ways.

The consequences also compound. Joint pain leads to less activity, less activity leads to weaker muscles, weight gain and poorer balance, and those raise the risk of falls, heart disease and diabetes. Osteoporosis is silent until a bone breaks, and a hip fracture in an older adult is a life-changing event that can end independent living. Each link in that chain is a point where you can intervene.

The encouraging news is that bone and joint health is unusually responsive to things you control. Exercise, a healthy weight, enough calcium and vitamin D, not smoking, sensible alcohol use and attention to fall hazards all have solid evidence behind them. Many of the treatments that help most are cheap, safe and available to almost everyone, and it is rarely too late to start.

The common conditions, and how they differ

Bone and joint problems are often lumped together as "arthritis" or "wear and tear," but they are different conditions with different causes and, crucially, different treatments. A stiff knee in a 70-year-old, a swollen set of knuckles in a 35-year-old and a throbbing big toe after a night out may all be called arthritis, yet each calls for a different response. Knowing roughly which one you are dealing with helps you ask the right questions and recognize when something needs prompt attention.

Osteoarthritis

Osteoarthritis is the most common form of arthritis. It involves changes to cartilage, the underlying bone and the tissues around the joint, producing pain and stiffness that typically affects the knees, hips, hands and spine. Calling it wear and tear is misleading, because it suggests the joint is a part being used up. In fact, joints affected by osteoarthritis usually do better with sensible use, and the core management is physical activity, including strengthening and aerobic exercise. The diagnosis is usually based on symptoms and examination, and how bad an X-ray looks often does not match how much the joint hurts.

Inflammatory arthritis

Rheumatoid arthritis and related conditions are autoimmune: the immune system attacks the lining of the joints. The typical pattern is swelling and pain in the small joints of the hands and feet, often on both sides, with morning stiffness that lasts more than 30 minutes. This matters because early treatment with disease-modifying antirheumatic drugs (DMARDs), usually overseen by a rheumatologist, substantially reduces long-term joint damage. Blood tests can be normal early on, so a normal result does not rule it out.

Gout

Gout is caused by uric acid crystals forming in a joint. The classic attack comes on suddenly, often overnight, with severe pain, redness and swelling, most famously in the big toe. Flares are treated with anti-inflammatory medicines such as NSAIDs, colchicine or steroids, and people with repeated flares can take long-term urate-lowering therapy such as allopurinol. Alcohol (especially beer), sugary drinks and purine-rich foods can trigger attacks, but genetics and kidney function matter more than diet alone.

Osteoporosis

Osteoporosis means reduced bone density and quality, so bones break from minor trauma such as a fall from standing height. It causes no symptoms until a fracture happens, most often in the wrist, spine or hip. Spinal fractures can show up as height loss or a stooped posture rather than a single painful event. A first fragility fracture substantially raises the risk of the next one, which is why any bone broken in a minor fall deserves a conversation about bone health.

Risk factors you can and cannot change

Some risks are fixed. Age raises the risk of osteoarthritis, osteoporosis and falls. Women are more likely to develop osteoporosis and rheumatoid arthritis; men are more likely to develop gout earlier in life. Family history matters for osteoporosis, gout and inflammatory arthritis. Previous joint injuries, such as a torn knee ligament in your twenties, raise the chance of osteoarthritis in that joint decades later.

Other risks are within reach. Excess weight increases the load on knees and hips with every step and is also linked to inflammation that affects joints elsewhere; losing weight meaningfully improves knee and hip symptoms. Physical inactivity weakens muscle and bone together. Smoking and heavy drinking both reduce bone density. For gout, alcohol and sugary drinks are the most modifiable triggers.

Medicines are a risk factor people often overlook. Long-term steroid tablets such as prednisone are a major cause of bone loss. Some medicines raise the chance of falling, including sedatives, sleep aids and some blood pressure medicines. Diuretics ("water pills") can raise uric acid and trigger gout. Fluoroquinolone antibiotics such as ciprofloxacin carry an FDA warning about tendon rupture. None of this means you should stop a prescribed medicine on your own, but it is worth asking your doctor or pharmacist whether anything you take affects your bones, joints or balance.

Warning signs and what they can mean

Most aches and stiffness come and go and improve with movement. A few patterns, however, point to something that should not wait. The single most important is a hot, red, swollen joint, especially with a fever. That can be septic arthritis, an infection inside the joint that can destroy it within days, and it can look exactly like gout. It needs same-day assessment at urgent care or an emergency room, not a wait-and-see approach.

