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That Hip Pain Could Actually Be a Sciatica Problem: Healthy Life Family Medicine: Family Medicine Clinic

Your hips are incredibly active joints and no strangers to the occasional ache and pain, especially as you get older. But searing pain in one of your hips may have nothing to do with your hip at all, but a pinched nerve root in your lower back.

At Healthy Life Family Medicine in Goodyear, Arizona, Dr. John Monroe understands the many conditions that can lead to radiating pain. One of the biggest culprits in this regard is sciatica, which develops when certain nerve roots in your lower back are irritated or compressed, causing symptoms to travel down your sciatic nerve.

Here’s a look at how sciatica pain develops and why your hip pain may be a result of a problem in your lower back.

Understanding sciatica

The first thing to understand is that sciatica isn’t a condition, but a symptom of a problem that’s connected to your sciatic nerve. This nerve is the longest in your body and begins in your lower spine, where five nerve roots come together to form your sciatic nerve, which splits and travels down either side of your buttocks, hips, and legs.

When any of the nerve roots are irritated in your lower back, the symptoms can radiate out along the sciatic nerve, creating symptoms that run down your lower extremities, typically only on one side.

The hallmarks of sciatica pain include:

  • Searing pain in your lower back that can come and go with certain movements
  • Pain that radiates down one side of your buttocks, hips, and legs
  • Dull pain in your back, hips, and buttocks
  • Numbness or tingling anywhere along the nerve
  • Weakness in your leg

The characteristics of your pain can vary, depending upon which nerve root is compressed or pinched. For example, if you’re experiencing pain in your foot, this is likely caused by a compressed nerve near your L5 vertebra.  

In most cases, sciatic pain stems from a herniated or bulging disc, but it can also develop because of:

  • Spinal stenosis
  • Spondylolisthesis
  • Tumors
  • Bone growths

Whatever the cause, the end result can leave you with moderate-to-severe pain that you feel in your back, hips, buttocks, and leg.

So, if you’re experiencing pain in your hip, and you haven’t had any problems with the joint before, the problem may lie in your lower back.

The indirect results of nerve compression

Another reason you may be feeling pain in one of your hips is that when you have a pinched nerve in your back that affects one side of your lower body, you tend to favor that side. The pain may alter the way you move, which can place added stress on your already hard-working hips.

So, if your hip pain is more of a dull ache and you’re also experiencing some of the more classic signs of sciatica, the two are likely related.

Treating sciatica pain

The good news is that we have plenty of options for quickly resolving your sciatic and hip pain. Dr. Monroe can administer a corticosteroid injection into the nerve root to quiet the pain signals and reduce the inflammation, which should bring you relief. Also, stretching and physical therapy can go a long way toward relieving the pressure on your nerve roots.

Whether your hip pain is a result of a problem in your sciatic nerve or something else, we can help you find a solution and put an end to your discomfort. Simply contact us at Healthy Life Family Medicine to set up an appointment.

Hip Problems, Age 12 and Older

Do you have a hip problem?

This includes symptoms like pain and trouble moving the hips normally.

How old are you?

Less than 12 years

Less than 12 years

12 years or older

12 years or older

Are you male or female?

Why do we ask this question?

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Have you injured the hip in the past month?

Yes

Hip injury in the past month

No

Hip injury in the past month

Have you had hip surgery in the past month?

If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.

Yes

Hip surgery in the past month

No

Hip surgery in the past month

Is the problem mainly in your low back or buttock rather than your hip?

Is the leg blue, very pale, or cold and different from the other leg?

If the leg is in a cast, splint, or brace, follow the instructions you got about how to loosen it.

Yes

Leg is blue, very pale, or cold and different from other leg

No

Leg is blue, very pale, or cold and different from other leg

Do you have any pain in your hip?

How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?

8 to 10: Severe pain

Severe pain

5 to 7: Moderate pain

Moderate pain

1 to 4: Mild pain

Mild pain

How long has the pain lasted?

Less than 2 full days (48 hours)

Pain less than 2 days

2 days to 2 weeks

Pain 2 days to 2 weeks

More than 2 weeks

Pain more than 2 weeks

Has the pain:

Gotten worse?

Pain is getting worse

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is getting better

Do you think the problem may be causing a fever?

Some bone and joint problems can cause a fever.

Are there red streaks leading away from the area or pus draining from it?

Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?

“Hardware” includes things like artificial joints, plates or screws, catheters, and medicine pumps.

Yes

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

No

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

Are you having trouble moving your hip or leg?

Yes

Difficulty moving hip or leg

No

Difficulty moving hip or leg

Is it very hard to move or somewhat hard to move?

“Very hard” means you can’t move it at all in any direction without causing severe pain. “Somewhat hard” means you can move it at least a little, though you may have some pain when you do it.

Very hard

Very hard to move

Somewhat hard

Somewhat hard to move

How long have you had trouble moving your hip?

Less than 2 full days (48 hours)

Difficulty moving for less than 2 days

2 days to 2 weeks

Difficulty moving for 2 days to 2 weeks

More than 2 weeks

Difficulty moving for more than 2 weeks

Has the loss of movement been:

Getting worse?

Difficulty moving is getting worse

Staying about the same (not better or worse)?

Difficulty moving is unchanged

Getting better?

Difficulty moving is improving

Have you had hip problems for more than 2 weeks?

Yes

Symptoms for more than 2 weeks

No

Symptoms for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines and natural health products can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

There are other reasons for colour and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal colour returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Back Problems and Injuries

Hip Problems, Age 11 and Younger

Post-Operative Problems

Hip Injuries, Age 12 and Older

Osteoarthritis of the Hip (Hip Arthritis)

In this article:

Basics of hip arthritis

Many kinds of arthritis can affect the hip joint. The most common type of hip arthritis is osteoarthritis, which some people call “degenerative joint disease.”

Osteoarthritis occurs when the joint surface cartilage (also called hyaline cartilage or articular cartilage) becomes worn away leaving the raw bone beneath exposed. The cartilage normally serves as a “pad” or a bearing in the joint. Under normal conditions, the cartilage bearing is slicker than a hockey puck on ice. When the bearing wears away, the result is a roughed joint surface that causes the pain and stiffness that people associate with osteoarthritis (See Figures 1-4).

Osteoarthritis of the hip is a serious condition. Osteoarthritis is the most common of the more than 100 kinds of arthritis and the hip joint is the second most commonly affected large joint in the body.

Osteoarthritis is a chronic disease that can takes months to years to appear. While it is not “curable,” it most certainly is treatable using activity modifications, medications, and/or injections. If those interventions don’t work, hip replacement surgery often will relieve the pain associated with hip arthritis.

Osteoarthritis of the hip results in pain, stiffness, and joint deformity. The symptoms of osteoarthritis can affect one’s ability to walk, work, and enjoy life.

For most patients who have mild arthritis, pain can be managed with ice, rest, activity modifications, pills, or joint injections.

However, for patients with severe arthritis, the pain may not respond to those kinds of interventions. Patients with severe arthritis sometimes can benefit from total hip replacement surgery (See Figures 5 and 6).

 

Hip Arthritis Image Gallery

Click an image below to enlarge.

Symptoms of Hip Arthritis

Initial symptoms

Hip joint pain and stiffness are the main symptoms of hip arthritis. When it becomes more advanced, joint deformities and leg-length differences can result.

The typical pain from hip arthritis is located in the groin thigh or buttock.  The pain is generally worse with weight bearing activities (e.g., walking, standing, or twisting).

Some patients report “start-up” pain – an especially bad discomfort upon standing after being seated for a prolonged period of time. This sometimes works itself out after a few steps.

Osteoarthritis of the hip is not an emergency. It can however result in disturbing “flare ups ” with increased pain and stiffness. Many patients who experience a sudden flare-up will go to the doctor for care. For many of these patients,  this “acute” set of symptoms will result in the diagnosis of osteoarthritis.

Progression

Early in the course of arthritis, symptoms can be intermittent, perhaps related only to particular activities or sustained activity. Rest and avoiding the precipitating activity will improve the symptoms.

As arthritis worsens, symptoms can become more persistent or more severe, such that simply walking on level ground can result in pain.

When arthritis is severe, the pain with activities can linger even after the activity stops. When arthritis is severe, the hip can remain painful even after one stops walking.

As the condition worsens it often becomes less responsive to medical treatments such as pills or injections.

In many patients with advanced arthritis, particularly if those medical approaches are no longer helpful, surgery can offer relief of symptoms. Some patients with severe osteoarthritis sometimes can benefit from total hip replacement surgery.

Impacts on Daily Life

Daily activities

Osteoarthritis of the hip can affect one’s ability to walk, climb stairs, enter or exit a vehicle, sit or arise comfortably, perform housework and enjoy one’s day-to-day activities.

Even mild to moderate osteoarthritis of the hip can adversely impact athletic performance and enjoyment of sports, particularly impact sports and sports that involve running.

Energy

Many patients find that the chronic pain associated with osteoarthritis of the hip does contribute to fatigue.

Osteoarthritis of the hip does not affect metabolism but some patients attribute weight gain to the inactivity that results from the hip pain caused by osteoarthritis of the hip.

Mobility and independence

Osteoarthritis of the hip can affect one’s ability to walk, climb stairs, enter or exit a vehicle and enjoy one’s day-to-day activities. These things do affect one’s ability to remain independent particularly as the disease reaches its more severe stages.

Fertility and pregnancy

Osteoarthritis of the hip can cause sexual intercourse to be uncomfortable in some patients. However, apart from that, it will not affect a patient’s ability to get pregnant or have children. It is important to note, though, that some medications used to treat arthritis need to be used with care (or not at all) during a pregnancy. It is important to inform one’s obstetrician and family physician about all medications and nutritional supplements that one takes.

Relationships

Osteoarthritis of the hip can affect relationships and social interactions to the extent that it makes getting around more difficult. In some patients with more severe hip arthritis, sexual intercourse can be uncomfortable because of the pain associated with moving the hips that accompanies the condition.

Joint deformity

Osteoarthritis of the hip is associated with joint deformity that sometimes results in a leg-length inequality. These joint deformities, including leg-length inequality, are not readily managed by interventions other than surgery but can sometimes be corrected at the time of hip replacement for patients who elect to have that surgery. Shoe lifts can help patients before surgery who have leg-length inequalities and are sometimes used if the leg length cannot be made equal at the time of hip replacement surgery.

Conditions with similar symptoms

A number of conditions that are not actually related to the hip joint can cause hip joint pain and symptoms in the “hip” area. These include:

Spinal stenosis (arthritis of the lower back)
This condition most commonly causes pain in the buttock, low back, and back of the upper thigh (See Fig. 7). Spinal stenos is a lower-back problem, not a hip problem. Spinal stenosis causes pain in the buttock area that some identify as part of the “hip.”

Greater trochanteric bursitis
This causes pain over the “point” of the hip (imagine the part of the hip that would touch the ground if one were to lie directly on one’s side (See Fig. 8). It also causes tenderness and sensitivity to pressure. Although this seems like a “hip” problem, it is a problem well away from the joint itself and is related to an inflammation in a “lubrication point” called a bursa.  Greater trochanteric bersitis is not a joint problem (and only rarely is it a surgical problem).

Click an image below to enlarge.

Figure 7

Figure 8

 

Non-orthopedic conditions
Very occasionally, non-orthopedic conditions can cause pain in the groin that masquerades as hip joint symptoms – ovarian cysts, hernias, and other intra-pelvic conditions can sometimes cause pain that is mistaken for hip joint pain.

Other types of arthritis
Other forms of arthritis can cause similar symptoms to osteoarthritis of the hip; in particular, post-traumatic arthritis and avascular necrosis (osteonecrosis) are almost indistinguishable in many cases from osteoarthritis of the hip.

Rheumatoid arthritis
Rheumatoid arthritis, the next most common cause of arthritis, can also affect the hip. It tends to cause other joints to be involved and often causes more of an inflammatory set of symptoms (swelling and warmth as well as pain) and can, in fact, affect other organ systems as well.

The diagnosis of osteoarthritis versus rheumatoid arthritis can be made by a physician with experience in treating conditions of this type.

Causes

It is not possible to predict who will get osteoarthritis of the hip. However, there are some risk factors that may increase the likelihood that hips will become arthritic. These risk factors include:

  • Genetics – Arthritis often runs in families.
  • Childhood hip diseases including developmental hip dysplasia (DDH), Legg-Calve-Perthe’s Disease and slipped capital femoral epiphysis (SCFE) all can predispose an individual to premature hip arthritis. 
  • Acquired conditions such as avascular necrosis (osteonecrosis) can result in hip arthritis if left untreated or if treatment fails. Avascular necrosis can be caused by excessive alcohol intake, some medications (including prednisone a medical steroid), and some medical conditions that affect blood clotting.
  • Variations in hip anatomy (the shape of the hip joint itself) including a condition called femoroacetabular impingement can cause the hip to become arthritic.
  • Severe trauma. Fractures (broken bones) or traumatic dislocations of the ball from the hip socket can, in time, result in arthritis of the hip. Whether this really is “osteoarthritis” or should be considered a separate kind of arthritis (post-traumatic arthritis) remains an open question. Though, in the severe stages of this condition the treatments are the same.
  • Obesity. Some studies have associated this condition with arthritis of the hips. Though interestingly, obesity is more strongly linked to arthritis of the knees than to arthritis of the hips.

Diagnosis

To diagnose osteoarthritis of the hip, a physician will take a thorough history and perform a thorough physical examination first. Following this, simple x-rays taken with the patient standing are an effective way to diagnose this condition.

