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Hip Pain Relief

Hip pain relief is one way to delay the need for hip surgery. Managing the severity of the pain won't stop the progression of the disease, let alone cure it, but it might mean you can postpone surgery.

Three Things You Must Know About Hip Pain Relief

Pain medication work best when the pain is just starting. doctor

Many of us are reluctant to take medication and wait till the pain gets unbearable - that is not a good strategy. Take the medication as soon as the pain starts - don't let it get a hold
If you are taking any over the counter medication or any supplements on a regular basis it is essential to let your doctor and pharmacist know.

As an example. When you have your operation you will be given anti-coagulants to help prevent a DVT forming. If you are given too high a dose it will be hard to stop any bleeding - getting the correct dose is essential. However other medication and supplements also have anticoagulant properties e.g. aspirin and ginko biloba so your doctor MUST know if you are taking these in order to get the dose right.
If a single medication doesn't prove to be effective your doctor can, and probably, will prescribe two different medications in order to get the most effective hip pain relief. So do let them know about your pain levels. There is no need to suffer.

Hip Pain Treatment

There is a wide range of medications that can help with hip pain relief.

Pain killers

Called analgesics by medics (from the latin an = without and algos = pain). They come in three main forms

Paracetamol
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Opioids

For pain without inflammation

Paracetamol (known in the US as acetaminophen) is the most widely used analgesic for non-inflammatory pain.

These work simply by masking the pain so you must take care not to push yourself to hard as you will not be receiving the usual pain signals telling you that it's time to stop.

For pain with inflammation

NSAID (nonsteroidal anti-inflammatory drugs) include aspirin and ibuprofen.

Side effects of NSAID include stomach ulcers and damage to the kidneys

NSAID inhibit the action of two enzymes called COX-1 and COX-2 (COX is short for cyclooxygenase). COX-2 is responsible for the feeling of pain caused by arthritis. Whilst COX-1 protects the stomach lining. So taking traditional NSAIDs can lead to stomach problems. The newer versions, called selective COX-2 inhibitors, work only on the COX-2 enzyme leaving the COX-1 enzyme in place to do its work.

COX-2 inhibitors don't give a better level of pain relief than COX-1s but they do lessen the chances of incurring a stomach ulcer.

Opioids

These are great at relieving pain. They also produce a feeling of well-being, cause sleepiness.

It is because of the feelings of well-being they create that they are regularly sold on the black market.

The downsides are that they are addictive, they become less effective with time and cause constipation. Taken over a short period of time they are very effective.

Examples are tramadol and codeine.

Different doctors have strong opinions about which to use. My GP immediately took me off the codeine I'd been prescribed in hospital replacing it with tramadol.

Corticosteroid

These are derived from hormones produced by the adrenal glands examples are prednisolone or cortisone.

Corticosteroids have a strong anti-inflammatory effect. They work by suppressing the formation of prostaglandins - which are pain producing compounds. They are frequently used in the treatment of rheumatoid arthritis if NSAIDs aren't effective.

However they must be used with caution as the can cause further damage to the bones (osteoporosis) in the joint and are associated with weight gain and lower resistance to infections.

Serious side effects may occur with long-term or heavy use. These include stomach ulcers, avascular necrosis and osteoporosis.

Although it is common to inject these directly into the knee (intra-articular) for people with knee problems it is much more difficult to give an injection into the hip joint as the joint is much deeper. Results can be unpredictable. Using fluoroscopy (a continuous X-ray) to guide the injection is recommended.

Pain-relieving creams and rubs

Topical analgesics are creams applied at the site of pain e.g. capsaicin.

Capsaicin works by depleting or interfering with a chemical called substance P. This chemical is involved in the transmission of pain impulses to the brain.

For effective hip pain relief it needs to be taken for about two weeks before becoming effective and is not suitable for everyone especially pregnant/breast feeding mothers, people prone to skin irritation or who have a rash or broken skin.

In the UK it is only available on prescription.

Glucosamine and Chondroitin

These are both readily available over the counter from chemists and health food stores. A vegetarian version of glucosamine is now available.

Academic research into the efficacy of these supplements has never been consistent but recently (17th Sept 2010) a review of 10 trails of glucosamine and chondroitin states that they just don't work.

But try telling that to the mass of people, worldwide who swear they work resulting in sales of well over £1 billion pounds per year. Is it really just a placebo effect?

Owing to the controversy of their effectiveness neither supplement is available on the NHS.

Advocates of the products emphasise the need for long-term use opponents say that is simply a way to persuade you to buy more.

Joint lubricants

These are injection into the joint to relieve pain. For example hyaluronan or hyaluronic acid. The manufacturers claim they work by stimulating cartilage growth. Difficulties with hip injections have already been discussed.