The length of morning stiffness is a useful clue. Stiffness that eases within half an hour fits osteoarthritis; stiffness lasting more than 30 minutes, particularly with swelling in several small joints, suggests inflammatory arthritis and is a reason to see your doctor promptly. Joint symptoms starting at a younger age than you would expect for wear-related problems point the same way.

For back pain, certain symptoms signal a possible emergency. Numbness in the groin, buttocks or inner thighs, difficulty passing or controlling urine, loss of bowel control, or weakness in both legs can indicate cauda equina syndrome, which compresses the nerves at the base of the spine and needs emergency surgery. Back pain with fever, unexplained weight loss, a history of cancer, a recent significant injury, or pain that is worse at night and not relieved by lying down should also be checked promptly.

• A broken bone from a minor fall, or height loss and a newly stooped posture
• Sudden severe back pain in someone with osteoporosis, which can be a spinal fracture
• A pop or snap with sudden pain, inability to push off or raise the arm, or a visible gap in a tendon
• A joint that gives way, or a pop followed by immediate swelling after an injury

How bone and joint problems are checked

For most joint and back pain, the most useful test is a careful conversation and examination. Your doctor will ask where it hurts, when it started, what makes it better or worse, how long stiffness lasts, and whether other joints are involved. Osteoarthritis is usually diagnosed this way, and X-rays are not always needed. For uncomplicated low back pain, imaging is not routinely recommended because the findings — disc bulges and age-related changes — are common in people with no pain at all and often do not match the symptoms.

Tests are useful in specific situations. Blood tests can support a diagnosis of inflammatory arthritis, although they can be normal early on. Fluid drawn from a swollen joint can be examined for crystals (confirming gout) or bacteria (confirming infection). X-rays are needed for suspected fractures, and an MRI may be ordered when nerve compression or a significant soft tissue injury is suspected and the result would change treatment.

Bone density screening

Osteoporosis is diagnosed with a DXA scan, a quick, low-dose X-ray that measures bone density, usually at the hip and spine. The US Preventive Services Task Force recommends screening for women 65 and older, and for younger postmenopausal women who are at increased risk based on factors such as low body weight, a parent who broke a hip, smoking, heavy drinking or long-term steroid use. Evidence on routine screening for men is less settled, so men with risk factors — especially long-term steroid use or a fracture from a minor fall — should ask their doctor whether testing makes sense. Medicare covers bone density measurement for people who meet its criteria.

What helps: movement, weight and everyday habits

Exercise is the closest thing bone and joint health has to a universal treatment. The Physical Activity Guidelines for Americans recommend at least 150 minutes a week of moderate aerobic activity, such as brisk walking, plus muscle-strengthening activity on at least 2 days a week. Older adults are advised to add balance training. For people with arthritis, these targets are a destination, not a starting point: begin with whatever you can manage and build up gradually.

Expect some discomfort when you start. Mild pain during or after exercise that settles within a day or so is normal and does not mean you are damaging the joint. If pain is much worse the next day, scale back a little rather than stopping. Low-impact options such as walking, cycling, swimming and water exercise are good places to begin, and a physical therapist can design a program around a specific joint.

Weight-bearing activity (anything where your feet and legs carry your weight, such as walking, stair climbing and dancing) and resistance exercise (working muscles against weights, bands or body weight) both load bone, which is the signal bone needs to maintain its strength. Swimming and cycling are excellent for joints and fitness but put little load on bone, so pair them with strength work. If you already have osteoporosis, ask a physical therapist which movements are safe, as some deep forward bending and twisting may need modifying.

• If you carry excess weight and your knees or hips hurt, even modest weight loss can ease symptoms
• Stop smoking and keep alcohol within US guidance: no more than 2 drinks a day for men and 1 for women

Calcium, vitamin D and food for bone

Calcium is the main mineral in bone, and vitamin D is what allows your gut to absorb it. If vitamin D is inadequate, calcium intake achieves less than the number on the label suggests, which is why the two are always discussed together. According to the NIH Office of Dietary Supplements, most adults need 1,000 mg of calcium a day, rising to 1,200 mg for women over 50 and men over 70. The vitamin D recommended dietary allowance is 15 mcg (600 IU) a day for adults up to 70 and 20 mcg (800 IU) over 70.