Diagnostic tests

The simplest test to diagnose osteoarthritis of the hip is the x-ray. Taken with the patient standing up plain x-rays can diagnose the condition with great accuracy.

Very mild arthritis can be seen on a bone scan or an MRI even before it is visible on plain x-rays, but in reality, these tests are seldom helpful clinically for this purpose.

Effects

The diagnostic tests for osteoarthritis of the hip, including x-rays and MRIs, are generally not painful and they are well-tolerated by most patients.

Treatment

Simple steps that can be taken which don’t have much risk include avoidance of the activities that cause symptoms (activity modification) and weight loss (if appropriate). Some patients find nutritional supplements, such as glucosamine and chondroitin, to be helpful. However, the data on these products is somewhat inconsistent. They don’t help everyone.

Should those interventions not be satisfying, in consultation with one’s physician, the next steps might include over-the-counter pain remedies such as acetaminophen (Tylenol) and over-the-counter anti-inflammatories such as ibuprofen (Advil Motrin) or naproxen (Naprosyn), among others. However, these pills are not for everyone and if one hasn’t used them before one should consider consulting one’s family physician first. Sometimes prescription-strength, non-steroidal, anti-inflammatory drugs (NSAIDs) can be prescribed; but again, this must be done in consultation with a physician and these drugs do have risks and side effects associated with them.

In general, narcotic pills (“painkillers” like Tylenol #3 Vicoden Percocet oxycodone) and narcotic pain patches (fentanyl Duragesic) should be avoided for most patients with osteoarthritis of the hip.

Joint injections including intra-articular corticosteroid injections can be helpful for some patients. However, joint injections generally appear to be less useful for hip arthritis than they are for arthritis in other joints, in part because of the difficulty of injecting the hip joint accurately.

Patients with severe arthritis who have tried the above remedies sometimes can benefit from total hip replacement surgery.

Self-management

Keeping one’s body weight appropriate and choosing activities that don’t reproduce the arthritic pain are two things patients with osteoarthritis of the hip can do to help decrease their arthritic symptoms.

Health care team

Several kinds of health care providers participate in the management of osteoarthritis of the hip including:

  • Family physicians and internists
  • Rheumatologists
  • Physical Medicine and Rehabilitation Specialists (Physiatrists)
  • Orthopedic Surgeons

Finding a doctor

Both rheumatologists and orthopedic surgeons are “specialists” in arthritis care.

If surgery is being considered to manage osteoarthritis of the hip, visiting with a fellowhip-trained, high-volume hip replacement surgeon would be a reasonable step to consider.

Managing arthritis pain and fatigue

Several approaches can be used to manage the pain associated with osteoarthritis of the hip including:

  • Activity modification appropriate kinds of exercise and weight loss when necessary may alleviate some hip arthritis symptoms
  • Nutritional supplementation (glucosamine and chondroitin) are helpful to some patients, although the literature on these supplements is not consistently in favor of their use
  • Non-narcotic pain tablets (acetaminophen/Tylenol), or over-the-counter non-steroidal anti-inflammatory drugs, if medically appropriate, sometimes are helpful
  • Prescription strength, non-steroidal, anti-inflammatory drugs (NSAID) are useful for some patients, though, in general, long-term use of these drugs is discouraged
  • Arthritis unloader braces or hip sleeves are helpful for some patterns of arthritis
  • Joint injections (corticosteroid or “cortisone” injections) might help
  • Total hip replacement surgery may be used if non-operative interventions don’t suffice.

Diet

Keeping one’s weight proportional to one’s height can decrease the likelihood of developing osteoarthritis of the hip and can decrease the symptoms of the condition once it has set in.

Exercise and therapy

There is some limited evidence that appropriately-designed exercise programs can decrease the pain of hip arthritis, in particular, earlier stages of the condition. In general, staying fit and height-weight proportional also are helpful.

Medications

  • Nutritional supplementation (glucosamine and chondroitin) are helpful to some patients although the literature on these supplements is not consistently in favor of their use.
  • Non-narcotic pain tablets (acetaminophen/Tylenol) or over-the-counter, non-steroidal, anti-inflammatory drugs, if medically appropriate, sometimes are helpful.
  • Prescription strength, non-steroidal, anti-inflammatory drugs (NSAID) are useful for some patients, though, in general, long-term use of these drugs is discouraged.
  • Joint injections (corticosteroid or “cortisone” injections) might help.
  • Narcotic painkillers, in general, whether in pill form (oxycodone Tylenol #3 Vicoden Percocet Lortab etc.) or patch form (Duragesic fentanyle etc.), should be avoided for the treatment of osteoarthritis of the hip.

Surgery

Hip replacement is a surgical procedure that decreases pain and improves the quality of life in many patients with severe arthritis of the hips.

Typically, patients undergo this surgery after non-operative treatments (such as activity modification anti-inflammatory medications or hip joint injections) have failed to provide relief of arthritic symptoms.

Surgeons have performed hip replacements for over four decades ,generally with excellent results. Most reports have ten-year success rates in excess of 90 percent.

Learn more about total hip replacement surgery.

Joint aspiration

Joint injections can be effective at relieving the symptoms associated with osteoarthritis of the hip. Broadly speaking, there are two kinds of injections:

  1. Corticosteroid injections (“cortisone shots”) –  These injections have been used to relieve arthritis symptoms–including pain swelling and inflammation–for over 50 years. Despite this, there have been surprisingly few well-designed scientific studies to determine which patients might benefit from this treatment or how long the relief might last.

    Just the same, cortisone shots are commonly used–and often are successful–in helping to relieve arthritis symptoms temporarily. Some patients are able to use them to get enough pain relief to hold off joint replacement surgery for months or even years. Cortisone shots are a treatment for pain; they do not alter the course of arthritis and they do not cure the condition. In general, they are more commonly used for arthritis of other joints than they are for arthritis of the hip joint.

  2. “Viscosupplement” injections – These are any of several compounds that are made up of hyaluronic acid which is a component of normal joint fluid. Some of the common ones include Synvisc Hyalgan Supartz and Orthovisc. They are given as a series of injections usually weekly for 3-5 weeks. There is some disagreement as to how and whether they work.  Read more details on JBJS Article – Corticosteroids VS. Hylan GF20 in pdf format (0.13MB). They are FDA-approved for managing the pain associated with arthritis of the knee but they are not, as of December 2007, FDA-approved for use in the hip joint.

Hip arthritis patients who have perceptible leg-length inequalities can be managed with a shoe lift either inside the shoe (typically if the difference is <1/4”) or built onto the outside of the shoe (if the difference is larger).

Alternative remedies and treatments

Nutritional supplementation (glucosamine and chondroitin are the most common forms of this) is helpful to some patients though the science on this is not entirely supportive of their effectiveness.

There are some studies to suggest that acupuncture can decrease the pain associated with osteoarthritis of the hip.

Although there is little “hard science” on this point, most hip surgeons and rheumatologists (doctors who treat arthritic conditions non-operatively) believe that patients with osteoarthritis of the hip should consider avoiding impact sports such as running in order to avoid increasing the rate at which the disease progresses.

It is important that patients with osteoarthritis of the hip avoid decreasing their activity level and it is important that they remain fit. However this often does require some modification of exercise programs – running and walking programs are usually poorly tolerated by (and not recommended for) patients with osteoarthritis of the hip. Stationary bike, swimming and water aerobics usually are well-tolerated and they are recommended.

Work

Looking for a “light duty” alternative to heavy manual labor is one good approach for coping with osteoarthritis of the hip.

Many patients who work at desks find that prolonged sitting in one position is associated with stiffness and pain upon first arising so periodically standing stretching or moving the hip through an arc of motion can be helpful at minimizing this “start-up” pain.

Adaptive aids

For some patients, particularly those who cannot tolerate surgical interventions for medical or other personal reasons, use of a cane crutches or a walker can be of use.

Additional Resources

For more information about arthritis contact the Arthritis Foundation (www.arthritis.org).

For more information about orthopedic surgery contact the American Academy of Orthopedic Surgeons (www.aaos.org).

Research on osteoarthritis of the hip

Condition research

Medical researchers continue to look into the causes and best treatments for symptoms of osteoarthritis of the hip, which is very common and sometimes disabling.

Pharmaceutical research

There is considerable research being done into the medical management of osteoarthritis which is increasing awareness of the complications and problems associated with use of non-steroidal anti-inflammatory drugs (NSAIDs), including their effects on the kidneys, the stomach, and the heart.

Surgical research

There is considerable research being done studying the surgical approaches for this condition, including newer approaches for total hip replacements and newer implants.

Other surgical interventions, including osteotomy (cutting and re-orienting the bones around the hip) and arthroscopy (using a surgical camera and small motorized shavers to “clean up” the raw bone ends), also are topics of surgical research that may someday be relevant to patients with hip arthritis.

Summary of hip arthritis

  • Osteoarthritis of the hip is common and can result in severe hip joint pain and disability. as a result of this condition, several hundred thousand people each year in the U.S. undergo total hip replacement.
  • Most people with osteoarthritis of the hip can be managed without surgery.
  • The cause of osteoarthritis of the hip is not known but some risk factors include obesity, severe hip trauma, and acquired conditions in adulthood, such as osteonecrosis (avascular necrosis) and genetics.
  • There are many other kinds of arthritis that can affect the hip.  It is important to make sure that the correct diagnosis is made as some of these other conditions are treated very differently.
  • The diagnosis of osteoarthritis of the hip is usually very straightforward and is made in almost all cases by a physician taking a thorough history, performing a physical examination, and getting x-rays with the patient standing up.
  • Patients usually seek care for the typical symptoms of hip arthritis, including pain located in the groin thigh or buttock. The pain associated with osteoarthritis of the hip is generally worse with weight bearing (walking standing) or twisting. Stiffness and leg-length inequality are other symptoms.

Facts and myths

Following are several misconceptions about osteoarthritis of the hip.

MYTH: Osteoarthritis of the hip is usually the result of “overuse.”

FACT: Osteoarthritis of the hip is NOT usually the result of “overuse.”  There have been studies of long-distance runners that show that they are not more likely to get arthritis than more sedentary individuals.

MYTH: Osteoarthritis of the hip is a “normal result of aging.”

FACT: Many older people – in fact most – DO NOT develop arthritis of the hip and many younger people do experience osteoarthritis.

MYTH: Osteoarthritis of the hip is just “aches and pains.”

FACT: Osteoarthris of the hip is NOT just “aches and pains.” Osteoarthritis of the hip is a condition whose biology, x-ray appearance and clinical symptoms are defined.

MYTH: Not much can be done for osteoarthritis of the hip.

FACT:  While it is not “curable”, it most certainly is treatable using activity modifications, medications, injections and if those interventions, don’t work hip replacement surgery often will relieve the pain associated with hip arthritis. In fact, there are exercise programs that can alleviate the pain in mild arthritis, a variety of medications can be helpful for moderate arthritis, and severe arthritis of the hip is very commonly successfully treated with hip replacement surgery.

 

 

What Are the First Signs of Hip Problems?

November 06, 2019

 

Is a bad hip affecting your daily activities? Hip problems can cause pain and are a common concern for many people, particularly as we get older and maintain an active lifestyle.

The specific location of hip pain can help to pinpoint the underlying cause. This can include problems in the tendons, muscles, ligaments, and other soft tissues surrounding the hip joint, or an issue in the lower back or spine. Hip pain can be felt in the outer hip, groin, or upper thigh.

Hip problems are usually associated with age. However, without proper care, anyone can develop a worn joint – including the hip.

The following signs are frequent early symptoms of a hip problem:

1.     Hip Pain or Groin Pain

This pain is usually located between the hip and the knee. Hip pain can be felt during exercise, sleep, or when walking. It can lead to loss of motion of the hip.

Discomfort and soreness during or after exercise is often the earliest sign of hip arthritis. Hip pain can cause sleep problems, as the discomfort affects your natural movement at night. Moreover, if the pain in the hip prevents you from walking short or regular distances, immediately see a specialist for a medical evaluation and treatment.

2.     Stiffness

A common symptom of stiffness in the hip is difficulty putting on your shoes or socks. You may also find it difficult to bend down or to pick up something from the ground.

3.     Limping

A serious symptom of a hip problem is when you start to limp when walking. Limping can either be acute or chronic, and it can be treated with proper medical care by an orthopedist.

4.     Swelling and Tenderness of the Hip

Another sign of a problem in the hip is swelling and tenderness. Swelling can occur internally or at the outer skin and muscle. If it becomes unbearable or doesn’t go away in a few days, immediately contact your doctor.

These symptoms may vary depending on the cause of the pain. If not treated, hip pain can be a cause of disability, which is why it is so important to consult with an experienced physician who is a specialist in the hips and other joints.

Orthopedic Doctors in North Dakota

At The Bone & Joint Center Orthopaedic Center of Excellence, our orthopedic surgeons can quickly evaluate your hip pain and determine the root cause. We know the best and most effective treatments, and we will always aim for the least-invasive procedures to provide relief from your pain.

We also have an experienced team of physical therapists and occupational therapists who can help you learn some excellent exercises for strengthening your hip, movements to avoid in order to prevent overstressing the hip, and other tips that will help you keep your hip and other joints in peak condition.

If you have hip pain from arthritis or any other condition, seek treatment today. Call us at (800) 424-2663 to schedule an appointment with one of our providers, or you can visit our appointment request page now. We look forward to helping you find relief from your hip pain so you can maintain the active lifestyle you enjoy.

When Hip Pain May Mean Arthritis

Many forms of arthritis and related conditions can cause pain, stiffness and swelling in the hips. Hip pain can occur on the outside or inside of the hip, the upper thigh or outer buttock. Here are some diseases that can affect the hips.

Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis. Also known as “wear and tear” arthritis, OA is a chronic condition caused by the breakdown of the cartilage, which cushions the ends of the bones where they meet to form joints. This breakdown causes the bones to rub together, causing stiffness, pain and loss of movement and the formation of bony overgrowths (spurs). Pain from hip OA is often felt in the groin area and front of the thigh. Stiffness may be worst after periods of inactivity, and decreased range of motion may affect your ability to walk.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disease that occurs when the immune system doesn’t work properly and attacks the joints (and possibly other parts of the body). Hip involvement in RA is often signaled by pain, stiffness or swelling in the hips, thighs or groin area. RA usually affects the same joint on both sides of the body (both hips). 

Juvenile Arthritis

Juvenile arthritis is the term used to describe joint and rheumatic diseases that affect children and teens 16 years and younger. There are several types of juvenile arthritis that cause hip joint pain and swelling.

AxSpA

Ankylosing spondylitis is a form of arthritis that primarily causing inflammation of the spine (running from the neck to the lower back). It can also lead to chronic pain and stiffening that may spread to the hip.

Psoriatic Arthritis

Psoriatic arthritis (PsA) is a form of arthritis that usually happens along with the skin disease psoriasis. Arthritis pain and inflammation can affect large and small joints, including the hip. Hip involvement in PsA is often signaled by pain in the groin, outer thigh or buttocks.

Bursitis

Bursae are fluid-filled sacs that reduce friction and cushion the areas between bones, tendons and muscles. They are found in hips and other parts of the body. When these soft tissues become inflamed, they cause pain in the affected area. The condition is called bursitis. Injury or overuse of bursae are common causes of bursitis.

Tendinitis

Tendons are fibrous tissues that join muscle to bone and some of them surround the hip joint. When they become inflamed, irritated or swollen, it can cause pain. The condition is called tendinitis. Injury or overuse of tendons are common causes of tendinitis.

Infectious Arthritis

Also called septic arthritis, this condition is caused by an infection from bacteria, virus or fungus. The infection travels through the bloodstream and can affect many joints, including the hip. Symptoms usually come on rapidly and involve intense swelling, pain and fever. Infectious arthritis rarely affects more than one joint.

Reactive Arthritis

Reactive arthritis is a chronic form of arthritis that often occurs following an infection of the genital, urinary or gastrointestinal system. Large joints are often affected, especially the shoulders, hips and knees.

Arthritis-Related Conditions

Myositis

Myositis belongs to a group of disorders that cause inflammation and muscle weakness. Weakness and pain in the muscles of the hips and shoulders is often a first sign of myositis. The weakness may make it difficult to lift heavy objects or even lift your arm to comb your hair or to put on a coat.

Polymyalgia Rheumatica

Polymyalgia rheumatica is a rheumatic disorder that causes pain and stiffness especially in shoulders and hips. It usually develops gradually but may come on suddenly. It is rare in people under the age of 50. Symptoms tend to affect both sides of the body and are worse in the morning. 

Getting a Proper Diagnosis

Other common sources of hip pain include stress fractures, muscle strains and hip dislocations. 

Arthritis is difficult to self-diagnose. Talk with your primary care doctor as soon as possible about your symptoms. You may be referred to a rheumatologist or orthopedist to get an accurate diagnosis so you can get the medical care you need. Left undiagnosed and untreated, your condition may worsen and cause disability.  

 

Why Does My Hip Hurt? 12 Common Causes of Hip Pain

If your hips are healthy, you probably don’t think about them very often. If you’re having hip pain, though, it may be the only thing on your mind. The hip is a large joint that helps support your body and all of its supporting structures, so this means there are plenty of causes of hip pain. Here’s what you need to know, and whether you should consider seeking treatment.

What are the First Signs of Hip Problems?

Because the hip joint is a connecting point for bones, muscles, ligaments, and other connective tissues, it may be difficult to tell whether your pain is stemming from your hip itself. Generally speaking, however, a problem that’s stemming from the hip will cause pain in the groin area or the inside of the hip. 

Conversely, pain that affects the upper thigh, outer buttock muscles or the outside of the hip is more than likely a problem with a tendon, ligament, muscle, or other soft tissue that surrounds the hip rather than the joint itself. And, sometimes pain that feels like it’s due to hip issues is actually caused by injuries, diseases, or conditions in other parts of your body, including your lower back. 

How Do I Know if My Hip Pain is Serious?

Hip pain can be uncomfortable, but how do you know whether it’s a “weekend warrior” injury that will subside in a few days or something more serious? One of the first signs that your hip problem might require medical attention is how long it lasts. If it’s longer than a few days without signs of improvement, it may be wise to see a doctor.

Signs that you should seek immediate medical help for a hip injury include:

  • Fever
  • Bleeding
  • Exposed bone or muscle
  • An area that’s warm to the touch
  • A popping sound 
  • Inability to bear weight

It’s also important to seek help right away if you experience swelling, redness, warmth, tenderness, or soreness in the area of your hip joint because these could be signs of more serious conditions. Septic arthritis, for example, is a joint infection that can lead to deformities or osteoarthritis if not treated.

Common Causes of Hip Pain

If your hips are bothering you, here’s a list of some of the most common causes of hip pain, along with some less common causes.

1. Arthritis

Several different types of arthritis can affect the hip joint, but the most common is osteoarthritis. Osteoarthritis, also known as “wear-and-tear” arthritis, indicates that the protective cartilage in the joint has degenerated to the point where bone rubs on bone. This type mainly affects those over 50, although those younger can experience it as well. Arthritis hip pain can keep someone from being as active as they would like, and can seriously impact well-being. Hip replacement may be recommended for osteoarthritis if other treatments don’t work. 

2. Labral Tears

A labral tear is damage to the cartilage that surrounds the hip socket. Repetitive motions, a fall, or an accident can lead to labral tears, and they can also appear in early osteoarthritis. Often, sports like ice hockey, football, ballet, golf, and soccer can lead to hip labral tears. However, they can also be caused by abnormalities in the structure of the hip joint itself. Symptoms can include a locking or clicking sensation in your hip joint, stiffness, and pain that’s made worse by long periods of inactivity.

3. Femoroacetabular Impingement (FAI)

This condition occurs when one or both of the bones that form the hip joint grow an irregular shape. There are three types of impingements:

  • Pincer: When the bone growth extends over the edge of the acetabulum.
  • Cam:  A bone growth on the edge of the femur that restricts movement of the ball joint.
  • Combined:  When both pincer and cam growths are present.

When the labrum and femur do not fit correctly around the hip joint, it causes damage to the joint, pain, and limited mobility.

4. Bursitis

Fluid-filled sacs called bursae cushion and lubricate your joints. There is one that resides between the hard bone on the outside of each hip and the connecting tendon. If these bursae become inflamed and swollen, it’s known as trochanteric bursitis, and can be exquisitely painful, particularly when lying on the affected side, moving around a lot, or even simply walking around.

5. Osteonecrosis

This hip condition is a bit lesser-known, and occurs when cells of the hip bone start to die due to insufficient blood supply. Most often, osteonecrosis (also called avascular necrosis) happens as a result of excessive use of alcohol or corticosteroids. However, it can also be the result of hip dislocation or fracture.

Symptoms of osteonecrosis include pain in the thighs, buttocks, or knees, as well as hip and groin pain that gets worse with walking. It’s most common in the hip, although it can occur in other joints as well.

6. Hip Fractures

Hip fractures are significant injuries. They can vary in severity, but all hip fractures need immediate attention from an orthopedic specialist. These are often caused by severe trauma, but older people can experience a hip fracture with just a fall. They are severely painful and result in an immediate loss of mobility.

While it usually takes direct trauma to fracture a hip, factors such as cancer, osteoporosis, or stress injuries can weaken the joint and make it more susceptible to injury.

7. Tendonitis

Tendons attach muscles to bones and are found throughout the body. They are thick and strong because of the work they do every day, but can become irritated or inflamed. When tendons are injured or overused, the resulting pain is called tendinitis. 

The tendons around the hips are especially strong, but they’re also especially subject to stress and strain due to the hip’s weight-bearing responsibilities. Especially with sports, repeated, stress-inducing activities can wear on your hip tendons. What might start as a mild strain due to overuse can eventually progress into an injury without treatment. 

Tendonitis is often marked by pain in your hip flexor muscles, which are the muscles that allow you to raise your knee toward your body, and are connected to movement or even touch. It can be common in athletes, such as soccer or tennis players, and runners.

8. Hip Flexor Strain

A strain happens when a muscle or tendon — or both at the same time — gets stretched or torn. In the hip, the at-risk muscles are the hip flexors (the iliopsoas and rectus femoris muscles), which allow you to move your legs up and down. A hip strain refers to a stretching or tearing of a muscle or its associated tendon (or both).

Hip flexor strains commonly happen when the muscles are overused due to sports with repetitive motion, such as cycling or tennis, or from trauma, such as a direct hit. A hip flexor strain can cause swelling, weakness in the muscle, or restricted movement.

9. Snapping Hip Syndrome

The main symptom for this type of hip injury is exactly what it sounds like — a snapping sound or popping sensation in the hip joint. It can also be accompanied by side hip pain with walking, getting up from a chair, or other similar movements. The snap happens when soft tissue, such as tendons or muscles, move over a bony part of the hip joint.

One of the most commonly affected tissues in snapping hip syndrome is the iliotibial band, more commonly referred to as the IT band, which runs from the hip along the outside of the thigh. When the IT band passes over the upper thigh bone, it creates the snapping sound.

Like other hip injuries, snapping hip syndrome is common in athletes or others who engage in repetitive, stressful motion that causes them to bend at the hip. In fact, it’s also referred to as “dancer’s hip.”

10. Sciatica

Sciatica hip pain can be significant. The sciatic nerve runs from your lower back, through your hips and buttocks and down each leg, and generally affects only one side of your body. It’s caused by compression of the sciatic nerve from many potential factors, such as a bone spur on your spine, a herniated disk, or narrowing of the spine.

11. Inguinal Hernia

An inguinal hernia can cause pain in the front of the hip joint and happens when tissue (part of the intestine, for example) protrudes through a weak spot in the abdominal wall. It can happen as the result of a sports injury, or because of the extra pressure that women experience on their abdomens as the result of pregnancy. 

Regardless of how they occur, hernias can be quite painful, especially if aggravated by a cough or lifting something heavy. One symptom is a bulge on either side of your pubic bone that’s easier to see when standing up. It can burn or ache at the site, or cause a heavy or dragging sensation in the groin.

Sometimes, hernias resolve on their own and are not dangerous. Others, however, can cause persistent pain, get larger, or cause severe complications. In these cases, surgery is often recommended.

12. Gynecological and Back Issues for Women

Especially for women, what feels like hip pain might actually stem from a problem with the pelvis. Gynecological issues, such as fibroids or endometriosis, can cause significant pain in the groin area during either ovulation or menstruation. Likewise, issues with the urinary or digestive systems — prostate cancer or gastroenteritis, for example — might also feel like an issue with the hip.

Finally, women might also feel issues stemming from the back or spine down around the hip and buttocks area. Sciatica is one common issue that usually causes pain on one side of the body, including the back side of the hip and even down the leg.

How is Hip Pain Diagnosed? 

Doctors determine the source of hip pain using a number of different diagnostic techniques, from medical history to medical imaging. During a physical exam, your doctor may ask you to walk around to observe joint movement, measure it compared to your normal hip, or manipulate the hip joint using various range-of-motion techniques. 

If sciatica is suspected, for example, a straight-leg raise might cause aggravation. If an infection is present, touching the affected area might cause pain. You may also encounter questions about your pain, including whether it’s affected by the time of day, position, activity, and when it first started to bother you.

Further diagnostics can include imaging tests, such as ultrasounds, MRI scans, CT scans or X-rays, blood bests, or examinations of joint fluid. Any combination of these tests can create a more thorough picture of your issue.

What are the Treatments for Hip Pain?

At-Home Remedies

Unless there’s an obvious fracture, dislocation, deformity, or other injury that requires surgery, doctors usually begin with conservative treatments. These can include suggestions about lifestyle changes, such as controlling your weight, getting regular exercise, and doing yoga or other stretching exercises. They may also advise at-home remedies, like ice, over-the-counter anti-inflammatories, elevation, or rest.

If your hip pain increases with certain activities or positions, your doctor may recommend modifying the activity or stopping it altogether to manage and limit the pain. However, the course of treatment depends on the source of the pain.

Non-Surgical Treatments

In some cases, especially when inflammation is determined to be the cause of your pain, your doctor may be able to offer you a cortisone steroid injection. If an infection is present, you may be prescribed antibiotics.

Surgical Treatments

Treatment for hip pain depends on what’s causing it. At Alexander Orthopaedics, we offer several hip pain treatments that can help you feel better. One common procedure we offer is hip arthroscopy, which allows doctors to visualize your hip joint and make repairs without using a large incision. Fractures may necessitate surgical repair such pinning, plates, and screws. Both fractures and severe arthritis can require total joint replacement. Total hip replacement surgery removes an arthritic joint and replaces it with a hip prosthesis in order to regain motion and reduce pain.

What Causes Hip Pain After Sitting? (And What To Do)

Stuck sitting at your desk all day?

If you’re among the one in four adults who sit for more than 8 hours a day, you might be feeling it at the end of the workday. All that time at your desk may be impacting how your hips feel when you finally get to stand.

Why Are My Hips Stiff After Sitting?

Stiffness in your hips after sitting aren’t simply a reflection of getting old. Often, this stiffness is simply a reflection of your hips and legs being in the same posture for an extended period of time.

