What Exercises Can I Do While Waiting For A Hip Replacement
The hip surgery will address the joint issue, but you will need to continue exercising regularly to stretch and strengthen your muscles to support your new joint adequately. Consider the following exercises on how to minimize pain while waiting for hip replacement:
- Thigh squeezes . Push the back of your knee into the bed to tighten the muscles on the top of your thigh. Wait for 5 seconds and relax.
- Leg slides . Move your surgical leg to the side, keeping your kneecap pointing up towards the ceiling. Return your leg to the starting position. Place a plastic bag beneath your heel to make it easier to slide.
- Bed mobility exercise. Lie perfectly flat on your back. Bring both elbows up. Come to a sitting posture by straightening your arms behind you. Lower yourself back down to your elbows, then to lying flat.
- Ankle pumps. Pump your feet up and down by bringing them toward you and then pushing them away from you.
- Buttocks squeeze . Squeeze your buttocks muscles together to tighten them. Wait for 5 seconds and relax.
- Sitting kicks . Sit on a solid chair. Straighten your right knee. Relax as you slowly drop your leg
Will Lower Back Pain Resolve After Tha
Editors Note: Research papers intended for presentation at the canceled annual meeting of the American Academy of Orthopaedic Surgeons are now available online at the AAOS Virtual Education Experience. Well be highlighting a few of the more interesting papers throughout the summer.
Its not uncommon for patients who need a total hip arthroplasty to also complain of lower back pain, which is often related to the change in body mechanics caused by osteoarthritis in the hip. In most patients but not all this back pain resolves after THA.
Is there a way for surgeons to predict which THA patients would be more or less likely to experience resolution of back pain after hip surgery?
That was the question researchers from Hospital for Special Surgery and NYU Langone Health sought to answer in their recent study investigating whether the use of spinopelvic parameters specifically, pelvic incidence and sacral slope change from standing to sitting could predict the likelihood of lower back pain resolving after THA.
In 500 consecutive THA patients, 204 had documented lower back pain in addition to osteoarthritis of the hip. The researchers collected demographic data and Oswestry Disability Index and Visual Analog Scale scores preoperatively and at 6 weeks and 1 year after surgery. They also obtained biplanar standing and sitting radiographs before surgery to calculate pelvic incidence and sacral slope change.
Dos And Don’ts To Protect Your New Hip
Whether you are experiencing severe pain after your hip surgery or not, it is important to pay attention to a few things to help accelerate the healing process. Be sure to work closely with your healthcare provider and physical therapist and follow their list of do’s and don’ts to avoid any complications after your surgery. Here are a few common things you should and should not do post surgery:
- Do not cross your legs at your knees for up to 8 weeks of surgery.
- Do not raise your knee up higher than the level of your hip.
- Do not lean forward when sitting.
- Do not bend forward to pick something from the ground while sitting.
- Do not turn your feed outward or inward while bending down.
- Do not bend excessively at the waist beyond 90 degrees.
- Do keep the leg straight and facing forward.
- Do keep your leg right in front of you while standing or sitting.
- Do make use of a barstool or high kitchen while working in the kitchen.
- Do apply ice packs to the affected area to relieve pain and swelling.
- Do use heat before any exercise to improve your range of motion.
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Summary And Contact Us Can We Help You
We hope you found this article informative and it helped answer many of the questions you may have surrounding your hip problems. If you would like to get more information specific to your challenges please email us: Get help and information from our Caring Medical staff
Brian Hutcheson, DC | Ross Hauser, MD | Danielle Steilen-Matias, PA-C
Pain Medication And Physical Therapy Dont Work
For some people, pain medication is an effective treatment in relieving hip pain. But medication can have unpleasant side effects, like sleepiness and decreased appetite. It can also be addictive. It can be hard to tolerate these side effects, especially when medication doesnt give you the relief you want.
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Did You Know That Lower Back Pain Can Be Caused By Hip Joint Osteoarthritis
Hip joint osteoarthritis is among the most common joint disorders with 87,733 hip replacements recorded by the national joint registry in 2016. Research studies suggest that the incidence of lower back pain accompanying hip arthritis is in the range of 20-40% of cases.
Arthritic changes to the cartilage surface lining the head of the femur and the acetabulum cause gradual thickening and shortening of the hip joint capsule . The resulting reduction in flexibility at the hip joint impacts upon surrounding muscle tissue often causing shortening and decline in strength and control, thus accelerating the rate of damage to the cartilage surfaces.
The long term effect of reduced mobility at the hip joint is often over use of neighbouring joints, namely the knees and lower back. Hip rotation is often most affected by the hip joint soft tissue changes, and the movement that appears most limited when we assess hip arthritis. The consequence of this when turning ones body is that the ball and socket joint of the hip will contribute only little towards the turn. Often unknown to the individual, the lumbar spine and knees will over contribute and experience additional torsion.
