Last year, I had my youngest-ever patient come in looking for naturopathic medicine support to help get through an upcoming hip replacement surgery. A lifelong long distance runner with a tip-top attitude, he told me his original hip warrantee had expired and he was going in for a spanky new one. He was 37 years old. Total joint replacement (hip or knee) has become one of the most common surgeries in the U.S. and the most common surgery covered by Medicare. More than 300,000 total hip replacements are performed each year in America. As baby boomers grow older and live longer, hip replacement surgeries will become even more commonplace. If you are facing a hip replacement, you will want effective strategies to manage pre- and post-operative pain, maximize mobility, and speed your recovery.
Naturopathic medicine can help support hip replacement patients—before surgery, immediately after the operation, and during the rehabilitation process to help address pain, shorten recovery and improve outcomes.
Hip Replacements More Common in 40s, 50s and Beyond
With ongoing innovations in surgical technique and implant design, outcomes of hip replacement surgery have improved significantly over the years. Most patients report better quality of life after hip replacement surgery, and according to the American Association of Orthopedic Surgeons, serious complications now occur in less than 2% of patients. While the standard recommendation in years past was to wait as long as possible before choosing hip surgery because the replacement parts did not last, today’s implant parts are more durable. Consequently, patients are opting for surgery earlier in life, such as my recent patient.
The most common reasons to have a hip replaced are osteoarthritis, rheumatoid arthritis, and/or a history of trauma to the area—each of which leads to marked pain, reduced range of motion, and decreased capacity for walking, exercising, and the activities of daily living.
Additionally, avid runners, cyclists and other individuals who consistently practice strenuous exercise experience more wear and tear on weight-bearing joints including the hip. This is one reason why we see younger people, unwilling to accept ongoing discomfort or interference with an active lifestyle, choose hip replacement.
Rising obesity rates and the resulting extra load on weight-bearing joints also contributes to younger people having joint replacement surgery.
An x-ray of the hip must show substantial damage to the joint before a patient would be a good candidate for total hip replacement. The operation involves removing damaged areas from the head of the thigh bone and damaged cartilage from the surface of the hip socket and then inserting metal, plastic, and/or ceramic components to create a smooth gliding surface for the joint.
Often, before arriving at the point of surgery, most people who eventually have a hip replaced must address pain, discomfort, and inability to move with ease.
Hip Pain Can Be Safely Addressed with Natural Medicine Options
Many hip pain patients are taking over-the-counter or prescription painkillers to get through their days. Sometimes, these medications are not as effective as patients want them to be, and oftentimes, side effects of non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, and Celebrex® begin to mount. From digestive issues like stomach pain or bleeding ulcers, to cardiac problems to weakness, unwanted impacts from these medications can be challenging. Patients also develop tolerance to medications, especially if they are taking narcotic pain relievers, so more is needed to attain the same effect.
Injecting corticosteroids into the painful joint is another common treatment for hip pain. While this can provide welcome relief in the short-term, studiesshow it may hasten the degeneration of joint cartilage if used too frequently.
And, many hip pain patients begin taking opioids to relieve day-to-day pain after their surgery, if not before. When absolutely indicated and used judiciously, these drugs can be very useful. But there are so many ways the use of opioids can go wrong, and patients can easily become addicted. Statisticsshow that overdose is now the leading cause of accidental death in the U.S., with opioid overdoses making up the bulk of those deaths.
Here are 10 natural strategies to address hip pain and promote healing—not only before surgery, but also afterward during post-operative recovery. Keep in mind, the most effective natural medicine strategies are individualized for the patient. A licensed naturopathic doctor is an excellent resource for evaluating individual needs and developing a personalized health plan.
1. Reduce underlying inflammation with diet.An anti-inflammatory diet can help reduce joint pain and inflammation. This includes: plentiful fresh vegetables and fruits, beans and nuts, whole grains, cold water fish, and fresh herbs and spices. Pomegranate juice is another great anti-inflammatory. After surgery, eating adequate animal protein and reducing refined carbohydrates, simple sugars, and alcohol can help promote tissue healing.
2. Use natural anti-inflammatory and nutritional supplementsthat support healthy connective tissue and also help reduce inflammation that causes pain.
3. Lose weight. Weight loss is important for patients who are overweight or obese. Carrying extra weight puts additional stress on the joints and leads to more pain. Future hip replacement surgery, recovery, physical therapy, and enduring healing will be easier for those at a healthy weight.
4. Eat bone broths. Soups made from chicken or other meat/fish that have been cooked for a long time—8 to 10 hours or more. Bone broth is packed with the amino acids glycine and proline, which help to build muscle and repair tissue. The gelatin in bone broth supports wound healing and decrease recovery time. We also find nutrients like glucosamine and chondroitin, which are helpful for painful joints.
5. Eat cultured foods and take a probiotic supplement.Sauerkraut, kefir, yogurt, kombucha, and miso help to diversify and make more robust the bacterial flora in the gut. This helps decrease the risk for infection after surgery and promotes healing.
6. Engage the brain in healing.Positive imagery and/or guided meditation or mindfulness meditation can be helpful to both address pain and to promote healing. Good online resources include things like this and this.
7. Keep moving. Because joints bear less weight in water, swimming, water aerobics, or even just water walking may be easier than other forms of land exercise. Exercise helps keep the blood moving, which is essential preparation for post-surgical healing. Good blood flow amplifies all the other good work a patient is doing. For instance, if you are eating well, taking your supplements, and using positive imagery, then moving your healthier blood to all the places it needs to go stretches the positive impact of all the good choices you’ve made.And reaching optimal health, post-surgery, will be supported by regular exercise. Of course high impact exercises are less appropriate but talk to your doctor about what would be good for you.
8. Use physical therapy as well as other appropriate bodyworkincluding chiropractic, Alexander Technique, Bowen therapy, massage therapy, neuromuscular therapy, myofascial release, trigger point therapy, and acupuncture can help people maintain and regain mobility. Bodywork should be individualized to the patient and sought once your surgeon says you’re ready for it.
9. Stop smoking. Smoking reduces blood flow and interferes with good health in general. Studiesshow that patients that smoke have more complications during and after surgery than non-smokers.
10. Get fit for custom orthotics.Many of my patients have benefits from good supportive shoes and orthotics made for their anatomy, gait and foot placement patterns.
With all the advances that continue to be made in the field of orthopedics, patients with long-standing or severe hip pain who are candidates for hip replacement have more hope and more options. Going into a hip replacement with knowledge and understanding of all the things you can do, including natural integrative medicine, to assure a good outcome, should offer confidence about having a successful outcome with surgery. As to my 37, now 38 year old fellow, a model patient in all regards, 6 months after surgery, he is now back to running, though keeping his mileage down, with his beautiful pain-free new hip!
These FAQs on naturopathic medicine as well as this patient gallery, both from the Institute of Natural Medicine might be of interest to you. And if you think the skills and expertise of a licensed naturopathic doctor might be a good match for where you are right now, you can find one here.
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