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When does “chronic” become too chronic?


The word “chronic” describes an illness or condition that has gone on for a long time. In Orthopedic (bone) medicine a chronic condition usually involves the joints and bones in the body. In the United States, one in two people will have a musculoskeletal condition (MSK) in their lifetime. Some of these MSK conditions are marked by the following:

  • Pain – ongoing, constant, or unrelenting
  • Stiffness
  • Decrease in range of motion
  • Inability to do the things you used to do
  • Depression or malaise
  • Feeling of hopelessness
  • Anger when feeling there is not an end to your condition

When is “chronic” too chronic?

Most orthopedic conditions have an “end date” or a time period when the pain or continued difficulty from your condition will typically “get better”.  With proper treatment for your specific illness, injury or condition, you should expect that you will improve and become pain free. But what is the timeframe for feeling better?

Chronic is too chronic when the following occurs:

  • Your pain has continued for longer than 6 months.
  • When the treatment, operation, or procedure you had does not relieve pain.
  • If your symptoms worsen.
  • If other joints, bones or muscles begin to have problems.
  • A new injury to the same area.
  • If you find you are taking more and more medication to alleviate pain.
  • Swelling does not decrease.
  • If you haven’t regained your range of motion and mobility within 6 months.
  • You are losing strength.

What do I do for a chronic condition that has gone on too long?

Our experts at Best In Class MD offer the following advice for when muscle and bone pain has gone on too long:

  • Get a second opinion: A second set of eyes and a fresh perspective on your condition or injury can not only give you an alternative to treatment, but can tell you if what you are experiencing is normal. A second opinion by an expert can help turn-around your chronic condition.
  • Research your condition: The more you know about your injury or condition, the better. There is plenty of reliable information about how long your recovery should take and when to expect to be pain-free and back to your regular activities.
  • Change doctors: Sometimes it is difficult to admit that the doctor we’ve chosen isn’t helping us. However, not all orthopedic specialists are equal in their expertise, understanding and treatment methods. If your chronic pain or injury isn’t improving, it may be time to change doctors.
  • Follow your treatment program: Any orthopedic procedure you decide upon should be approached with a “team attitude.” The doctor will do his or her part, the physical therapist will have a part, and you, the patient, need to do your part in your own recovery. Active participation in post-surgical protocols is key to your success in recovering from any musculoskeletal condition.

How long should I wait to feel better?

There are general guidelines for when your pain should lessen and when you can get back to your normal routine, activities and exercise or sports that you love. The following guidelines are a general timeframe for patients who are healthy, do not have any underlying medical conditions and who follow the prescribed post-operative protocol.

Bone Fractures: Bones take time to “knit” back together. Bones, rather assisted surgically to place them in their proper position, or splinted or casted (non-surgically_ take 6 weeks to heal. Patients can expect a month or two of physical therapy to regain their strength.

Joint Replacement: Many of the joints in the body can be replaced with metal and plastic parts, creating a pain-free glide for the bones within the joint. Depending on the type of joint replacement, full recovery can take 6 to 12 months.

Sprains and strains: Depending on the severity of the sprain or strain and the location, most sprains can take up to 6 weeks to heal.

Knee Ligament Reconstruction: When a knee ligament reconstruction is required, the healing time can vary, depending on the severity of the injury. The number of ligaments that need to be reconstructed, as well as other soft structure repair will determine the length of recovery.  In general patients can expect full recovery in 7 to 12 months.

Rotator Cuff Surgery: If done arthroscopically (minimally invasive surgery) most patients recover from rotator cuff surgery in 6 to 9 months.

Hip Impingement: Patients receiving surgery for Cam impingement or FAI can expect to return to their regular routine in approximately 6 to 9 months.