“When you sit with your knees bent, your hamstrings are in a relaxed, shortened position, and your hip flexors are at the maximum shortened length,” said Kirsten Zambon, DPT, CLT-LANA, a physical therapist at Franciscan Health Lafayette East. “Hip pain from sitting can be from poor posture, but if you’re sitting 40 to 50 hours week over 5, 6 months or longer, you probably have decreased strength in your hips. When you do get up from your desk, your glutes, core and hip extensors will be  weaker, and you don’t feel as strong.”

How Should I Sit To Reduce Or Prevent Hip Pain?

“First thing to prevent the pain coming on good ergonomic setup,” Zambon said. Sitting with your feet properly aligned, pelvis aligned and spine straight may often make a difference in your back health.

When sitting, avoid crossing your legs or sitting “crooked” or leaning to one side, said Susan L. Helton-Groce, MS, CSP, OHST, ergonomic specialist at Franciscan Health WorkingWell in Greenwood.

Check out this video on how to improve your work station.

For some employees, a standing desk may be an option.

Can A Standing Desk Help My Hip Pain?

The increasing popularity of standing desks can impact your posture and hip pain as well.

“Make sure that you vary your posture by shifting your stance and placing one foot on a small stool for a few minutes and then alternating to the other side,” Helton-Groce said. “Avoid static postures, whenever possible, if standing.”

Posture isn’t the only thing that impact hip pain. Helton-Groce added wearing proper shoes can make a difference in how you feel at the end of a work day.

“Make sure that your shoes are in good shape,” she said. “Consider new insoles if your shoes are older. Oftentimes, hip pain can be magnified from older, worn shoes with little cushion.”

Does Arthritis Cause Stiff Hips When Sitting?

While arthritis in the hip joint can cause stiffness, the way the stiffness occurs is different from stiffness from tight muscles. A hip sore from arthritis typically has more stiffness or pain in the morning. That joint stiffness can generally improve with gentle movement but may be aggravated from vigorous activity.

“The best thing with arthritis, if you’re stiff, is to try gentle walking and stretching to warm up the joints,” Zambon said.

How Can You Stretch Your Hips At Your Desk?

Even if you’re at your desk all day, there are seated hip stretches that can help relieve stiffness in the hip flexors and tight hamstrings. These stretches include:

Seated Hip Flexor Stretch

  • Begin sitting upright in a chair.
  • Move to the side of the chair, extending your leg back backward.
  • Hold onto the chair or another sturdy object for balance
  • Gently rock your pelvis forward to feel a stretch in the front of your hip.

Seated Hamstring Stretch

  • Begin sitting upright in a chair.
  • Straighten one leg.
  • Lean your trunk forward, hinging at your hips until you feel a stretch in the back of your leg.
  • Keep your knee straight during the stretch. Do not arch your back.

Seated Figure 4 Piriformis Stretch

  • Sit upright in a chair with both feet on the ground.
  • Bring the ankle of one leg up onto the knee of your opposite leg.
  • Apply a gentle pressure with one hand on the top of your bent knee
  • Lean forward until you feel a stretch in your buttocks.
  • Keep your shoulders relaxed and back straight during the exerciseo

What Other Stretches Help Stiff Hips?

If you’re able to close the door to your office or carve out time at home to stretch, these stretches are other alternatives to stretching your hip flexors and hamstrings:

Standing Hip Flexor Stretch

  • Start in a standing position, one leg in front of you.
  • The leg you are going to stretch will be positioned behind your body. Rest hands on hips.
  • Keeping your back straight and upright, squeeze your buttock muscles and slowly shift your weight forward until you feel a gentle stretch in the front of your hip.
  • Your hips and shoulders should face forward. Do not arch your back.

Standing Hamstring Stretch on Chair

  • Begin in a standing upright position with a chair or step in front of your body.
  • Lift one leg to rest your heel on the chair with a very slight bend in your knee.
  • Bend at your hips, leaning your trunk forward until you feel a stretch in the back of your upper leg
  • Keep your back straight during the stretch.

Supine Figure 4 Piriformis Stretch

  • Lie on your back with both legs bent and your feet on the ground.
  • Lift one leg, placing that ankle on your opposite knee
  • Apply a gentle pressure to your bent knee with your hand. You should feel a stretch in your buttocks.
  • Keep your low back flat on the floor during the stretch.

Supine Posterior Pelvic Tilt

  • Lie on your back with your knees bent and feet resting flat on the floor.
  • Slowly bend your low back and tilt your pelvis backward into the floor, then return to the starting position and repeat.
  • Make sure to only move your pelvis and low back and keep the rest of your body relaxed.

Beginner Bridge

  • Lie on your back with your knees bent and feet resting flat on the floor.
  • Lift up through your pelvis as you exhale, inhale and slowly lower back down, and repeat.
  • Maintain a neutral spine, and keep your upper back on the floor during the exercise.

It’s important to remember with these hip exercises to keep your back in the correct position, as noted for each exercise.

What Other Steps Can Help Reduce Hip Pain?

Movement can make the difference in reducing hip pain at work. Keep your muscles loose by taking standing or walking breaks frequently.

“I recommend if you are in a sitting job, you get up every hour,” Zambon said. “Walk or stretch your hip flexors or hamstrings and hip joints as well. Even 5 to 10 minutes of walking can help, even if it’s at lunch or after work before you get into the car. At the end of the day, do a good hamstring stretch or hip flexor stretch, as well as some gentle core work.”

Zambon suggests simple core exercises such as pelvic tilts or bridging (if back pain is not an issue) to help stretch those key hip areas.

“If you’re having pain you can’t relieve within 30 minutes after you leave work, gentle stretching on your own should do the trick,” Zambon said. “If you have pain when you wake up, or with whatever you’re doing progresses through the evening, it’s a good time to contact a physician.”




90,000 Pain when walking – EMC

Sciatic nerve caprices

The list of exercise-related summer concerns and joys is truly inexhaustible. Sometimes unusual efforts, working in an uncomfortable position, cooling can provoke damage to the sciatic nerve.

Typical signs are pain in the buttock, spreading along the back of the thigh and lower leg and sometimes reaching the foot, numbness of the skin of these areas and weakness (up to paralysis) of the muscles of the legs, as well as sharp pain and involuntary muscle contraction, upon examination by a doctor.

All these symptoms are due to the functional characteristics and location of the sciatic nerve, which starts from the sacral plexus, passes under the muscles of the buttocks through the back of the thigh, and almost reaching the popliteal fossa, bifurcates into two descending branches.

The sciatic nerve provides skin sensitivity of the corresponding zones, conducts motor impulses to the muscles that extend the trunk and thigh, flex the lower leg and lift the foot up.

Causes of sciatic nerve diseases

The most common of these is squeezing. The symptoms look different, depending on the level at which it happened and what caused it.

How does the disease develop when one of the spinal roots of the sacral nerve plexus is compressed? If the cause is a hernial protrusion of the intervertebral disc, suddenly there is a sharp pain that increases with movement and coughing. At the same time, skin sensitivity disorders and muscle weakness are increasing.The root, squeezed by a thickened ligament or bone growth in osteochondrosis, gradually gives increasing pain and numbness. Muscle weakness joins much later, with an advanced disease, muscle atrophy is possible.

Compression of the sciatic nerve by muscles is called tunnel syndrome. Some diseases of the spine and joints, injuries, flat feet and even unsuccessful injections into the buttock can lead to it. The manifestations of tunnel syndromes are varied: from pain in the buttock to burning pain in the sole of the foot and the inability to control the movements of the foot.

Sciatic nerve injury

Injuries to the sciatic nerve (bruises, lacerations, stab and cut wounds) are usually accompanied by moderate pain, but impair the transmission of motor impulses. They can lead to muscle atrophy, paralysis, as well as dry skin and trophic ulcers on the legs.

A number of diseases that disrupt metabolism, can disrupt the work of the sciatic nerve – this is diabetes mellitus, some diseases of the thyroid gland, various poisoning.

Shingles, caused by the herpes virus, sometimes causes severe pain and blistering eruptions along the sciatic nerve. Modern diagnostic methods allow you to accurately find out the causes of trouble.

First of all, as a rule, they resort to X-ray diagnostic methods; X-ray of the spine with functional tests. Computed tomography makes it possible to examine in detail not only bone structures, but also intervertebral discs, to “see” the spinal cord, to predict its viability when compressed, using magnetic resonance imaging.Electromyography (studies of the bioelectrical activity of muscles under the influence of various types of electrical stimulation) allows to judge the nature of the lesion of the sciatic nerve, the peculiarities of the process occurring in it.

Treatment

Treatment of sciatic nerve lesions is, first of all, the elimination of the damaging factor. With small hernias of intervertebral discs, as a rule, they resort to drug therapy. Its purpose is to improve blood circulation, relieve inflammation, swelling and painful muscle spasms.

When acute symptoms are eliminated, treatment is continued with the help of physical and manual therapy, acupuncture, electrical muscle stimulation. Remedial gymnastics, traction on “ORMED professional” are also useful.

With massive disc hernias, when the functions of the limbs are grossly impaired, surgical treatment becomes necessary.

Neuromuscular tunnel syndromes are treated mainly conservatively. Blocks, manual therapy, massage, acupuncture, wearing special belts and orthopedic insoles in combination with taking anti-inflammatory and decongestants, as well as drugs that reduce excessively high muscle tone, make it possible to achieve success.

Inflammatory lesion of the vertebrae and intervertebral joints requires not only the fight against inflammation, but also antibacterial therapy, if the cause of the inflammatory process is an infection invading the body.

The degree of restoration of the sciatic nerve function depends, first of all, on the severity and duration of its damage. Many complications and consequences can be avoided if you consult a doctor in a timely manner and start treatment as early as possible.

Prevention of sciatic nerve damage

First of all – take good care of your spine (in particular, learn how to properly lift weights).It is especially important to monitor his condition for those who are faced with heavy physical labor. To avoid many troubles will help regular visits to the pool and physical education (at least morning exercises).

There are contraindications. Read the instructions or consult a specialist.

Heading health: how to cure flat feet

Almost 70% of Russians suffer from various degrees of flat feet.And this problem is not so harmless: because of it, young men are recognized as unfit for military service. Women are also concerned about flat feet. How to avoid flat feet or relieve suffering, you will learn from our conversation.

What is flat feet?
Flat feet is a violation of the arch of the foot. The feet flatten and stop “springing” when walking, hence the pain and excessive fatigue. If in the evening the legs get very tired even after a normal load, and when pressing on the middle of the sole, pain occurs – these are the first signs of flat feet.Sometimes the legs swell, but usually it goes away in the morning. At the second stage, flat feet remind of itself around the clock. Severe pain in the feet and legs makes you avoid long walks. Sometimes you even have to change jobs. At the same time, the gait becomes heavy, duck – the rest of the body can hardly keep up with the chest, problems with shoes appear. Disfiguring bumps at the base of the thumbs are not only a cosmetic defect. They are constantly being rubbed with the great difficulty of the chosen shoes.The foot is deflected outward so that it is not possible to return it to the physiological position.
The third stage is a neglected disease. Walking is extremely difficult, the feet are severely deformed and resemble the usual outlines only by their location – below the ankle joints. Patients at this stage are disabled. Only a surgeon can help them out.

What is the threat of flat feet?
Normally, the foot is not at all flat, because powerful ligaments and muscles form two arches – longitudinal (along the inner edge of the foot) and transverse (between the bases of the toes).Such a complex structure is needed not only for support, but also in order to dampen vibrations when walking and save the body from overload, primarily the brain. Normal vaults protect from “shaking” no worse than a foreign car, but a flat foot – alas! – copes with this in about the same way as the wheels of a cart. With flat feet, the role of a shock absorber is taken by the knee and hip joints and the spine, although they are not adapted for this task. Therefore, arthrosis, osteochondrosis, scoliosis and postural disorders are common and frequent companions of flat feet.

How is flat feet formed?
Flat feet are congenital, but more often it is an acquired problem. In children, flat feet, as a rule, occurs against the background of congenital connective tissue failure, while one of the important factors in the development of the disease is improperly selected shoes. Constant stimulation is needed to properly shape the arch of the foot. Hard grass, stones or sand make muscles and ligaments work, but usually we only have flat surfaces under our feet.At home – carpet, on the street – asphalt through the thick sole of the sneakers, which is remarkably springy when walking and thus takes over the natural function of the foot. Without load, the feet begin to get lazy, and the arches “sag”. The result is flat feet “for the rest of your life”

According to statistics, more than 65 percent of children acquire flat feet by school age. To prevent this from happening, carefully approach the choice of children’s shoes. And, first of all, do not let the kids wear other people’s shoes: the worn-out last does not distribute the load on the feet correctly.Children’s shoes should have a small heel, a hard back and a soft instep support – compensating for the absence of bumps and stones under the feet, it ensures the correct formation of the foot.

How does flat feet occur in adults?
In adults, static flat feet are more common, which is associated with excessive stress on the legs. What leads to it? First of all, overweight: it falls on the feet with an exorbitant weight. The situation is aggravated by standing for a long time, so hairdressers, teachers, salespeople, priests, traffic police officers and surgeons are more at risk than others.Athletes are also not immune from this misfortune: skaters and weightlifters have flat feet – an occupational disease. It must be said that women suffer from flat feet four times more often than men. This is easy to explain.

First, weight increases during pregnancy. In addition, women who are expecting a baby produce a special hormone called relaxin, which relaxes the ligaments.