Diagnosis Is It Your Hip Back Or Both
Your doctor may use some combination of a comprehensive physical exam, X-rays, and diagnostic injections to get to the bottom of your pain problem. Usually patients will get a hip and lumbar spine X-ray, but often miss the thoracic spine, pelvis and hip areas. Were making sure to get that middle segment to see how the spine and hips work together, says Dr. Vigdorchik.
Dr. Bjerke states, Its critical to understand the hip-spine connection. All of my spine patients have X-rays of the hips to make sure we dont neglect problems there. Theres such an overlap in symptoms with these two that the other area may be overlooked.
A diagnostic injection of lidocaine into the hip joint can help pinpoint pain. This can be done in the doctors office using ultrasound or X-ray to guide the needle. If theres no pain relief from the hip injection, Im very nervous to do a hip replacement because the pain may be coming from their back, adds Dr. Vigdorchik.
A critical part of the diagnosis isnt just the imaging, Dr. Bjerke explains: the most important part of my patients visit is taking a good history of their symptoms. Sometimes the X-rays and MRI may show what looks like a problem, but the symptoms are coming from somewhere else.
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How Could My Hip Mri Be So Wrong
So again, you went and had an MRI of your hip. Your MRI came back and showed a lot of degenerative problems. You may have been told you have bone on bone, nothing can be done for this short of hip replacement. You went in for hip surgery. After months of rehabilitation, you still have the same hip pain. Upon further review and another MRI, it is determined that your pain is actually coming from your SI joint and/or your lower back. You may be finding yourself on this page because you are now researching alternatives to SI joint and low back surgery.
Something we hear, perhaps more often than one would think is, how was my hip MRI so wrong?
Talk With Your Doctor
Your orthopaedic surgeon will review the results of your evaluation with you and discuss whether hip replacement surgery is the best method to relieve your pain and improve your mobility. Other treatment options â such as medications, physical therapy, or other types of surgery â also may be considered.
In addition, your orthopaedic surgeon will explain the potential risks and complications of hip replacement surgery, including those related to the surgery itself and those that can occur over time after your surgery.
Never hesitate to ask your doctor questions when you do not understand. The more you know, the better you will be able to manage the changes that hip replacement surgery will make in your life.
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What Should You Not Do Before Hip Replacement
If there are things you should do before hip replacement, there are also things you should not do. Here are some things you should not do before hip replacement:
- Dont raise your knee over your hip.
- Try not to pick up anything on the floor while seated.
- When resting in bed, do not reach down to pull up covers.
- Avoid crossing your legs at the knees for at least 6 to 8 weeks.
- Do not lean forward while you sit down or sitting.
- Dont turn your feet too much outward or inward when bending down.
- Do not bend at the waist more than 90 degrees.
Seven days before surgery: Stop taking all NSAIDs , such as naproxen , ibuprofen and aspirin. They interfere with blood clotting, which can increase blood loss during surgery.
Back Pain Culprit: Chronic Conditions
Several chronic conditions can lead to low back pain.
- Spinal stenosis is a narrowing of the space around the spinal cord, which can put pressure on the spinal nerves.
- Ankylosing spondylitis inflames the joints of the spine, and sometimes the shoulders, hips, ribs, and other areas too. It causes chronic back pain and stiffness. In serious cases, spinal vertebrae start to fuse .
- Fibromyalgia causes widespread muscle aches, including back pain.
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Develop Your Hip Stretching Strategy
Releasing tight hip muscles is an indirect approach to relieving back pain. Because of that, you might consider taking a strategic approach based on where you’re the tightest.
One thing to keep in mind as you create your hip muscle stretching strategy is that in general, muscles that work your hips are categorized according to their location: Front, outer, back and inner. To a great extent, the muscles location determines the type of movement it can produce.
For example, your quadriceps are a group of four muscles that are located at the front of the thigh one of the group members, the rectus femoris, flexes the hip, which brings your lower extremity forward, in front of you. On the other hand, your hamstring muscles are located at the back of the thigh. When they contract, they extend the hip and flex the knee, bringing it behind you.
Hss Is A Top Choice For Hip Replacement
At HSS, our hip replacement surgeons are among the most skilled surgeons in the world. In addition to their deep expertise and extensive training, they have a singular focus on joint replacement surgery. This experience allows them to achieve very high success rates, avoid complications and help effectively relieve our patients pain.
Another advantage is that the hip replacement surgeons at HSS embrace the multidisciplinary aspects of orthopedic care. They work closely with anesthesiologists, rehabilitation specialists, nurses and many others to keep our patients safe and healthy so they can get back to what they love to do.