Food is the preferred source of calcium. Dairy products such as milk, yogurt and cheese are the richest sources in the American diet, and fortified plant milks, fortified orange juice, tofu made with calcium, canned fish with soft bones such as sardines and salmon, and some leafy greens add more. Vitamin D occurs naturally in few foods; fatty fish is the main one, and fortified milk and cereals supply much of what Americans get from food.

Supplements can fill a gap but have limits. More is not better: the upper limit for vitamin D in adults is 100 mcg (4,000 IU) a day, and the upper limit for calcium is 2,500 mg a day for adults up to 50 and 2,000 mg after that, counting food and supplements together. Very high calcium intake from supplements is linked to kidney stones. People with little sun exposure, darker skin, or conditions that affect absorption are more likely to be low in vitamin D and should ask their doctor whether they need a supplement. Talk to your doctor before supplementing if you have kidney disease, sarcoidosis, a parathyroid disorder, or a history of high blood calcium or kidney stones.

Treatment and care options

Treatment depends on the condition, but some principles run across all of them. Self-management — exercise, weight, sleep and pacing — comes first and continues alongside everything else. Medicines are used to make movement possible, not to replace it. Injections and surgery are useful for specific problems, and they work best when combined with rehabilitation. Whatever the treatment, the goal is the same: less pain and more function, measured by what you can do in daily life rather than by what a scan shows.

For osteoarthritis pain in the knees and hands, topical NSAIDs (gels applied to the skin) are often tried before tablets, because less of the drug reaches the rest of the body. Oral NSAIDs such as ibuprofen and naproxen can help but carry risks for the stomach, kidneys and heart, so long-term use needs review by your doctor. Acetaminophen (Tylenol) is an option for some people, though its benefit for osteoarthritis pain is modest. For back pain, simple pain relief used short-term to help you keep moving, plus exercise, physical therapy and heat, are the helpful options; bed rest is not recommended.

Medicines for specific conditions

Inflammatory arthritis is treated with DMARDs, started early to protect the joints. Some of these medicines suppress the immune system, so call your doctor urgently for any fever or infection while taking them, and never stop them without advice. Gout flares respond best when treated early, and people with repeated flares are offered urate-lowering therapy such as allopurinol, which should be continued during a flare once it is established. Any rash while taking allopurinol needs urgent medical attention. Osteoporosis medicines reduce fracture risk; your doctor will discuss the options, benefits and side effects, and you should not stop them without that conversation.

Physical therapy and tendon rehabilitation

A physical therapist can assess how you move, identify weak links and build a progressive program. For tendon problems this is the main treatment: tendons respond to gradually increasing load, and complete rest weakens them further. Improvement takes months rather than weeks. Steroid injections can give short-term relief but, for some tendons, may not help or may even harm in the long run, so repeated injections should only follow advice from a sports medicine or orthopedic doctor.

Joint replacement

Hip and knee replacements are among the most common and successful operations in the US, and most implants last many years. Outcomes depend heavily on the parts you can influence: exercise before surgery (prehabilitation), stopping smoking to reduce wound complications, arranging home support and equipment in advance, and sticking with physical therapy for months afterward, even when it is dull. Hospital stays are often short, and some people go home the same day. Delaying surgery so long that muscle wastes away can make recovery harder.

Falls, fractures and injuries

Falls are the main reason weak bone actually breaks. The CDC reports that more than one in four adults 65 and older falls each year, and that a fall predicts further falls. Most falls have several contributing causes — weak legs, poor balance, medicines, vision, footwear, foot problems and hazards at home — and each can be addressed. The US Preventive Services Task Force recommends exercise interventions to prevent falls in community-dwelling adults 65 and older who are at increased risk.

The strongest single intervention is exercise that builds strength and balance, done at least twice a week; tai chi is one well-studied option. Alongside that, ask your doctor or pharmacist to review your medicines for anything that causes drowsiness or dizziness, keep up with eye exams and glasses, and have foot problems treated. At home, remove loose rugs and trailing cords, light stairways well, add grab bars in the bathroom, and avoid walking in socks or loose slippers. Tell your doctor about every fall, even one without injury.