And secondly, it is the legs that have to pay for the beauty: in high-heeled shoes and with pointed noses, we do not rely on the entire foot, but only on the heads of the metatarsal bones.Sooner or later, the foot will cease to resist this violence and will adapt to beautiful shoes: it will become depressingly flat. At the same time, the fingers will also not remain in debt – they will slowly but surely deform. Therefore, doctors advise to save hairpins for special occasions, and in everyday life to give preference to practical, comfortable models with low heels with a hard back.

How do you know if you or your child have flat feet?
For a simple flatfoot test, you only need two things – a fat cream and a piece of paper.Lubricate the soles with cream and step on the paper. Stand upright, otherwise the result may be wrong. Now take a close look at the trail. Normally, there is a notch along the inner edge of the foot (there is no print here), which takes more than half of the foot in the middle. If this notch is absent at all or it is narrow (half a foot or less), there is no way to go: you need an orthopedist. The characteristic position of the big toes in your child – in different directions outward – also indicates probable flat feet. Here are some more warning signs:
The leg seems to have grown – you have to buy shoes one size larger.
The foot has become so wide that you no longer fit into your favorite shoes;
Matching shoes is a challenge as most models are painful; on old shoes, the heels are worn down on the inside.
The final diagnosis of will be made by an orthopedic surgeon on the basis of X-ray images or computerized foot examination data.

How to cure flat feet?
Unfortunately, a radical cure for flat feet is possible only in childhood.In adults, the development of the disease can only be slowed down.

Here are the main ways

Leg Exercise
1. With the initial position of the legs apart, the socks “look” inward, make alternate turns of the body to the right and left with the rotation of the corresponding foot to the outer edge.
2. Then walk on your socks for a few minutes.
3. Then walk on your heels for the same time.
4. Walk a little with tucked toes.
5. Then walk with your fingers raised.
6. Several times a day for 10-15 minutes walk on the outer edges of the foot, like a “clubfoot bear”.
7. Try to pick up a small object from the floor with your toes several times: a pencil, a handkerchief, dominoes.
8. Lie on the floor and twist your feet to the left and right, back and forth, bend and unbend your toes.
9. From childhood, teach your child to read, write and draw with their feet on the outside edge.It is even better to combine this passive posture with active gymnastics: during sedentary work and classes, let the baby, as it were, rake imaginary sand into a pile with his soles. If you find yourself on the beach, let the real sand shovel. Since it is difficult to keep a pile of sand under your child’s desk, put a rolling pin, a hard rubber ball, and roll these objects along the arches of the feet.

Self-massage is best done after therapeutic exercises, with complete relaxation of the muscles.The main self-massage techniques are as follows:
– the shin should be stroked, rubbed with palms, kneaded, beaten with the ends of the fingers. Massage the lower leg from the ankle to the knee, mainly the inner surface of the lower leg;
– the foot should be stroked and rubbed with the back surface of bent fingers. The plantar surface of the foot should be massaged from toes to heel; for self-massage it is useful to use special rubber mats and massage rollers.

Herbal baths
-Bath of a decoction of oak bark
-Tincture of immortelle flowers
-Peppermint infusion
-Mint and linden blossom infusion
Such a bath relieves leg fatigue well.

When the foot is steamed, massage it again. After such a procedure, both children and adults sleep well: the calming effect of the baths through the reflexogenic zones of the sole affects. This procedure not only relieves fatigue, stress, it is also important for foot hygiene. Contrast baths are good: after hot – cold and so repeat several times.

Wearing an instep support
To save the spine and internal organs from the constant shaking that flat feet provide them, the instep support insoles will help.They return the foot to its normal position and take over the functions of a shock absorber. Sometimes a heel pad is also used (it is needed when developing heel spurs, and also if one leg is slightly shorter than the other). At the slightest signs of deformity of the big toe, an interdigital corrector will help – a small soft silicone spacer that is inserted between the first and second toes, so that the big toe can no longer deflect towards the little toe.
orthopedic surgeon will help you to find all these simple and so necessary devices.If the disease has gone far, he will advise, medications to relieve pain, suggest physiotherapy procedures.

How often should instep support be worn?
With pronounced flat feet constantly. It is even advisable to put them in house slippers, since this is the only way to block the disease. For preventive purposes, instep supports should be used no more than 3-4 hours a day, the rest of the time, giving the feet a reasonable load. There is a reason for this: the muscles and ligaments of the foot, naturally, get used to the support – so much so that they stop working on their own.

Your health | STADA

STADA Health Report

The purpose of the STADA Health Report is to help people stay healthy. Our company is committed to ensuring that people responsibly handle the most valuable resource they have – their own health. Only in this case will they be able to lead a full-fledged lifestyle.

To learn more

Your body

Strengthen your immune system, stay healthy and live an active life.We only have one body, so we should take care of it. Learn more about the symptoms of diseases, clinical conditions, but most importantly, how to lead a fulfilling lifestyle.

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Your soul

When our soul is in harmony with our body, we feel healthy and full of strength. In addition to relaxation and stress management techniques, we want to emphasize other ways to strengthen your inner balance and peace of mind.

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Your family

Every day of family life is filled with both joy and new challenges. But we boldly accept them. We will provide you with useful insights and information that is addressed to your entire family.

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Your food

The basis of a healthy life is a balanced diet, which is also very tasty.In this section, you will find information and tips for your nutrition.

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Ecology

STADA pays great attention to the issues of preserving the environment and, as a result, improving the quality of life of society.

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All about medicines

How to take medicines, how to store them correctly, how to drink them, and whether medicines are compatible with alcohol – we will cover all these topics in this section.

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90,000 If your hip hurts … | Floris Medical Center

ACUTE pain in the hip can cause many reasons – from banal overexertion of the limbs to very serious diseases.

Therefore, if the pains recur and become regular, it is necessary to urgently consult a specialist in order to establish a diagnosis and prescribe treatment.After all, some limb diseases directly lead to permanent disability. One of them is Perthes disease – aseptic necrosis of the femoral head in adults (ANFH). As a rule, it affects men of quite working age – 30-50 years old, and in half of the cases both legs are affected. The causes of the disease can be very different: hip neck injuries, taking certain medications (most often high doses of glucocorticoid hormones), prolonged exposure to high blood pressure (divers, miners), frequent alcohol consumption (it damages blood vessels, which can cause necrosis) , chronic metabolic disorders (diabetes mellitus, obesity, acute and chronic pancreatitis, fatty embolism, Gaucher disease, decompression sickness, etc.). The result of this most dangerous disease is the necrosis of a part of the bone substance of the femoral head, followed by its destruction.

More details about the development and diagnosis of aseptic necrosis of the femoral head were given to us by a specialist doctor at the Floris Medical Center MIROSLAV STARKIV:

– The first symptom of ANFH is pain in the hip joint when transferring body weight to the affected leg. The pain can spread to the groin, gluteal region, give on the front of the thigh.Then lameness and dysfunction (mobility) of the joint appear. In advanced stages, the patient feels severe pain even at rest, which causes sleep disturbances. At this time, one leg becomes shorter than the other, a pronounced lameness appears, the need for a cane or crutches – and it is no longer possible to change the situation. Therefore, it is very important that the patient see a doctor at an early stage – when pain occurs from time to time, and the joint is still fully mobile.

Unfortunately, the diagnosis of ANFH at an early stage is difficult – the traditional X-ray examination of incipient pathological changes does not reveal, the spherical surface of the femoral head is preserved, the joint space remains of the usual width.X-ray does not always allow us to answer the question of the exact location and size of the pathological process, the condition of the cartilage and periarticular tissues, and to trace the dynamics of the restoration of the bone affected area after treatment.

But the solution to this problem was found – the study of the soft tissue and cartilaginous elements of the hip joint became possible thanks to such a highly informative, non-invasive, fast and affordable method as ultrasound sonography. Ultrasound examination of the hip joints using high-precision equipment of the Floris Medical Center allows diagnosing the manifestations of necrosis of the femoral head and its severity.In addition, ultrasound can be used repeatedly without risk to the health of patients, unlike X-ray.

At the stage of vascular disorders, the process of developing bone necrosis can not only be slowed down, but also reversed. Violations of regional blood supply in various pathologies helps to detect ultrasound with Doppler ultrasound. Today, the doctors of the Floris Medical Center are familiar with this technique. In April 2009, they prepared a report on the early diagnosis of ANFH at the international conference on ultrasound diagnostics in St.Kiev. According to statistics, in our center for 2009-2010, more than 220 ultrasound examinations of the femoral head with dopplerography were performed. Of these, in 25% of the examined patients, the disease was detected at an early stage, which made it possible to prescribe treatment for them in time and monitor its effectiveness.


Methods for managing hip pain during pregnancy

Methods for managing hip pain during pregnancy

Hip pain during pregnancy is a common symptom you may experience.This symptom is most often felt during late pregnancy, especially in the third trimester. This is because your body is organizing itself for an important cause. Soreness and pain are often felt most strongly on the side of the baby in your uterus.

What causes hip pain during pregnancy?

During pregnancy, your body produces hormones that allow connective tissue to relax and soften.As a result, the joints, as well as the ligaments between the bones in your pelvis, begin to weaken. Increasing the flexibility of these bones is necessary so that the baby can move more easily through the pelvis during the entire period of labor. Lower back pain, in addition to changes in posture, plus a heavier uterus, can cause the soreness you feel.

Ways to Relieve Hip Pain Throughout Pregnancy:

Aerobics that strengthens your back and abdominal muscles at the same time reduces hip pain.One workout that can provide relief is raising your hips above chest level while lying on your back for a few minutes. Taking a warm bath or applying warm compresses to the painful area can also reduce pain. Plus, massage can relieve pain too.

As your due date approaches, try to sleep on your side with your knees bent. Using special pillows to support your abdomen can relieve anxiety while sleeping. If your hip pain worsens while lying on your side, place a pillow or blanket under your lower back.This will reduce the strain on your hips.

When should you call your doctor?

If hip pain is accompanied by pressure or pelvic discomfort before the 37th week of pregnancy, be sure to contact your obstetrician-gynecologist. This could be a signal of premature birth.

Along with pelvic pressure, other signs of preterm labor are:

  • Abdominal cramps and discomfort, mainly in the lower abdomen

  • Low back pain that extends to the front and sides of the body, not passing after a change of position

  • Unexpected contractions that occur approximately every ten minutes

Pain in the legs in Kazan

Leg pain is often caused by lower limb ischemia (LIC).
Main symptoms of the disease:

  • “Intermittent claudication”: pain in the legs occurs when walking and disappears after stopping movement;
  • The skin of a diseased limb in comparison with a healthy one has a pale color;
  • Painful sensations also appear at night, at rest;
  • Pain relievers do not give the desired effect when pain occurs at rest;
  • From time to time, there is a cold snap of the affected limb;
  • Increased fragility of nails and / or a slowdown in their growth is observed;
  • The hair on the skin of the diseased limb is practically absent;
  • Abrasions and wounds heal poorly.

Atherosclerosis

This is a disease that affects the arteries due to excessive deposition of cholesterol in them, which leads to impaired blood supply. Atherosclerotic plaques narrow the lumen of the vessels, as a result, the muscles of the legs are supplied with insufficient oxygen.
Atherosclerosis, according to experts, is the cause of ischemia (weakening of blood circulation) of the lower extremities in 90% of those suffering from this disease.

Ischemia of the lower extremities

The structure of cardiovascular pathologies is as follows: in the first place – ischemic heart disease, in the second – stroke, in the third – ischemic lesions of the lower extremities.
In Russia, at present, about 1.5 million people suffer from INC. At the same time, a severe form of the disease is detected annually in 144 thousand Russians who are at risk of amputation. Every year about 40 thousand patients amputate the affected limbs …

Diagnostics INK
Having discovered at least one of the above symptoms, do not hesitate! Contact a specialist as soon as possible.
At the MEDEL Clinic, you will first be examined and listened to your complaints. Further, after an instrumental examination, a diagnosis will be made and a treatment strategy will be determined.
For the treatment of INK in the MEDEL Clinic, the newest non-surgical method, Therapeutic Angiogenesis, is currently used.

Innovative INK treatment: therapeutic angiogenesis
Angiogenesis is the process of creating new blood vessels in a tissue or organ.
Therapeutic angiogenesis is a non-surgical therapeutic strategy based on drug-induced enhancement of the natural angiogenesis process (therapeutic vascular growth).

Neovasculgen
The newest innovative domestic drug Neovasculgen, developed by Russian scientists for the first time in the world, implements Therapeutic Angiogenesis.

  • This is an injection that triggers the growth of blood vessels in the injection site;
  • It is necessary when, due to the nature and extent of the lesion, it is impossible to carry out a surgical operation in the treatment of INK.

As a result of neovasculgen therapy, the structure of new vessels is stabilized, and the patient’s condition improves:

  • Blood supply and oxygen utilization in the tissues of the limb are resumed;
  • The feeling of chilliness in the legs disappears;
  • The condition of the skin is normalized;
  • The patient can walk a great distance without pain.

After the course of Neovasculgen, the positive effect, according to the studies, is stable for up to 2 years.

Benefits of treatment with Neovasculgen at MEDEL Clinic:

The use of Neovasculgen in the framework of complex conservative therapy allows:

  • Significantly increase the painless walking distance;
  • Avoid amputation, save the patient’s limb and possibly life;
  • Exclude long-term treatment, multiple injections and the recovery period;
  • Improve the quality of life of patients.

Therapeutic angiogenesis is a technically simple procedure that is well tolerated by the patients of MEDEL Clinic. At the same time, as the practice of the surgical department of the Clinic shows, it is more effective than the standard conservative treatment of INK.

There are few contraindications: pregnancy, lactation, individual intolerance to the drug.