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Standing Hip Abduction Progression
- Hold onto a counter for balance
- Lift your operated leg out to the side while standing tall
- Keep your hips level and upper body straight
- Do not hike your hip. Try to keep your foot slightly off the floor
- Keep your toes pointing forward
- Alternate legs
Progression: Tie a TheraBand® around your lower thighs
When Can I Go Home After A Hip Replacement
Most patients can start walking and can go home the day of the surgery, says Thakkar. Most people dont need bed rest. In fact, moving your new joint keeps it from becoming stiff.
If you have a preexisting condition , or if no one can give you a ride and help around the house right after the surgery, you might need to spend the night at the hospital. People who had complex surgeries or lack support at home may benefit from starting their recovery in an inpatient rehabilitation unit.
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S Of The Hip Are They Worth It
What are the types of imaging a person can be ordered when they have chronic pain? Are these tests accurate in helping him or her in treatment? Are these tests accurate?
A look at the imaging studies
Usually, a person with chronic hip pain will come into our office and they will have one, two, three, or all four of the following performed over a period of time.
- Hip X-ray
- Hip MRI , and
- Hip Ultrasound
Make An Appointment With Your Orthopedist
Are you experiencing lower back pain in conjunction with hip pain? Call your orthopedist to make an appointment for a consultation and X-rays. A total hip replacement may provide relief for your back as well as your hip. You do not have to accept chronic pain as a way of life. One procedure could provide double benefits, so call today.
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The Evidence For Alternatives To Hip Replacement
In this section we will discuss three regenerative medicine techniques and hip replacement:
- Treatment option: Prolotherapy injections. This is the injections of dextrose, a simple sugar that provokes a healing response in damaged soft tissue. This would include the hip ligaments, the hip tendons attachments that connect muscle to bone , and the hip cartilage.
- Treatment option: Platelet Rich Plasma injections . This is an injection treatment that uses your blood platelets. This treatment also works on soft tissue. We have an extensive article on Platelet Rich Plasma for treating Hip Osteoarthritis that goes deeper into this subject.
- Treatment option: Stem Cell Therapy. In our clinic:
- We use bone marrow-derived stem cells.
- We do not use this on every patient.
- Stem cell therapy utilizes cells from your own bone marrow to begin the regeneration process. This treatment is typically reserved for patients who have significant damage to their hips, but where there is a realistic expectation that the treatment will help the patient avoid a hip replacement.
Should You See A Chiropractor For Low Back Pain
If youve ever seen a doctor for back pain, youre not alone. An estimated 85% of people experience back pain severe enough to see a doctor for at some point in their life. Yet despite how common it is, the precise cause of pain is often unclear. And a single, best treatment for most low back pain is unknown. For these reasons, doctors recommendations tend to vary. “Standard care” includes a balance of rest, stretching and exercise, heat, pain relievers, and time. Some doctors also suggest trying chiropractic care. The good news is that no matter what treatment is recommended, most people with a recent onset of back pain are better within a few weeks often within a few days.
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I Have Groin And/or Thigh Pain At Rest And It Is Worse At Night I Feel Weak And Lethargic The Pain Is Constant Achy And Sometimes Burning Or Throbbing
This is more concerning because it could indicate a joint infection or bodily reaction to metal or plastic debris. Blood work and aspirations of the joint are helpful to rule these conditions out as long as the patient is not on antibiotics for some other reason. Advanced imaging like MRI and bone scans can also be helpful. Recent dental work, an immune system depressing virus, or certain medications can make this problem much worse because the immune system may not be functioning, as it should.
Overall, hip replacements are very successful and help most patients. The risk of complications like dislocation and infection are about 1-2% for total hip replacements, and not all complications require revision surgery. Some will heal with time while others may just need conservative treatment.
Studies show the most common causes for hip revision after a total hip replacement are instability , aseptic loosening of the implants from wear, and infection.
A recent article found the number one cause for hip revisions was from aseptic loosening in 45% of their recorded hip revision cases , followed by wear , instability , infection , and fracture.
They are also seeing a rise in revisions of metal on metal hip replacements secondary to metal debris causing local tissue reactions and destruction of the hip tissues.
It is important to see your total joint surgeon if you are experiencing any pain after replacement. Its also important to understand why your hip might hurt.
Signs It’s Time To Consider Hip Replacement
Talk with your doctor about hip replacement if:
- The pain keeps you from doing everyday activities.
- Stiffness prevents you from bending over, such as when you put on your shoes and socks.
- You rely on a cane, walker, or other mobility aid.
- Your hip hurts even when youre sitting still or laying down.
- Imaging reveals advanced arthritis or significant joint damage.
- The pain is wearing you down emotionally and mentally.
After taking a full account of your symptoms and medical history, your doctor can order advanced imaging tests, such as X-rays and MRIs, to determine the extent of joint damage. Based on these images and your experiences with hip preservation techniques, we can help you decide whether hip replacement surgery is right for you.
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