For acute injuries during sport or activity, the first 48 hours matter. Brief rest, ice, compression and elevation (often called RICE) help early on, and heat and alcohol are best avoided at first. After that, early and gradual return to movement beats prolonged rest. Inability to bear weight, deformity or tenderness directly over bone suggest a fracture and need an X-ray.

Concussion is a joint-and-bone issue too

Any suspected concussion in sport means immediate removal from play — never a same-day return, even if the athlete says they feel fine. The CDC HEADS UP program advises that athletes return only with clearance from a health care provider and by following a gradual, step-by-step plan that increases activity in stages. Returning while still symptomatic risks a second, more serious injury. Call 911 for loss of consciousness, repeated vomiting, a worsening headache, confusion, a seizure or unusual drowsiness.

Specific groups

Bone and joint advice changes shape across a lifetime and in people with other health conditions. The principles stay the same — load builds strength, early assessment of the right symptoms matters — but the emphasis shifts. Building bone matters most in youth, protecting it matters most around menopause, and preventing falls matters most later in life, while medicines and other conditions can change which treatments are safe at any age.

Children and teens

Childhood and adolescence are when most bone mass is built, so active play, sports and enough calcium and vitamin D during these years pay off for life. Young athletes are prone to overuse injuries when training volume jumps suddenly, and growing bones have growth plates that can be injured differently from adult bone, so a child who cannot bear weight or has a deformed limb needs prompt assessment. Vitamin D deficiency in children causes rickets, which is why pediatricians pay attention to vitamin D intake.

Women, pregnancy and menopause

Women lose bone faster in the years around menopause, which is why osteoporosis screening is recommended earlier for women than for men. During pregnancy, calcium needs are generally met by the same intake as other women of the same age, but ask your obstetric provider about vitamin D and any supplements, and about which pain relievers are safe; NSAIDs are generally avoided in later pregnancy. Low back and pelvic pain are common in pregnancy and usually respond to activity and physical therapy.

Older adults

After 65, falls prevention moves to the center of bone and joint health. Balance training, medicine review and home safety become as important as calcium and vitamin D, and the vitamin D RDA rises to 800 IU a day after 70. Older adults are also more vulnerable to the side effects of NSAIDs and sedating medicines, and benefit from periodic review of everything they take. Strength training works at any age.

People with other conditions

People with kidney disease, high blood pressure or heart disease should check with their doctor before taking NSAIDs, which can affect all three. People taking long-term steroids should ask about bone protection. Those with psoriasis should report joint pain, which may be psoriatic arthritis. Anyone on immune-suppressing treatment should treat fever as urgent. People with diabetes should have foot problems checked promptly, since nerve damage can hide injuries.

Myths and the guidance behind them

A lot of bone and joint advice has changed over the past few decades. Bed rest for back pain, avoiding exercise with arthritis and routine scans for every ache were once standard and are now known to slow recovery or mislead. Some of the old ideas persist in family wisdom and online, and they can quietly stop people from doing the things that help most. Here are the ones that most often get in the way.

• Myth: Rest is the best thing for a painful joint. Guidance: Activity and strengthening are the core treatment for osteoarthritis, back pain and tendon problems; prolonged rest worsens function.
• Myth: Arthritis is just wear and tear, so nothing helps. Guidance: Exercise, weight loss, physical therapy and the right medicines all improve symptoms and function.
• Myth: You need an X-ray or MRI to know what is wrong. Guidance: Osteoarthritis and uncomplicated back pain are usually diagnosed by examination, and imaging often shows changes unrelated to the pain.
• Myth: Osteoporosis is an inevitable part of aging. Guidance: Screening, exercise, nutrition, falls prevention and medicines all reduce fracture risk.
• Myth: Gout is caused by rich food. Guidance: Diet plays a part, but genetics and kidney function matter more, and medicine prevents flares effectively.

Costs, coverage and talking to your doctor

Physical therapy is one of the most effective treatments for joint, back and tendon problems, and most insurance plans cover it, though many limit the number of visits or require a referral and charge a copay for each session. Many states allow you to see a physical therapist directly without a referral, but your insurer may still require one, so check before booking.

Medicare Part B covers bone density testing for people who meet its criteria, physical therapy that is medically necessary, and durable medical equipment such as walkers when prescribed. The Medicare Annual Wellness Visit includes a review of your fall risk and a chance to discuss your medicines. Marketplace and most employer plans cover the USPSTF-recommended osteoporosis screening without cost-sharing. Over-the-counter options — topical NSAID gel, generic ibuprofen and acetaminophen — are inexpensive, but ask a pharmacist which suits you, especially if you take other medicines.

