Hip Non operative techniques
Non operative techniques are useful in the earlier stages of arthritis, and there are multiple techniques which work together to help alleviate some of the discomfort. Below are a few examples, and combined together can be effective for mild and moderate arthritis
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Physio
A structured exercise programme can help many patients with early arthritis. Maintaining strength, stability and movement helps how a joint feels and functions. As arthritis progresses, these techniques become less effective and other methods to help the pain should be considered.
Tablets
Simple painkillers are a good adjunct for arthritis pain. Paracetamol is a good place to start, and short term use of anti inflammatories are helpful if you don’t have stomach, kidney or cardiac issues. If the pain needs stronger opiates, then its worth considering operative management to give you more longer lasting pain relief than relying on strong medication with their associated side effects.
Diet & Supplements
A diet or supplements aiming at reducing inflammation has some merit, but there is no strong evidence that it will make a prolonged difference. Nonetheless some people do find that a low salt mediterranean diet, or supplements such as cod liver oil, glucosamine or turmeric may help.Â
Weight Management
We all have different body shapes, and when we have joint pain it’s very easy to put on a bit of weight. Extra weight increases the forces through the joints, and it’s suggested that an extra 1kg on the body is equivalent to an extra 4-5kg through the hips and knees! What we also know is that if our height to weight ratio, or Body Mass index (BMI) is higher than we have an increased risk of infection when having a joint replacement. From baseline a BMI >35 has 2 times, and a BMI >40 has a 3 times increased risk of infection. It’s important that our BMI is ideally less 40 prior to surgery, and hopefully less than 35 to minimise risks. That’s not always easy, so you may need help from your GP and a dietician.Â
Activity Modification
It makes sense that higher impact activities on your joints will cause more pain, so substituting sports form running to swimming or cycling can help with the pain. Aerobic low impact exercises are good for your general health, mental health and muscle strength, all of which help your joint pain.Â
Injections
There are 3 main types of injections that are useful for mild and moderate arthritis. As arthritis becomes more advanced the injections become less effective and don’t last as long. There are broadly 3 types of injections:
1. Cortisone
These are cost effective injections, and whilst they act quickly, they wear off quickly as well, with most injections lasting around 3 months. They act by suppressing the body’s response to inflammation, so if injected within a few months of surgery can increase the infection rate of a joint replacement.
2. Hyaluronic Acid
These injections aim to reproduce the lubrication fluid in the joint. they have various names such as Synvisc, monovisc, durolane, cingal to name a few.  Following an injection most patients get around 4 months of reduced pain, with a small risk of an allergic reaction.
3. PRP Injections
In this technique your own blood is taken and is then centrifuged, with the healing proteins preferentially removed and injected back into the joint. There is a low risk of any adverse effects, and the pain is reduced for 6 months on average. For arthritis the evidence supports 3 low volume injections, or a single higher dose injection.
