Millions of Americans live each day with hip arthritis. It can cause significant pain and disability with problems walking depending on how severe the problem is.
Interestingly enough, the person may have severe arthritis on an x-ray and not have a lot of discomfort from it. O that same person also may have very little abnormality on x-ray and have severe pain. Regardless of this nuance, how can a person avoid hip replacement surgery when dealing with significant arthritis pain?
There are several avenues of treatment which can allow patients to avoid surgery and here are the top three.
1. Activity avoidance-activity avoidance is a treatment that basically involves ceasing activities that flare up a person's pain. For instance, if an individual is an avid skier, it places severe stress across a person's hip joint. The same is true for a person who is an avid jogger.
Unfortunately, it may be necessary to switch activities into something like cycling or swimming in order to maintain the cardiovascular benefits but to take such pressure off of the hip joint. Every time a person runs, forces between two and six times body weight go through each hip joint. In a hip that has significant arthritis, this may exacerbate the situation dramatically.
2. Medications- over-the-counter medications such as Tylenol and anti-inflammatory medications can help with hip arthritis substantially. Care should be taken to only take the medication according to the manufactures recommended dosing. For Tylenol, this is usually no more than 4 g per day otherwise the patient can develop a liver problem.
Good old anti-inflammatories such as ibuprofen can help a lot and if a person has normal kidney and G.I. function they can be taken according to the manufacturers recommended dosing. Other medications that are over the counter include glucosamine and chondroitin sulfate.
These are called nutraceuticals and are sold at health food stores and drugstores without a prescription. They consist of natural substances that can help preserve existing cartilage and may even help promote some regeneration of lost cartilage. At any rate the risk profile of these nutritional substances is very safe.
Taking narcotic medications for hip arthritis is a bad idea for a chronic time period. Taking it for an acute flareup of arthritis can be fine and may be necessary if a person has a fall or simply is disabled from the acute flareup of the pain and narcotics and help get them through it.
3. Injections - There are multiple types of injections that can be done for hip arthritis. The first is steroid injections, and these have been around for decades. They do not fix hip arthritis and may even make it worse, at least in animal studies that has been seen.
But they can delay the need for hip replacement and also can be repeated every few months. They should not be done in an office setting, as the injections require a real time x-ray machine called fluoroscopy. There is a lot of soft tissue between the skin and the hip joint, and some vital structures. So it is important to do the injection safely.
Another material that can be injected instead of steroid is hyaluronic acid. This can help regenerate some joint fluid as it is a component of the fluid anyway and it can promote more fluid being made. Lastly, stem cell injections are making their way into arthritis treatment. It's exciting, and research will show their effectiveness.
Hip replacements are quality of life procedures, and if at all possible should be avoided.
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