If your legs begin to hurt, especially when walking, contact a specialist as soon as possible! Don’t waste precious time! Just call tel.(843) 207-18-00 and make an appointment with the surgeon at the MEDEL Multidisciplinary Clinic.

90,000 About hip replacement surgery

This guide will help you prepare for your hip replacement surgery at Memorial Sloan Kettering (MSK). It will also help you understand what to expect as you recover.

Use this manual as a reference as you prepare for the day of surgery. Always take it with you to MSK, including on the day of your surgery.You and your healthcare team will guide you through your treatment.

to come back to the beginning

Operation Information

The structure of the hip joint

The hip joint is a ball joint. This means that it is made up of 2 parts for movement and rotation. The joint consists of the femoral head at the upper end of the femur and a fossa in the pelvic bone called the acetabulum (see Figure 1).The head of the thigh is rounded and ball-like. It is inserted into the acetabulum and allows smooth movement of the hip joint.

Figure 1. Structure of the hip joint

If you need a hip replacement, the damaged parts will be replaced with artificial components called prostheses. They are usually made of metal or plastic. The new joint helps relieve pain and improve your ability to move.

Types of hip joint replacement

There are two types of hip replacement – partial and complete.

In a partial hip replacement, the femoral head is removed and replaced with a metal stem that is inserted into the femur. A ball is installed on the top of the leg. The device, called a “bipolar cup,” slides over the ball of the newly installed hip joint and rotates in the patient’s own acetabulum.

With a complete replacement of the hip joint, not only the head of the femur is replaced, but also the acetabulum, in place of which a metal prosthesis is installed. The acetabulum is anchored to the bone using cement, screws, or a snug fit to the bone.

Hip replacement surgery

The surgeon will make an incision (surgical incision) starting about 5 inches (12.7 cm) above the hip joint and ending about 6 inches (15.24 cm) below it.The doctor will remove the affected part of the bone and replace it with a prosthesis. The prosthesis will be positioned and secured.

to come back to the beginning

Before operation

The information in this section will help you prepare for your surgery. Read this section after you have assigned your surgery and refer to it as the date of your surgery approaches. It contains important information about what you need to do before your surgery.

As you read this section, write down the questions you want to ask your healthcare provider.

Preparation for surgery

You and your healthcare team will prepare for your surgery together.

Help us make your transaction as secure as possible: Tell us if any of the statements below match your situation, even if you’re not entirely sure.

  • I am taking a blood thinner, for example:
    • aspirin;
    • Heparin
    • Warfarin (Jantoven ® or Coumadin ® )
    • Clopidogrel (Plavix ® )
    • Enoxaparin (Lovenox ® )
    • Dabigatran (Pradaxa ® )
    • Apixaban (Eliquis ® )
    • Rivaroxaban (Xarelto ® )

    There are other similar medications, so be sure to tell your healthcare provider about any medications you are taking.

  • I am taking prescription drugs (prescribed by my healthcare provider), including patches and ointments.
  • I take over-the-counter medicines (which I buy without a prescription), including patches and ointments.
  • I take nutritional supplements such as herbs, vitamins, minerals, and natural or home remedies.
  • I have a pacemaker, Automatic Implantable Cardioverter Defibrillator (AICD), or other cardiac pacemaker.
  • I have sleep apnea.
  • In the past, I have had problems with anesthesia (injecting a medication that makes me fall asleep during surgery).
  • I am allergic to some drugs or materials such as latex.
  • I do not want to have a blood transfusion.
  • I drink alcohol.
  • I smoke or use electronic smoking devices (eg disposable e-cigarettes, vape, Juul ® ).
  • I take soft drugs.
Alcohol use

The amount of alcohol you drink may affect your condition during and after surgery. It is very important to tell healthcare providers how much alcohol you are drinking. This will help us plan your treatment.

  • If you stop drinking abruptly, it can cause seizures, alcoholic delirium and death.
    If we know that you are at risk for these complications, we can prescribe medications for you to avoid them.
  • If you drink alcohol regularly, there is a risk of other complications during and after your surgery. These include bleeding, infections, heart problems, and longer hospital care.

To prevent possible problems, before the operation, you can:

  • Tell healthcare providers honestly how much alcohol you drink.
  • After the appointment of the operation, try to stop drinking alcoholic beverages.If, after stopping alcoholic beverages, you experience headaches, nausea (vomiting sensation), increased anxiety, or have trouble sleeping, tell your healthcare provider right away. These are early signs of alcohol withdrawal that can be treated.
  • Tell your healthcare provider if you are unable to stop drinking.
  • Ask your healthcare provider questions about how drinking alcohol might affect your body in connection with surgery.As always, we will ensure the confidentiality of all your medical information.
About smoking

During surgery, smokers may experience breathing problems. Quitting smoking even a few days before surgery will help prevent these problems. If you smoke, your healthcare provider will refer you to the Tobacco Treatment Program. You can also contact this program by calling 212-610-0507.

Information about sleep apnea

Sleep apnea is a common breathing disorder that causes a person to stop breathing for a short period during sleep.The most common type is obstructive sleep apnea (OSA). In OSA, the airways are completely blocked during sleep. OSA can cause serious complications during and after surgery.

Let us know if you have sleep apnea attacks, or if you suspect you may have such attacks. If you are using a breathing apparatus (such as a CPAP machine) to prevent sleep apnea, take it with you on the day of surgery.

Within 30 days prior to surgery

Preoperative study

Before your surgery, you will be assigned a presurgical testing (PST). The date, time and location will be indicated in the appointment reminder that you receive at the surgeon’s office. You will help us if you take with you to the preoperative examination:

  • a list of all medicines you take, including prescription and over-the-counter medicines, patches, and creams;
  • Results of any tests you did outside of MSK, such as exercise ECG, echocardiogram, or carotid Doppler.
  • names and phone numbers of your medical staff.

On the day of your appointment, you can take your food and medicine as usual.

During the preoperative study, you will meet a highly qualified nurse. This is a medical professional who works with anesthesiologists (medical personnel who have received special training who will perform anesthesia during surgery). A senior nurse / nurse will review your medical record and your surgical history with you. You will need to undergo a number of tests, including an electrocardiogram (EKG) to check your heart rate, chest x-rays, blood tests, and other tests needed to plan your treatment.In addition, a trained nurse can refer you to other specialists.

The Nurse / Nurse will also advise you on what medications you will need to take on the morning of your surgery.

Determine who will look after you

Your caregiver plays an important role in your treatment. Before your surgery, your healthcare team will tell you and your caregiver about the surgery. In addition, the person will need to take you home after your surgery and discharge from the hospital.Also, this person will help you at home.

Information for caregivers

Existing materials and support are available to help you meet the many responsibilities that come with caring for someone undergoing cancer treatment. For support resources and information, visit www.mskcc.org/caregivers or read the resource Guide for Caregivers

Complete the Health Care Proxy Form

If you have not yet completed the Health Care Proxy, we recommend that you do so now.If you have already completed this form or have other advance directives, please take them with you to your next appointment.

The Power of Attorney for Health Care Decisions is a legal document that specifies the person who will represent you in the event that you are unable to do so on your own. The person listed there will be your health care agent.

Talk to your healthcare provider if you are interested in completing a Health Care Proxy.You can also read the resources Advance Care Planning and How to Be a Care Representative for information about health care proxies, other advance directives, and acting as a care agent.

Perform breathing exercises and exercises that stimulate coughing

Take deep breaths and clear your throat before surgery. Your healthcare provider will give you a stimulation spirometer to help expand your lungs.For more information, see the resource How to use your incentive spirometer.

Physical activity

Try to do aerobic exercise daily. Aerobic exercise is any exercise that increases your heart rate, such as walking, swimming, or cycling. In cold weather, take the stairs in your home, go to the mall or shop. Physical activity will help improve the condition of the body for the operation, as well as help facilitate and speed up the healing process.

Stick to a healthy diet

Prior to surgery, try to eat a well-balanced, healthy diet. If you need help with diet planning, ask your healthcare provider to refer you to a dietitian nutritionist.

Buy a 4% chlorhexidine gluconate (CHG) antiseptic cleanser (such as Hibiclens®).

4% CHG solution is a skin cleanser that kills various microorganisms and prevents their appearance within 24 hours after use.Showering with this solution before surgery will reduce the risk of infection after surgery. You can purchase a 4% CHG antiseptic skin cleanser at your local pharmacy without a prescription.

7 days before surgery

Follow your healthcare provider’s instructions when taking aspirin

If you are taking aspirin and any medicines containing aspirin, you may need to change your dose or not take them for 7 days before your surgery.Aspirin can cause bleeding.

Follow your healthcare provider’s instructions. Do not stop taking aspirin unless directed to do so. Read the resource Common Medicines Containing Aspirin and Other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or Vitamin E for more information.

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before surgery.These medicines can cause bleeding. For more information, read the resource Herbal Remedies and Cancer Treatments.

2 days before surgery

Stop taking nonsteroidal anti-inflammatory drugs [NSAIDs].

Stop taking NSAIDs such as ibuprofen (Advil ® and Motrin ® ) and naproxen (Aleve ® ) 2 days before surgery. These medicines can cause bleeding.For more information, read the resource Common Medicines Containing Aspirin and Other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or Vitamin E.

1 day before surgery

Record the time at which the operation is scheduled

An admissions officer will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, you will receive a call the previous Friday. If no one contacts you by 19:00, please call 212-639-5014.

A staff member will tell you when you should come to the hospital for your surgery. You will also be reminded how to get to the ward.

The operation will be performed at one of the following addresses:

  • Presurgical Center
    1275 York Avenue
    (between East 67 th and East 68 th Streets)
    New York, NY 10065
    M Lift 2nd Floor
  • Presurgical Center on 6th Floor
    1275 York Avenue
    (between East 67 th and East 68 th Streets)
    New York, NY 10065
    Elevator B, 6th Floor
Shower with a 4% CHG antiseptic cleanser (e.g. Hibiclens®)

The evening before the day of surgery, shower with a 4% CHG antiseptic cleanser.

  1. Shampoo your hair with a regular shampoo. Rinse your hair thoroughly.
  2. Wash face and genital area with your usual soap. Rinse your body thoroughly with warm water.
  3. Open the 4% CHG solution. Pour a small amount into your hand or onto a clean washcloth.
  4. Move away from the water jet. Lightly massage the 4% CHG solution into the body from neck to feet. Do not apply it to your face or genital area.
  5. Return under tap water and rinse with 4% CHG solution.Use warm water.
  6. After showering, dry yourself with a clean towel.
  7. Do not use any type of lotion, cream, deodorant, makeup, powder, perfume or cologne after showering.
Sleep

Go to bed early and try to get a good night’s sleep.

Instructions for eating before surgery

Do not eat after midnight before your surgery. This also applies to candy and chewing gum.

Morning before surgery

Instructions for drinking drinks before surgery

You may drink a maximum of 12 ounces (350 ml) of water between midnight and 2 hours prior to arrival at the hospital.Don’t drink anything else.

Do not drink any liquid two hours before your scheduled arrival time at the hospital. This also applies to water.

Take medication as directed

If your healthcare provider tells you to take some medicines in the morning before your surgery, take only those medicines with a small sip of water. Depending on the medications, this may be all or some of the medications you usually take in the morning, or you may not need to take them at all.

Shower with a 4% CHG antiseptic cleanser (such as Hibiclens®)

Shower with 4% CHG antiseptic skin cleanser before leaving the hospital. Use the same product you used the night before.

Do not apply any lotion, cream, deodorant, makeup, powder, perfume or cologne after a shower.

Points to Remember
  • Remove nail polish and decals.
  • Do not wear metal objects. Remove all jewelry, including body piercings. Equipment used during the operation may cause burns if it comes into contact with metal.
  • Leave valuables at home, such as credit cards, jewelry, or a checkbook.
  • Before going to the operating room, you will need to remove your hearing aid, dentures, dentures, wig, and religious paraphernalia.
  • Put on comfortable, loose-fitting clothing.
  • If your period (period) begins, use a sanitary towel, not a tampon. You will be given disposable underwear and a pad if needed.
What to take with you
  • Sneakers with laces or other shoes with soles, but without laces and fasteners. Your legs may become swollen. Lace-up sneakers or sturdy shoes without laces and fasteners will be easier to put on after surgery. Do not wear open-heeled shoes such as flip flops or slippers.
  • Your own breathing apparatus for the prevention of sleep apnea (eg CPAP apparatus), if available.
  • Stimulating Spirometer
  • Power of Attorney to Make Health Care Decisions, if completed.
  • Mobile phone and charger.
  • Bag for keeping personal items (such as glasses, hearing aids, dentures, dentures, wig, and religious items), if you have them.
  • These are recommendations.Using these guidelines, your healthcare team will guide you on how to take care of yourself after your surgery.
Where to park

MSK Garage is located at East 66 th Street between York Avenue and First Avenue. For parking prices, call 212-639-2338.

To enter the garage, turn East 66 th Street from York Avenue. The garage is located approximately a quarter block from York Avenue, on the right (north) side of the street.A pedestrian tunnel leads from the garage to the hospital.

There are other garages located at East 69 th Street between First Avenue and Second Avenue, East 67 th Street between York Avenue and First Avenue, and East 65 th Street between First Avenue and Second Avenue.

Upon arrival at the hospital

You will be asked to state and spell your first and last name several times, as well as indicate your date of birth. This is for your safety.People with the same or similar names can be operated on on the same day.

Change for operation

When it’s time to change for your surgery, you will be given a hospital gown, gown, and non-slip socks.

