Can a Knee Replacement Save Your Marriage?
Anyone who has or knows someone with osteoarthritis (OA) also knows the physical pain it can cause. But OA can damage relationships as well as joints—by straining spouses even as it wears down cartilage in the hands, knees, hips, and spine. That’s because “partners often act as caregivers, bearing the brunt of daily home tasks, which can be distressing and isolating,” notes clinical psychologist, Supatra Tovar, Psy.D., who practices holistic psychotherapy in Pasadena, CA. Still, research shows that spouses also have the power to help improve their loved one’s OA and better their marriage. We’ll tell you how.
A Sometimes Backfiring Burden
The role of caregiver puts a lot of responsibility on a spouse’s shoulders. “It can feel like a big sacrifice that easily becomes overwhelming,” says Tovar. Not only that, but when caregivers turn taskmasters, the intention can totally backfire. For instance, even though staying active is critical for the 32.5 million Americans with OA, a report in the journal Annals of Behavioral Medicine found that when husbands with osteoarthritis felt that their spouses were pressuring them to move more, they actually spent less time being active.
No “I” in “Team” When It Comes to OA
At the same time, needing to rely on your spouse’s caregiving support can strain marital happiness, too. “Being cared for by your spouse may lead to feelings of helplessness and uselessness that can wear on your mental well-being,” says Tovar. However, when couples view the management of a chronic illness, like osteoarthritis, as a shared responsibility between partners, it often results in improved condition management, according to a report published in the American Psychologist Journal. Translation: The team approach brings better health.
The Prevalence of Sex Problems
Research shows that about two-thirds of people with OA develop sexual problems. And, up to 10% with OA-associated hip pain simply cease having sexual relations altogether, instead of modifying their positions or behaviors. “People feel nervous about bringing this topic up with an orthopedic specialist, but we can help navigate a lot of the do’s and don’ts,” says Dominic King, D.O., an orthopedic and sports medicine physician at the Cleveland Clinic in Ohio, noting that intimacy greatly impacts a couple’s happiness. Most of the time, total hip replacement improves sexual function, according to a report in the journal Sexual Medicine.
A Spouse’s Pain of Bearing Witness
It’s hard to watch someone you love suffer—and 61% of spouses say no longer having to do so is a main benefit of their partners getting joint replacement surgery, per a study presented at the 2020 American Academy of Orthopedic Surgeons’ (AAOS) Virtual Education Experience. It’s also difficult to truly understand the pain your partner is in. “When caregiving partners don’t appreciate the levels of pain, this can cause mutual resentment and depression,” says Tovar. The Arthritis Foundation recommends using a 1 to 10 pain scale. Say to your partner: “I’m not up for a walk—my pain is about a six.”
The Power of Spousal Empathy
While a spouse can never know exactly how their partner with OA feels, he or she can offer understanding. “When spouses show empathy for the severity of their partner’s pain, there are often positive psychological and physical results,” says Tovar. In fact, a report in Health Psychology found that when folks with osteoarthritis pain are met with spousal empathy, their function and activity levels improve. (Empathic responses might include validation, tell-me-more follow-ups, or putting your loved one’s message into your own words to show you understand.)
The Need for More Physical Exercise
Most people with knee or hip OA don’t get enough physical activity, according to a 2019 study. (And we already know nagging won’t improve the situation.) Researchers note that receiving empathy and support is often associated with more minutes of moderate-to-vigorous physical activity for those with osteoarthritis. Plus, individuals with OA who are in satisfying twosomes tend to take more daily steps if their partners do the same. (This means an active spouse can lead by example.) All super-important, since staying active is one of the most effective long-term strategies for managing knee osteoarthritis.
Partners in Inspiration
It’s not uncommon for a spouse to encourage an OA patient to get joint replacement surgery, even when the patient is wavering, remarks Michael Tanzer, M.D., Jo Miller chair of orthopedic research at McGill University Health Center in Montreal. “Patients are often more concerned about risks. The spouse—who’s watched the suffering and diminished quality of life—focuses more on the positive outcome of surgery.” That positivity can serve as beneficial catalyst, a good thing since 80% to 100% of total knee replacement patients go on to report satisfaction with the results, according to a study in HSS Journal.
