While the TOSH Moves program itself is new in that it incorporates a wide spectrum of treatment options in tandem, the treatments themselves are not new, he said.

"Many of the components here were underutilized," including doctor visits, physical therapy, education, stress management, nutrition and exercise science. By using those components together, rather than in isolation, specialists can help patients deal with many of the factors that contribute to their joint pain, he said.

Aguirre said the biggest part of the TOSH program is education, "just letting people know there are things you can do, and that surgery is not the only answer. A big part of it is managing the stress that comes with the pain."

Often, people don't even realize they are dealing with stress, but they're uptight "over having to live it for the rest of their lives. They get nervous. We have several special exercise regimes you can do to decrease that pain and have an effective, pain-free life."

Though specialists make recommendations about how best to manage pain, "we leave decisions about joint replacement totally up to the patient," Aguirre said. "Sometimes we take an X-ray and it looks horrible, but they don't want surgery. We'll take it and go other directions. If they get to the point that treatment has failed, they'll say 'I'm done, it's time for surgery.' "

Though joint replacement is often the final destination for those with severe arthritis, providers at TOSH are "very conscious of the cost" of preventive therapy, particularly because most insurance coverage doesn't pay for prevention, Rasmussen said.

With patients who can improve their health and mitigate pain through prevention, "It's still the right thing to do. It's always better for patients to do pre-habilitation (with proper diet and exercise) rather than rehabilitation (after surgery)."

e-mail: carrie@desnews.com

Health Hotline

Arthritis is the topic of today's Deseret News/Intermountain Healthcare Hotline. From 10 a.m. to noon, Dr. Lynn Rasmussen, an orthopedic surgeon, and Dale Aguirre, a physical therapist, both from Intermountain Healthcare, will answer questions about symptoms, treatments and joint replacement. From the Salt Lake area, call 236-6061. Elsewhere, the toll-free number is 800-925-8177, only operational during hotline hours.

This month, you can also e-mail questions to hotline@desnews.com from 10 a.m. to 5 p.m. Saturday. A sampling of questions and the answers will be posted online at deseretnews.com next Friday.