Nurse appointment

You will meet with the nurse before your surgery. Tell her / him the doses of all medications you took after midnight and when you took them (including all prescription and over-the-counter medications, patches, creams, and ointments).

The nurse may place an intravenous (IV) line into one of the veins, usually in the arm or hand. If the nurse does not give you an IV, your anesthesiologist will do it when you are in the operating room.

Meeting with anesthesiologist

You will also meet with your anesthesiologist before your surgery. This specialist:

  • will review the medical record with you;
  • will ask if you have had any problems with anesthesia in the past, including nausea or pain;
  • will talk about your comfort and safety during the operation;
  • will tell you about the type of anesthesia you will receive;
  • will answer your questions about anesthesia.

Your doctor or anesthetist may also discuss with you how to administer pain medication. You can enter it through:

  • An epidural catheter (thin, flexible tube) in the spine
  • a conduction anesthesia catheter placed near the nerves that transmit pain impulses from the incision;
  • intravenous drip.
Preparing for surgery

Before surgery, you will need to remove your hearing aid, dentures, dentures, wig, and religious paraphernalia (if you have any of the above).

You will go to the operating room yourself, or a staff member will take you there on a gurney. A member of the operating team will help you lie down on the operating table and put compression boots on your shins. They will inflate and deflate smoothly to improve blood flow in your legs.

When you are comfortable on the table, the anesthesiologist will administer anesthesia through an IV line and you will fall asleep. Your IV line will also give you fluids during and after your surgery.

During operation

When you fall asleep, a breathing tube will be inserted through your mouth into your windpipe to help you breathe. You will also receive a urinary catheter (Foley catheter) to drain urine from your bladder.

During the operation, you will receive plastic drainage tubes that extend from the site of the replacement prosthesis and exit near the incision. They will drain fluid from the site of the operation, which will help relieve swelling. To prevent the drain tubes from falling out, they can be sewn to the fabrics at the installation site.They are connected to a reservoir to collect the evolved liquid.

Surgical staples or stitches will be placed on your incision after surgery is complete. In addition, Steri-Strips (thin strips of patch) or Dermabond ® (surgical glue) may be applied to your incisions. The incision site may be covered with a bandage. The breathing tube is usually removed while you are still in the operating room.

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After operation

The information in this section will let you know what to expect after surgery, while you are in the hospital, and when you leave home.You will learn how to safely recover from surgery.

As you read this section, write down the questions you want to ask your healthcare provider.

In the waking chamber

When you wake up from your surgery, you will be in the awakening room. The nurse will monitor your body temperature, heart rate, blood pressure, and oxygen levels. You may receive oxygen through a thin tube under your nose, or through a mask that covers your nose and mouth.In addition, compression boots will be worn on the shins.

A Foley catheter will be inserted into your bladder to track the amount of urine you are making. You will be given a pain-relieving pump called a patient-controlled analgesia (PCA) machine. Read the resource Patient-Controlled Analgesia (PCA) for more information. If you do not have an epidural or conduction catheter, pain medication will be given through an IV line.

You will be in the awakening chamber until you come to your senses and until the pain subsides. In most cases, patients return to their wards after a few hours in the PACU, but some need to stay overnight for observation.

In the hospital room

After your stay in the wake-up room, you will be transferred to the hospital room. You will meet with one of the nurses who will look after you while you are in the hospital recovering from your surgery.

Use a stimulating spirometer. This will help expand the lungs, which will prevent pneumonia from developing. For more information, see the resource How to use your incentive spirometer. You should also talk with your doctor about how to use your incentive spirometer.

Read the material Call for help! Don’t fall! and find out what you can do to stay safe and avoid falls while you are in the hospital.

You may also have an ultrasound scan before you leave the hospital.This will allow us to check for blood clots. This will help us determine which blood thinning medication you should take after you are discharged. You will also be given antibiotics through an intravenous drip to help prevent infection.

Frequently Asked Questions: Hospital Stay

Will I have pain after surgery?

After surgery, you will experience some pain at the incision sites. The doctor and nurse will often ask you about your pain and give you medication as needed.If you do not have an epidural or conduction catheter, pain medication will be given through an IV line.

If pain persists, tell your doctor or nurse. Pain relief is essential to be able to use your incentive spirometer and get out of bed and walk.

You may be given a prescription for pain medication before leaving the hospital. Talk with your doctor or nurse about the possible side effects and when you should switch to over-the-counter pain relievers.

What other side effects can I expect after surgery?

After the operation, the skin under the incision will become numb. This is due to the fact that some of the nerve endings have been cut off. After a while, the numbness will disappear.

Will I be able to eat after surgery?

Yes. Eating a balanced, high-protein diet will help you recover from surgery. Your diet should include a source of healthy protein with every meal, as well as fruits, vegetables, and whole grains.For more tips on increasing the amount of calories and protein in your diet, read the resource Eating Eating Well During Cancer Treatment.

If you have questions about your diet, ask for a referral to a dietitian.

How long will it take for me to have the drains installed?

Drainage tubes usually remain for several days after surgery. How long this will last in your case depends on the amount of fluid released.The nurse will measure it 3 times a day. The doctor decides whether the amount of fluid allows the drainage to be removed.

Removal of drain tubing usually does not take long. This is done in the ward and you do not need to take pain medication. You may experience a burning sensation that lasts only a few minutes.

What exercises should I do while in the hospital?

Leg exercise can improve circulation and prevent blood clots.These exercises are described below in the Recommended Exercise During Your Hospital Stay section. Do them 10 times an hour while awake.

Are there any restrictions on what I can do immediately after surgery?

Yes. After hip replacement surgery, you must take special precautions with this hip joint.

These precautions may vary slightly depending on the type of surgery you have had.Your physical therapist (PT) and occupational therapist (OT) will review them with you. In most cases, patients need to follow the precautions listed below.

  • Do not bend at the waist or hips below a 90 degree angle.
  • Do not cross your legs while standing, sitting or lying down.
  • Do not twist the operated leg (which was being operated on) towards the other leg. When lying, sitting or standing, do not hold your feet “clubfoot” (do not turn your toes in).

If you need to take additional or different precautions, your doctor, PT and OT will review them with you. While you are in the hospital, PT and OT will teach you how to get in and out of bed safely. They will also show you how to do your daily self-care tasks, such as getting dressed and going to the bathroom, while taking these precautions. For more information, see the Hip Precautions section below.

How long will I be in the hospital?

In most cases, patients who have undergone hip replacement surgery remain in the hospital for about 4 days.

By the time you leave the hospital, the incision in your body will begin to heal. Review your incision with your nurse before leaving the hospital. Knowing what your incision looks like will help you notice how it changes later.

How do I prepare for hospital discharge?

A curator will be assigned to help you plan your discharge.Some patients are transferred to a short-term rehabilitation center after being discharged from the hospital. Others may go home immediately. It happens differently for everyone. Your care team, PT, OT, and case manager will work with you to determine which plan is best for you. Your caregiver can make sure you provide the equipment, nurse / nurse services, or the rehabilitation you need after you leave the hospital.

Frequently Asked Questions: After Checkout

Read the resource What You Can Do to Avoid Falls and what you can do to stay safe and avoid falls at home and during your visits to MSK.

Will I feel pain when I get home?

The duration of the presence of pain and discomfort is different for each person. You may feel pain when you return home, and you may be taking pain medication. For some people, incision pain, tightness, or muscle aches may last for 6 months or longer. This does not mean that something is wrong with you.

The following guidelines can help you manage pain at home.

  • Take your medicine as directed and as needed.
  • If the prescribed medication does not relieve your pain, contact your healthcare provider.
  • Do not drive or drink alcohol while you are taking prescription pain medication. Some prescription pain relievers can make you drowsy. Alcohol can worsen sedation.
  • As the incision heals, the pain will decrease and you will need less pain medication.Over-the-counter pain relievers such as acetaminophen (Tylenol ® ) or ibuprofen (Advil ® or Motrin ® ) can help relieve pain and discomfort.
    • Follow your healthcare provider’s advice to stop taking your prescribed pain medication.
    • Do not take any medications in excess of those indicated on the label, or follow your healthcare professional’s advice.
    • Carefully read the labels on all medicines you take, especially if you have been prescribed a medicine that contains acetaminophen.Acetaminophen is found in many OTC and prescription drugs. Too much is bad for the liver. Do not take more than one acetaminophen product without talking to your healthcare team.
  • Pain medications should help you get back to your normal routine. Take enough medication to keep you comfortable with your daily activities and exercise. A slight increase in pain with increasing physical activity is normal.
  • Keep track of the timing of your pain medication. They are most effective 30–45 minutes after ingestion. It is better to take the medicine at the first manifestations of pain, without waiting for its intensification.

Pain medications may cause constipation (less frequent bowel movements than usual).

How can I prevent constipation?

After your surgery, your usual time to empty your bowels may change. Possible problems with bowel movement (stool separation).Talk with your nurse about how to prevent constipation. You can also follow the guidelines below.

  • Go to the toilet at the same time every day. Your body will get used to emptying your bowels during this time. But if you feel like using the toilet, don’t put it off.
  • Try going to the bathroom 5-15 minutes after eating. We recommend emptying your bowels after breakfast. During this time, reflexes in the large intestine are strongest.
  • Exercise if you can.Hiking is great exercise.
  • If you can, drink 8 glasses (8 oz. (240 ml) each, 2 L total) of liquid daily. Drink water, juices, soups, milkshakes, and other decaffeinated drinks. Caffeinated beverages, such as coffee and soda, flush fluid from the body.
  • Gradually increase your dietary fiber content to 25–35 grams per day. Fiber is found in fruits, vegetables, whole grains, and cereals. If you have a stoma or recently had bowel surgery, check with your doctor or nurse before making any dietary changes.
  • Prescription and non-prescription medications are used to treat constipation. Start with one of the following over-the-counter medicines. Follow the directions on the medication label or as directed by your healthcare professional.
    • Docusate sodium (Colace ® ): This remedy softens stools with only mild side effects. Do not take it with mineral oil.
    • Polyethylene glycol (MiraLAX ® ): This product softens stools and causes only minor side effects.
    • Senna (Senokot ® ): This is a stimulant laxative that can cause cramping. It is best to take it before bed.
  • If you have not had a bowel movement in 2 days, call your doctor or nurse.

Read the resource Constipation for more information.

When do I need to change the dressing?

If you have received other instructions from your healthcare provider (for example, not to remove the dressing before the postoperative appointment), then only follow them.

If your healthcare provider has applied a regular bandage (white gauze and bandage) to the incision:

  • Do not remove or change the dressing within 2 days after surgery. Call your healthcare provider if your dressing is completely wet.
  • Carefully remove the bandage after two days. Replace it with clean, dry gauze.
  • Change the dressing daily and whenever it becomes wet or dirty.

If your healthcare provider has applied a Mepilex dressing to the incision (light brown dressing with a soft spongy coating in the middle):

  • Do not remove or change Mepilex within 1 week after surgery.
  • Carefully remove Mepilex after one week. Replace it with clean, dry gauze.
  • Change the dressing daily and whenever it becomes wet or dirty.

Inspect the incision every time the gauze is changed. The incision may be slightly red, swollen, and bruised near the incision. This is fine. If the area around the incision is severely red or swollen, or if you notice discharge (fluid) or foul odor coming from the incision, call your healthcare provider.These phenomena are signs of the development of an infection.

How do I care for my incision?

If you have received other instructions from a healthcare professional, then follow only them.

  • Do not wet the incision until your healthcare professional has examined it at your appointment for follow-up. You can wipe off with a damp sponge, but remember to cover the incision with a plastic bag, a clean trash bag, and tape, or plastic wrap and tape to prevent it from getting wet.Your healthcare professional will tell you when to start cleaning your incision.
  • Do not apply lotions or creams to your incision unless directed by your healthcare professional.
  • If you have stitches or staples in your incision, they will most likely be removed at your appointment for follow-up.
  • If you have Steri-Strips applied to your incision, leave it on until it falls off by itself or your healthcare provider removes it.
When can I shower?

You can shower after removing the stitches; this usually occurs 2-3 weeks after surgery.Until then, you can wipe your body with a sponge, but do not wet your incisions.

While showering, remove bandages and gently wash incisions with soap and water. Pat dry with a clean towel after showering. Do not close the incision unless fluid is escaping from the incision. If the discharge persists, apply a new bandage to the incision after showering.

Do not take a bath until you discuss it with your doctor at your first visit after surgery. Refrain from using the jacuzzi, sauna, and pool until your doctor or nurse tells you that you are allowed to do so.

What physical activity restrictions will I face after I am discharged?

After surgery, you must take special precautions for the hip joint. If you receive additional physiotherapy or rehabilitation therapy after you leave the hospital, the specialists working with you will continue to teach you how to move safely. This will allow you to get stronger and re-familiar with walking and your usual activities.

When is it safe for me to drive?

You can drive again when your doctor tells you it is safe.This usually happens 3 months after surgery.

When can I return to work?

The timing of returning to work depends on what kind of job you have, what kind of surgery you have undergone, and how quickly your body recovers. Ask your doctor when you can return to work.

When can I resume sexual activity?

Ask your doctor how soon after you are discharged you can resume sexual activity. In most cases, this happens 2 weeks after discharge.

To take precautions for the hip joint, you only have to limit the positions that can be used during intercourse. You can be on the bottom or lie on your side. Place 2 pillows between your knees to spread 6-10 inches (15-25 cm) apart.

Try to schedule sexual activity at a time when you feel better. Some patients feel better in the morning. Others feel stiffness and pain during this time.Pain medication can also help if you take it about 45 minutes before your desired time.

Are there any other mandatory precautions?