Joint and back pain visits are often short, so preparation helps. Before you go, write down when the problem started, which joints are involved, how long morning stiffness lasts, what makes it better or worse, and what you have already tried. Bring a list of every medicine and supplement you take, including over-the-counter pain relievers and vitamin D. Say what you most want to be able to do again — walking the dog, gardening, playing with grandchildren — because that shapes the plan.

Do not hesitate to ask for a physical therapy referral, a falls risk assessment, or a bone density test if you have risk factors. If you have swelling in several joints with long morning stiffness, ask directly whether it could be inflammatory arthritis and whether you should see a rheumatologist. And if you have been on NSAIDs, steroid tablets or bone medicines for a long time, ask when they were last reviewed.

• Could this be inflammatory arthritis, and do I need a rheumatologist?
• Would a physical therapist help, and does my plan need a referral?
• Am I due for a bone density test?
• Do any of my medicines raise my risk of falls, bone loss or tendon problems?
• Do I need a calcium or vitamin D supplement, and how much?

A practical 4-week plan

You do not need to overhaul your life to make a difference. This plan builds habits in small steps, one layer each week, so that by the end of the month you have a routine covering movement, strength, balance, nutrition and safety. Adjust it to your fitness and any advice from your doctor or physical therapist. If a step causes pain that is much worse the next day, scale it back rather than giving up.

Week 1: Take stock

Write down your symptoms, medicines and supplements. Walk for 10 minutes on most days at a comfortable pace. Check your diet for calcium sources and note roughly how many servings you get a day. Walk through your home looking for fall hazards: loose rugs, trailing cords, dim stairs, a slippery bathtub. This week is about noticing, not fixing everything at once, so keep a simple list you can work through.

Week 2: Add strength

Add two short strength sessions: sit-to-stand from a chair, wall push-ups, step-ups on the bottom stair and heel raises holding a counter. Increase walks toward 15 to 20 minutes. Fix the easiest home hazards and add a night-light on the route to the bathroom. Start with 1 set of 8 to 10 repetitions of each strength move and add a second set when it feels easy. Mild muscle soreness for a day or two is normal.

Week 3: Add balance and review

Add simple balance practice, such as standing on one leg near a counter, or try a tai chi class. Book any overdue checkup, eye exam or bone density test, and ask a pharmacist to review your medicines for anything that causes drowsiness or dizziness. If you are short on calcium-rich foods, add one serving a day, such as a yogurt, a glass of milk or fortified plant milk, or a portion of tofu.

Week 4: Lock it in

Aim for a weekly pattern you can keep: several walks adding up toward 150 minutes, two strength sessions and regular balance work. Note what has changed in pain, stiffness and confidence. If progress has stalled or pain is limiting you, ask your doctor about physical therapy. Then repeat the month, nudging each part up a little as your strength and confidence grow.

Every guide in this topic

• What the Guidance Really Says About Osteoarthritis
• Osteoporosis: What Published Guidance Supports
• What the Guidance Really Says About Inflammatory Arthritis
• The Evidence on Gout, Without the Hype
• Back Pain: What Published Guidance Supports
• Falls Prevention: What Published Guidance Supports
• The Evidence on Joint Replacement, Without the Hype
• Tendon Problems: What the Evidence Actually Says
• What the Guidance Really Says About Vitamin D and Bone
• Sports Injuries: What Published Guidance Supports

Frequently asked questions

Should I rest a joint that hurts?

Usually not for long. For osteoarthritis, back pain and tendon problems, prolonged rest weakens the muscles and tendons that protect the joint and is linked to slower recovery. A day or two of easing off after a flare is reasonable, but the core treatment is gradual, regular movement and strengthening. The exception is an acute injury with signs of a fracture, or a hot, red, swollen joint, which need medical assessment first.

How do I know whether my joint pain is osteoarthritis or rheumatoid arthritis?

Only an examination can tell, but the pattern gives clues. Osteoarthritis usually affects weight-bearing joints or the hands, with stiffness that eases within half an hour. Rheumatoid arthritis tends to cause swelling in the small joints of both hands or feet, with morning stiffness lasting more than 30 minutes. If that second pattern sounds familiar, see your doctor promptly, because early treatment protects the joints.

