Hip Replacement Surgery

Hip Replacement Surgery:

Hip Pain is a condition which can develop suddenly or develop over a period of time.

Pain in this region can be caused  by a number of factors. Examples include: trauma as with a car crash, fall, excessive loading to the legs over time, or sports injury, to name a few. The most common cause for the need for hip replacement is progression of osteoarthritis, or “wear and tear” arthritis of the hip. No matter what the cause, hip pain can be a serious condition and can be life altering and impact your ability to concentrate, sleep or even move normally.

When osteoarthritis is the reason for this type of hip pain and no other approach to relieve the pain appears to be effective, then an orthopedic surgeon may recommend a Hip Replacement Surgery to reduce the pain and improve function effect from the osteoarthritis.

Pain in the lower extremity can limit normal range of motion of your Hip, knee and even ankle/foot. It can impact muscle function and cause a deactivation of muscle contraction ability which can lead to true muscle weakness and then impact your ability to perform daily functional tasks like taking a shower, dressing yourself, even standing at the sink brushing your teeth. Therefore, controlling the pain and inflammation is often key to improving pain and function (movement).

Does conservative management work?

In a large number of cases, yes. Range of motion and strengthening exercises that promote general, pain free motion of the hip joint should be emphasized, ensuring this region can remain flexible and have adequate muscle function. Muscle activation exercises such as isometric (tightening) exercises of the muscles of the hip and knee can be useful. These type of exercises can be performed in sitting, lying down or even standing positions.

Performing general leg exercises that are more stretching motions can emphasize activating and stretching these tight muscles and a stiff hip joint and can help you achieve a full range of motion. Decreasing the pressure on the hip joint (when standing and walking for example) can be helpful too. Stretching movements of the hip, the hamstring, piriformis, and gluteal muscles can help to relieve pressure on the joint and maintain / or improve flexibility.

You can also apply cold packs and warm packs to the painful area to attempt to relieve pain and control inflammation as well as reduce muscular tension.

Topical pain relieving agents like BioFreeze® or Celadrin® can also help to reduce pain and muscle tension and help improve comfort with motion exercises, stretches, isometric exercise. CBD (Cannabadiol) creams may also be helpful, though there is not yet much research on this treatment.

If self management is not successful at resolving the issue, then seek the care of a licensed healthcare provider such as a Physical Therapist or Chiropractor to help reduce loading pressure on the hip joint and improve joint and muscle function. Using specialized techniques, your qualified healthcare professional can implement effective treatment procedures that can include the following:

• Joint manipulation
• Soft tissue mobilization
• Cold laser therapy
• Ultrasound
• Electrical Muscular  Stimulation
• Fascial manipulation
• Cross Friction Massage
• Functional Manual Therapy
• Neuromuscular re-education
• Acupuncture or Dry Needling

Whether treating it yourself or with a professional, you can expect the pain and irritation to be up and down for the first few weeks, where it will seem to do better one day then worse the next. Maintaining consistency is key to resolving the issue effectively.

If the condition does not respond to conservative management and as it progresses into a more chronic experience (> 4 weeks), seeking professional intervention, such as with an orthopedic surgeon may be necessary to help to prevent a severe chronic problem that becomes much more difficult to manage.

Your healthcare professional can examine and advise you regarding a treatment plan along with a prognosis on your condition. Treatment can last from a couple of treatments to several times a week for several weeks, depending on the severity of your condition. More invasive treatments, including injections may be tried, but if no conservative management helps to improve your pain and functions then a total hip replacement surgery may be required.

Lespasio MJ, Sultan AA, Piuzzi NS, et al. Hip Osteoarthritis: A Primer. Perm J. 2018;22:17–084. doi:10.7812/TPP/17-084

Wu Y, Goh EL, Wang D, Ma S. Novel treatments for osteoarthritis: an update. Open Access Rheumatol. 2018;10:135–140. Published 2018 Oct 4. doi:10.2147/OARRR.S176666