If you are about to undergo a procedure that may cause bleeding, you should tell your doctor or dentist that you have a hip prosthesis. You must take an antibiotic. If an infection gets into the body, it can affect the newly installed hip prosthesis.For more information, read our resource Preventing Infection at Your Bone or Joint Replacement Prosthesis.

Is it normal to feel tired after surgery?

Feeling tired (weak) is the most common side effect after hip replacement. This is fine. You may need to sleep during the day, but try to stay awake for as long as possible. This will help you sleep better at night.It usually takes 6-8 weeks to fully recover.

When can I lift weights or exercise?

Do not exercise or lift heavy objects until your doctor tells you to. You may need special instructions for doing the exercises.

How can I deal with my feelings?

After surgery due to a serious illness, you may experience a new feeling of depression.Many people say that at some point they felt like crying, had to experience sadness, anxiety, nervousness, irritation and anger. You may find that you are unable to contain some of these feelings. If this happens, try to find emotional support.

The first step on this journey is to share your feelings. Friends and family can help you. A nurse, doctor, and social worker can give you comfort and support and advice. Be sure to tell these professionals about your emotional state and about the emotional state of your friends and loved ones.Numerous materials are available for patients and their families. Whether you are in the hospital or at home, nurses, doctors, and social workers are ready to help you, your friends, and loved ones deal with the emotional aspects of illness.

When will my first visit to the doctor after surgery take place?

Your first visit to the doctor will take place approximately 2 weeks after you leave the hospital. Call your doctor’s office as soon as possible after discharge to make an appointment.

What if I have other questions?

If you have any questions or concerns, talk to your doctor or nurse. You can reach them Monday through Friday, 9:00 am to 5:00 pm.

After 5:00 pm and on weekends and holidays, call 212-639-2000 and ask the doctor who is on duty in your place.

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When to contact your healthcare provider

Tell your healthcare provider if you have:

  • Temperature 101 ° F (38.3 ° C) or higher
  • numbness, tingling (tingling), or burning sensation in toes;
  • pain that does not go away with pain medication, or worsening pain;
  • discharge or foul odor from the incision;
  • problems with the mobility of the toes;
  • Increased swelling that does not go away after lifting your hip that was undergoing hip replacement surgery;
  • Toes are too cold and do not get warmer when you cover them;
  • Increased redness around the incision
  • breathing problems;
  • any unexpected or unexplained problems occurred;
  • have any questions or concerns.

Recommended Exercise During Your Hospital Stay

Wiggle foot

Figure 1. Wiggle foot

  1. Lie on your back with pillows under your head and shoulders.
    You can also do this exercise while sitting.
  2. Lift your toes up towards your nose (see Figure 1).
    You can do the exercise with both feet at the same time.
  3. Then lower them towards the floor.
  4. Repeat 10 times.

Do this exercise every hour while you are awake.

Compress Quads

Figure 2. Compression of the quads

  1. Lie on your back with pillows under your head and shoulders.
  2. Straighten your legs as much as possible.
  3. Press the back of your knees into the bed while contracting your upper thigh muscles (see illustration).Figure 2).
  4. Stay in this position, counting aloud to 5.
  5. Relax.
  6. Repeat 10 times.

Do this exercise every hour while you are awake.

Glute Compression

Figure 3. Compression of the gluteus muscles

  1. Lie on your back with pillows under your head and shoulders.
  2. Straighten your legs as much as possible.
  3. Squeeze your glutes tightly (see Figure 3).
  4. Stay in this position, counting aloud to 5.
  5. Relax your buttocks.
  6. Repeat 10 times.

Do this exercise every hour while you are awake.

Precautions for the hip joint

Movement safety when performing daily activities

You need to take special precautions for your hip joint.The following is a guide to making changes in your daily activities to help you ensure that these precautions are followed.

Stand with your toes straight and feet about 6-10 inches (15-25 cm) apart. Do not stand with your toes pointing in or out (see Figure 1).

Figure 1. Standing postures after hip replacement

When you need to lift something, use a special tool (see.Figure 2). Don’t bend over.

Figure 2. Using the Object Lifting Tool

The upper and lower parts of the body should move as one whole. Make sure your shoulders, hips and knees point in the same direction as your feet (see Figure 3). Don’t twist your body.

Figure 3. Upper and lower body move as one unit

To get out of a chair, move to the edge and lean on the armrests (see.Figure 4). When standing up, do not bend forward.

Figure 4. Rising from a chair

Place a raised toilet seat and a firm cushion while sitting on the chair (see Figure 5). Don’t sit on low seats.

Figure 5. Sitting on hard chairs

Do not cross your legs while sitting (see Figure 6). Do not cross your legs while sitting or lying down.

Figure 6. Sitting with uncrossed legs

Put on the slippers while standing (see Figure 7). Don’t bend down or to the side to get the slippers out from under the bed.

Figure 7. Putting on slippers while standing

Before going to bed, lift and stretch the blanket or sheet up to half of your body (see Figure 8).Do not bend forward to pick up and pull them while lying in bed.

Figure 8. Pulling up the blanket before going to bed

If you sleep on your back, place 1 pillow between your legs. When sleeping on your side, lay 2 pillows. You can also lie on your stomach if you turn over the non-operated side (the side where there was no operation), place a pillow between your legs, and rotate the operated leg (the leg on which the operation was performed) with the body as a whole.The foot, knee, and thigh must rotate at the same time (see Figure 9).

Figure 9. Sleep positions after hip replacement

Avoid sleeping on your back or on the unoperated side without a pillow between your legs. Do not lie on the operated side (the side where the operation was performed).

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Support services

This section provides a list of support services that can help you prepare for and recover from surgery.

As you read this section, write down the questions you want to ask your healthcare provider.

MSK Support Services

Admitting Office
212-639-7606
Call if you have questions about hospitalization, including requesting a single room.

Anesthesia Department
212-639-6840
Call if you have questions about anesthesia.

Blood Donor Room
212-639-7643
Call for more information if you would like to become a blood or platelet donor.

Bobst International Center
888-675-7722
MSK accepts patients from all over the world. If you are from another country, call for help arranging your treatment.

Chaplaincy Service
212-639-5982
At MSK, chaplains are ready to listen, support family members, pray, reach out to local clergy or religious groups, or simply provide comfort and a helping hand.Anyone can apply for spiritual support, regardless of their formal religious affiliation. The Interfaith Chapel is located next to Memorial Hospital’s main lobby and is open 24 hours a day. If you have an emergency, call the hospital operator and ask to speak to the duty chaplain.

Counseling Center
646-888-0200
Psychological counseling helps many people.We provide counseling for individuals, couples, families and groups of individuals, and we provide medications to help you cope with anxiety or depression. To make an appointment, ask your healthcare provider for a referral or call the phone number above.

Food Pantry Program
646-888-8055
The Food Pantry Program provides food to low-income patients during cancer treatment.For more information, contact your healthcare provider or call the phone number above.

Integrative Medicine Service
646-888-0800
The Integrative Medicine Service offers a variety of services to complement traditional health care. These services include music therapy, mind / body therapy, dance and movement therapy, yoga and tactile therapy.

MSK Library
library.mskcc.org
212-639-7439
You can visit our library website or contact library staff for more information on a particular type of cancer. Alternatively, you can check out the LibGuides section on the MSK library website at libguides.mskcc.org.

Patient and Caregiver Education
www.mskcc.org/pe
Visit the Patient and Caregiver Education website to find educational materials in our virtual library.You can find learning resources, videos, and online programs.

Patient and Caregiver Peer Support Program
212-639-5007
You may be encouraged to talk to someone who has received treatment like yours. Through our Patient and Caregiver Peer Support Program, you can talk to a former MSK patient or caregiver.Such conversations are confidential. You can communicate in person or by phone.

Patient Billing
646-227-3378
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.

Patient Representative Office
212-639-7202
Call if you have questions about a health care power of attorney or concerns about caring for you.

Perioperative Nurse Liaison
212-639-5935
Call if you have questions about who MSK will share your information with during surgery.

Private Duty Nursing Office
212-639-6892
You can request the assistance of a Private Duty Nursing Office or Companions. Call for more information.

Resources for Life After Cancer [RLAC] Program
646-888-8106
At MSK, patient care does not end after active treatment is completed. The Resources for Life After Cancer (RLAC) program is designed for patients who have completed their treatment and for their families. This program offers a variety of services such as workshops, workshops, support groups, and post-treatment counseling.She also helps with health insurance and employment issues.

Sexual Health Programs
Cancer and cancer treatments can affect your sexual health. MSK’s Sexual Health Program can help you get started and address sexual health issues before, during, and after treatment.

  • Our Women’s Sexual and Reproductive Medicine Program can help you if you have cancer-related sexual health problems such as premature menopause or decreased fertility.For more information or to make an appointment, call 646-888-5076.
  • Our Sexual and Reproductive Medicine Program for Men can help you if you have a cancer-related sexual health problem such as erectile dysfunction (ED). For more information and to make an appointment, call 646-888-6024.

Social Work
212-639-7020
Social workers help patients, their families and friends cope with the challenges of cancer.They provide one-on-one counseling and support groups during your treatment and can help you connect with your children and other family members. Our social workers can also refer you to local agencies and programs, and provide information on additional financial resources, if you are eligible.

Tobacco Treatment Program
212-610-0507
If you want to quit smoking, MSK has specialists who can help.Call for more information.

Virtual Programs
www.mskcc.org/vp
MSK Virtual Programs offer online training and support for patients and their caregivers, even if you cannot come to MSK in person. Through interactive activities, you can learn more about your diagnosis and what to expect during treatment and how to prepare for the different stages of cancer treatment. Classes are held confidentially, free of charge and with the involvement of highly qualified medical professionals.If you would like to join the virtual training program, visit our website at www.mskcc.org/vp for more information.

For more information online, see the Cancer Types section of www.mskcc.org.

External support services

Access-A-Ride Organization
web.mta.info/nyct/paratran/guide.htm
877-337-2017
MTA New York offers co-op travel and escort services for people with disabilities who are not can take the bus or metro.

Air Charity Network
www.aircharitynetwork.org
877-621-7177
Provides travel to treatment centers.

American Cancer Society (ACS)
www.cancer.org
800-ACS-2345 (800-227-2345)
Offers a variety of information and services, including Hope Shelter ( Hope Lodge is a free stay for patients and their caregivers during cancer treatment.

Cancer and Careers website
www.cancerandcareers.org
A resource for educational materials, tools and information on various activities for working people with cancer.

Cancer Organization Care
www.cancercare.org
800-813-4673
275 Seventh Avenue (between West 25 th Street and 26 th Street)
New York, NY 10001
Consulting, Groups support, educational workshops, publications and financial assistance.

Cancer Support Community
www.cancersupportcommunity.org
Provides support and educational materials for people facing cancer.

Caregiver Action Network
www.caregiveraction.org
800-896-3650
Provides educational materials and support for people caring for loved ones with a chronic illness or disability.

Corporate Angel Network Organization
www.corpangelnetwork.org
866-328-1313
Offers free travel for medical treatment around the country at the expense of seats on corporate flights.

Gilda’s Club
www.gildasclubnyc.org
212-647-9700
A place where men, women and children with cancer receive social and emotional support through communication, workshops, lectures and social events.

Good Days Organization
www.mygooddays.org
877-968-7233
Offers financial assistance to cover co-payments during treatment. Patients must have health insurance, they must meet a number of criteria, and they must be prescribed medications that are on the Good Days formulary.

Healthwell Foundation
www.healthwellfoundation.org
800-675-8416
Provides financial assistance to cover co-payments, health insurance premiums, and deductibles for certain drugs and treatments.

Joe’s House
www.joeshouse.org
877-563-7468
Provides cancer patients and their families with a list of places to stay near treatment centers.

LGBT Cancer Project Resource
http://lgbtcancer.com/
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT tolerant clinical trials.

LIVESTRONG Fertility Organization
www.livestrong.org/we-can-help/fertility-services
855-744-7777
Provides information on fertility and support for cancer patients whose treatment involves fertility risks and cancer survivors.

Look Good Feel Better Program
www.lookgoodfeelbetter.org
800-395-LOOK (800-395-5665)
This program offers workshops to help you learn more positively perceive your appearance.For more information or to sign up for a workshop, call the above phone number or visit the program website.

National Cancer Institute
www.cancer.gov
800-4-CANCER (800-422-6237)

National Cancer Legal Services Network
www.nclsn.org
Free Cancer Legal Advocacy Program.

National LGBT Cancer Network
www.cancer-network.org
Provides educational materials, training courses, and advocacy for LGBT cancer survivors at risk.

Needy Meds Resource
www.needymeds.org
Provides a list of programs that support patients in obtaining generic and registered brand drugs.

NYRx Organization
www.nyrxplan.com
Provides prescription drug benefits to current and former NYS employees who meet certain eligibility requirements.

Partnership for Prescription Assistance
www.pparx.org
888-477-2669
Assists eligible patients who do not have prescription drug coverage get free or buy drugs them at a low cost.

Patient Access Network Foundation
www.panfoundation.org
866-316-7263
Provides co-pay assistance for insured patients.

Patient Advocate Foundation
www.patientadvocate.org
800-532-5274
Provides access to medical care, financial assistance, insurance assistance, job security and access to a national resource directory for people with insufficient health insurance.

Organization RxHope
www.rxhope.com
877-267-0517
Provides assistance with getting medicines that people may not have enough money for.

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Educational resources

This section provides a list of the training materials that have been referenced in this manual. These materials will help you prepare for your surgery and recover safely from it.

As you read this resource, write down the questions you want to ask your healthcare provider.

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