Do I need an X-ray or MRI for back pain?

For most low back pain, no. Imaging is not routinely recommended because it often shows age-related changes that are common in people without pain and do not explain the symptoms. Scans are useful when there are warning signs, such as fever, a history of cancer, significant injury, weight loss, or nerve symptoms like leg weakness, numbness in the groin, or bladder or bowel changes.

How much calcium and vitamin D do I need?

Most adults need 1,000 mg of calcium a day, and women over 50 and men over 70 need 1,200 mg. The vitamin D RDA is 600 IU (15 mcg) a day through age 70 and 800 IU (20 mcg) after that. Try to meet calcium needs from food first, and ask your doctor before taking supplements, especially at higher doses or if you have kidney problems.

When should I get a bone density test?

The US Preventive Services Task Force recommends a DXA bone density scan for all women 65 and older and for younger postmenopausal women at increased risk. Men, and anyone who has taken steroid tablets for months or broken a bone in a minor fall, should ask their doctor whether testing is right for them. Medicare covers the test for people who meet its criteria.

Is it safe to exercise with arthritis?

Yes, and it is one of the most effective treatments. Start gently with low-impact activity such as walking, cycling or water exercise, add strengthening, and build up gradually. Some discomfort when starting is normal and does not mean damage. If pain is much worse the next day, cut back slightly rather than stopping. A physical therapist can tailor a program if you are unsure.

Can diet alone control gout?

Usually not. Cutting back on alcohol, especially beer, sugary drinks and purine-rich foods can reduce flares, but genetics and kidney function play a larger part than diet. People with repeated flares often benefit from urate-lowering medicine such as allopurinol, which is taken long term. Treat each flare early, and ask your doctor whether preventive treatment makes sense for you.

What should I do right after a sprain or strain?

In the first 48 hours, rest briefly, use ice and compression, and elevate the injured area. Avoid heat and alcohol at first. Then start gentle movement early and increase it gradually, rather than keeping the joint still for weeks. Get an X-ray if you cannot bear weight, the limb looks deformed, or there is tenderness directly over bone.

How can I reduce my risk of falling?

The most effective step is strength and balance exercise, such as tai chi, at least twice a week. Also ask your doctor or pharmacist to review medicines that cause drowsiness or dizziness, keep your eye exams up to date, wear well-fitting shoes, and remove hazards like loose rugs and trailing cords. Tell your doctor about any fall, even if you were not hurt.

How long does recovery from a knee or hip replacement take?

Most people are walking with help soon after surgery, and some go home the same day, but rehabilitation continues for months, not weeks. Exercising before surgery, stopping smoking and preparing your home all help. Keep up physical therapy even after the pain settles. Contact your surgeon urgently for increasing pain, redness or drainage at the wound, or fever.

When to speak to a doctor

See your doctor for joint swelling with morning stiffness lasting more than 30 minutes, joint pain starting at a younger age, a bone broken in a minor fall, height loss or a stooped posture, any fall (even without injury), or tendon pain while taking a fluoroquinolone antibiotic. Go to urgent care or the emergency room the same day for a hot, red, swollen joint, especially with fever, which can be a joint infection; for a sudden pop with a visible tendon gap or inability to push off; or for a wound that is red, hot or draining after joint replacement. Call 911 for numbness in the groin or buttocks, loss of bladder or bowel control or weakness in both legs with back pain; a fall with severe hip pain or inability to stand; a deformed limb; a head injury with loss of consciousness, vomiting or confusion; or chest pain or sudden shortness of breath after surgery.

Where this comes from

• National Institute of Arthritis and Musculoskeletal and Skin Diseases — Osteoarthritis
• National Institute of Arthritis and Musculoskeletal and Skin Diseases — Osteoporosis
• CDC — Arthritis
• CDC — Older Adult Fall Prevention
• US Preventive Services Task Force — Osteoporosis to Prevent Fractures: Screening
• US Preventive Services Task Force — Falls Prevention in Community-Dwelling Older Adults: Interventions
• NIH Office of Dietary Supplements — Calcium: Fact Sheet for Consumers
• NIH Office of Dietary Supplements — Vitamin D: Fact Sheet for Health Professionals
• Office of Disease Prevention and Health Promotion — Physical Activity Guidelines for Americans, 2nd edition
• Arthritis Foundation — Gout

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.