Reversing OA’s Social Burden
“Married couples who are active in their communities and have a rich social network of support report greater satisfaction and emotional well-being, both individually and within their marriage,” says Tovar. But when something like OA comes into play, a significant wrench can be tossed into that support, resulting in a less-gratifying union. The upshot: Dr. Tanzer’s research shows that spouses of OA patients experience marked life improvement after their partners undergo joint replacement surgery, with 70% noting that one of the main advantages is a renewed ability to engage in social and leisure activities again.
More OA Post-op Pluses
“While the decision for surgery is one for the patient, [my] study highlights the added benefits [for] the spouse, and perhaps the importance of dual decision making,” notes Dr. Tanzer. “If your spouse is in pain, and his or her activities and social interactions are limited because of that pain, it dramatically affects healthy partners, too.” Surgery may even make marriages happier: 54% of spouses reported “improved marital relationship” as a top benefit of their partners getting joint replacement surgery. Other wins include a diminished caregiver burden, and regaining a sense of independence to resume a normal life together.
A Happy Marriage: The Best Medicine
A chronic illness like osteoarthritis can strain the best of marriages. Keeping the bond strong is key. “Your mental well-being, including your happiness with your partner, is just as important as physical well-being,” says Dr. King. Folks with arthritis who are happily married tend to experience less pain and fewer physical disabilities than those who are in distressed unions, research shows. To help bolster your connection, take some advice from the Arthritis Foundation: Consider attending an OA support group together; schedule some time off from each other; and express affection in some way, every day.
- OA Stats: Centers for Disease Control and Prevention. (2020). “Osteoarthritis (OA).” cdc.gov/arthritis/basics/osteoarthritis.htm
- Nagging and OA: Annals of Behavioral Medicine. (2013). “Daily Spousal Influence on Physical Activity in Knee Osteoarthritis.” ncbi.nlm.nih.gov/pmc/articles/PMC3594506
- Shared Responsibility of OA: American Psychologist Journal. (2017). “Close Relationships and the Management of Chronic Illness: Associations and Interventions.” ncbi.nlm.nih.gov/pmc/articles/PMC5598776
- Sexual Problems and OA: Journal of Research in Medical Sciences. (2016). “Sexuality and elderly with chronic diseases: A review of the existing literature.” ncbi.nlm.nih.gov/pmc/articles/PMC5348839/
- OA Stats on Sexual Function: Sexual Medicine. (2014). “Sexual Function before and after Total Hip Replacement: Narrative Review.” ncbi.nlm.nih.gov/pmc/articles/PMC4272247/
- Benefits of Joint Replacement, According to Spouses: American Academy of Orthopaedic Surgeons’ Virtual Education Experience. (2020). “Marital Functioning and Spouse-Reported Improvements in Quality of Life after Joint Arthroplasty.” aaos.scientificposters.com/epsAbstractAAOS.cfm?id=1
- Pain Scale: Arthritis Foundation. (n.d.). “Keep Marriage Strong When You Have Arthritis.” arthritis.org/health-wellness/healthy-living/family-relationships/relationships/keeping-marriage-strong
- Empathy and OA Function: Health Psychology. (2017). “Spouse confidence and physical function among adults with osteoarthritis: The mediating role of spouse responses to pain.” ncbi.nlm.nih.gov/pmc/articles/PMC5033682/
- OA and Exercise: International Journal of Behavioral Medicine. (2019). “The Role of Cohabitating Partner and Relationship Characteristics on Physical Activity among Individuals with Osteoarthritis.” ncbi.nlm.nih.gov/pmc/articles/PMC7147336/
- Satisfaction With Knee Replacement Surgery: HSS Journal. (2018). “Patient Satisfaction After Total Knee Replacement: A Systematic Review.” link.springer.com/article/10.1007%2Fs11420-018-9614-8
- Happy Marriage and Arthritis Pain: The Journal of Pain. (2010). “Pain and functioning of rheumatoid arthritis patients based on marital status: is a distressed marriage preferable to no marriage?” pubmed.ncbi.nlm.nih.gov/20418185/