Avoiding Hip Joint Replacement Surgery for Arthritis of the Hip
There are millions of Americans dealing each day with the pain of hip arthritis. It can cause substantial pain and disability with walking and activities of daily life depending on how severe the arthritis is.
An individual may have very bad arthritis on an x-ray and not necessarily have a ton of pain. Or the person could have moderate arthritis and severe disabling pain. So the x-rays do not correlate with how a person feels. Regardless of this nuance, how do people avoid hip replacement surgery when dealing with significant pain of arthritis?
There are several methods of pain management treatment which can allow patients to avoid an operation. Here are the leading four.
1. Activity Avoidance-this is a treatment that essentially involves stopping activities that exacerbate a person’s pain. For instance, if a person is an avid skier, it places substantial stress across the hip joint. The same is true for jogging, which can place up to seven times body weight through the hip joint.
Unfortunately, one may need to change activities into a less stressful activity like swimming or cycling in order to maintain the heart healthy benefits, while at the same time reduce pressure through the hip joint. Every time an individual runs, forces between two and seven times body weight are transmitted through each hip joint. In a hip that has severe arthritis, this can make the situation go from bad to worse. Cross training can keep a person in shape while making the situation go from bad to better.
2. Medications- over-the-counter medications like NSAIDS and Tylenol can help a lot with arthritis pain. These medications should only be taken according to the manufacturers recommended doses.
Other medications include glucosamine and chondroitin sulfate, which are called nutraceuticals. No prescription is necessary, and they consist of natural substances that can help maintain existing cartilage and even help promote some cartilage regeneration. These nutritional substances have very low risk, so are worth trying to see if some benefit results.
Taking opiate medications for hip arthritis chronically is not recommended. For an acute exacerbation of arthritis, narcotics in the short term can be helpful to assist with getting through the flare-up.
3. Injections – There are several types of hip injections for arthritis. The first distinction is whether to inject the hip joint itself or the soft tissue around the hip. The outside area of the hip may have inflammation that is known as greater trochanteric bursitis. This is fairly straightforward to diagnose and amenable to a simple steroid injection in the office.
For hip arthritis with injections into the joint, steroid injections have been around for decades. They do not change the course of hip arthritis, but may be an excellent pain relief option.
But they can put off the need for hip joint replacement and also can be repeated every few months. Hip joint injections should be performed with x-ray guidance, as there is a lot of
soft tissue between the skin and the hip joint, and in that soft tissue are some vital structures. So for safety it is important to ensure accuracy with the needle into the joint.
4. Physical Rehabilitation and Chiropractic – as part of the treatment for symptomatic hip arthritis, physical rehabilitation and chiropractic treatment can help alleviate pain. As the treatments strengthen the muscles around the hip joint, pressure on the arthritic joint surfaces may be reduced, along with less pain. In conjunction with intermittent steroid injections and over the counter medications, the person may be able to avoid the need for surgery for quite a while.
An alternative material to steroid is hyaluronic acid. This can help build back some joint fluid as it is a component of the fluid anyway. There are also some basic science theories that it may also help with cartilage regeneration. Lastly, stem cell injections are starting to make some headway into arthritis treatment. Research is ongoing in that regard.
A hip joint replacement is a quality of life procedure, and should be avoided if possible. These four options are all available at Arizona Pain Specialists, with multiple Valleywide locations. The clinics have Award Winning and Board Certified pain management doctors and chiropractors, who are experts in the nonoperative treatment of hip arthritis.