Osteoarthritis is the wear and tear arthritis that many people suffer from as they age. It happens over time as the protective layer or cartilage on the end of the bone starts to breakdown. This changes how the joint glides and can lead to stiffness and pain.  Pain from hip arthritis is typically felt in the groin and along the front of the thigh.

Hip arthritis is usually diagnosed through a physical exam in combination with X-rays. An arthritic hip will demonstrate less joint space as compared to a healthy hip due to the protective covering on the end of the bone being worn away.
Treatment options typically start conservative, but end stage disease often leads to hip replacements. Non-surgical treatments can include medication, steroid injections, and/or physical therapy.

​During an initial evaluation of a patient with arthritis, I am often asked the same question:  If I already have arthritis, can physical therapy really help?   The answer to this question is definitely yes.  I would like to break down the types of exercise you might be asked to perform in a therapy session and the exact reasons why this will help with your pain and function.

Range of Motion/Stretching
By increasing joint range of motion, we are trying to accomplish several things.

• A joint must go through its full range on a daily basis to remain healthy.  Without the full range of motion, a nutrient rich and internally lubricating fluid known as synovial fluid cannot properly circulate and coat the joint surface.  Over time, this will lead to stiffness and further joint deterioration.
• Stretching a painful muscle or muscle spasm can activate internal stretch receptors in the muscle tendon unit, which helps the muscle to relax.  It can also change the blood flow to the area or affect the input on the nerve which results in some pain relief.
• Stretching releases positive endorphins and neurotransmitters in the brain which helps us to feel better.
• By improving joint range of motion, you can better perform tasks such as putting on your shoes and socks.

​Strengthening

• Strong muscles help keep joints stable and, as a result, decrease pain.
• By making your muscles stronger, it improves your ability to perform functional tasks such as climbing stairs or getting up out of a chair easier.

Endurance exercise

• Improves cardiovascular health.  This improves our overall health which leads to healthier joints and muscles.  It also decreases fatigue with daily tasks.
• Cardiovascular exercises such as riding a stationary bike help control weight which leads to less stress in the joints.
• Daily exercise has been proven to improve our mood by releasing positive endorphins.   This decreases pain and helps improve sleep.

Balance/neuromuscular reeducation exercises

• Our body has small muscles that surround each joint. The job of these muscles is to send information about the joint position to the brain. This information helps the brain to determine what signals to send to the muscles concerning how far, how fast, and how powerfully to move. Improving this mechanism will decrease forces on your joint and let you move less painfully.
• When we lose our balance, we use our ankle and hip muscles to try to regain our balance. By improving the hip strategy, we decrease our fall risk which allows us to perform more challenging tasks.

These four categories cover the majority of exercises your therapist might ask you to perform during your therapy sessions and at home.  It is important that you and your therapist establish goals together to direct your treatment and to make sure you get back to performing the things that you enjoy in life.  Building a good relationship with your physical therapist will help you to determine when and if you need to consider a total hip replacement.

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•    Get down on the ground

Many acute or new back injuries are related to the intervertebral disc in the spine.  Most of the time there has been some tearing of the outer fibers of the disc and an inflammatory process quickly starts.  Find a surface that is flat and lie on your stomach.  This may not be comfortable, but can be the most important thing you do!  Lying flat puts your spine in a good position to minimize damage and swelling around the injury.

• Avoid sitting for any length of time

When I say don’t sit, I mean Do Not Sit.  I tell my patients they can lay flat on their stomach or back or they can stand.  Sitting puts pressure on the back of that disc and inevitably will make it worse.  Many times, sitting can feel better, but it is almost never the right position for you.  Sitting to eat is fine, but other than that, no sitting for the first couple days after the injury.

• Ice it don’t Heat it!

When there is an acute inflammatory process, you want to put ice on the low back because it will decrease swelling.  Heat can feel better, but may also cause more blood flow to the area.  After the first couple of days heat is okay if it feels like it relieves symptoms or relaxes muscle spasm, but not right after the injury.

• No stretching the back muscles even if it does feel good

You will get some muscle spasm with new back injuries, but that doesn’t mean you need to stretch them by bending forward.  Often, flexing and bending will make the problem worse in the long run, even if you feel like the stretching relieves tightness in the muscles.  No knees to chest!

• Don’t ignore serious symptoms even if you are embarrassed

Large disc problems and pressure on the spinal cord can cause inability to control the bowel and bladder as well as severe back pain.  Patients do not often like to admit this, but it is very serious.  This loss of control can be permanent if it is not addressed quickly.  Other signs of a serious problem are progressive leg weakness or symptoms down both legs.  If you have these problems you need to see a doctor immediately.

​Hopefully this helps address some of the misconceptions and questions that people have after a new back injury. If you have further questions, give us a call or send us an email.  We are happy to help!

​​To Schedule An Appointment
Call 304.525.4445

Chronic pain is defined by pain that has lasted longer than 3 months. The National Institute of Health reports that 80% of Americans will suffer from back pain in their lives.  Of the people that have back pain, approximately 7% of those people will suffer chronic back pain.  If you do a little quick math, you will find that approximately 18 million people in the United States will suffer from chronic low back pain.  That statistic is staggering, and it doesn’t even take into account the people in the U.S. that have chronic neck pain. Chronic pain doesn’t have to be severe to be addressed and treated.  If your pain and problems are limiting your ability to live life the way you want, then you deserve treatment and improvement.

Treatment methods for chronic pain include medication, injections, counseling, physical therapy, and some surgical options. While any of these methods could work for you, physical therapy has been shown to be efficient and cost effective.  A recent study published in the Journal of Orthopedic and Physical Therapy shows that “patients who chose to enter care via the direct access physical therapy-led spine management program displayed significantly less costs ($1,543 on average) than those who chose traditional medical referrals”. This statistic is particularly relevant in today’s health care atmosphere because of the rising cost of healthcare.   Physical therapy is cheaper, less invasive, and more comprehensive because it uses a whole body approach to treatment.

The whole body approach takes into account not only the location of the pain, but also other areas of the body that can be contributing, as well as psychosocial components. Treatment of chronic pain cannot just focus on one joint or area.  One must evaluate the body as a whole and determine how all the different pieces are working in concert with each other, including the brain.  Those that have had pain for a long time know that the problem is no longer just physical, but also mental. Unless both components are addressed, it will be difficult to gain control over it and achieve a lasting resolution.

​True chronic pain can take several months to properly address, but that doesn’t mean that meaningful progress cannot be made in a short period of time.  Treatment should focus on small victories.  Much of the program can, and should, be done independently with guidance from your PT.  The ultimate goal is to gain an understanding of your problem and learn management techniques that can be used to proactively address the pain.
If you are someone with chronic pain that has not sought treatment, now is the time!  Waiting to see if the pain goes away is not a treatment, it is wishful thinking.   A physical therapist with experience treating chronic pain problems is an excellent resource to get you on the road to recovery.  Contact a physical therapist today and let them guide you on the path to taking control of your life and well being!

​To Schedule An Appointment
Call 304.525.4445