Managing Pain After Hip Surgery: What to Do Next?

Nail problems

Hello Dr.
Lee,
I would like to ask about my father.
He fell previously and fractured the bone connecting his pelvis to his thigh.
The doctor performed surgery and inserted a plate.
However, it has been three months since the surgery, and the doctor mentioned that we allowed my father to bear weight too soon, which has resulted in significant thigh pain.
The doctor only prescribed pain medication, but my father is still experiencing pain and his legs tremble when he stands, making it difficult for him to stand for long periods.

Is there any way for him to stand? Thank you.

Mr. Zhang, 40~49 year old female. Ask Date: 2018/04/12

Dr. Li Yongheng reply Orthopedics

The X-ray you provided shows that the bone screw has protruded from the femoral head, but the fracture reduction and healing speed are still acceptable.
Therefore, I recommend another surgery to replace the screw with a shorter one.
After the screw replacement, standing exercises can be practiced, and walking can be attempted in about two months.
Wishing your father a speedy recovery.

Reply Date: 2018/04/12

More Info

Managing pain after hip surgery can be a complex process, especially when complications arise or when recovery does not go as planned. In your father's case, it seems that he has experienced significant pain and difficulty standing three months post-surgery, which is concerning. Here are some insights and recommendations based on your description and general medical knowledge.

Understanding Post-Surgical Pain
After hip surgery, especially in cases involving fractures or significant trauma, it is common for patients to experience pain as they begin to mobilize. This pain can stem from several factors, including:
1. Healing Process: The body needs time to heal after surgery. Bone and soft tissue healing can take weeks to months, and pain is often a part of this process.

2. Nerve Sensitivity: Surgery can irritate nearby nerves, leading to pain or discomfort that may feel different from the original injury.

3. Muscle Weakness: If your father has been less active due to pain or fear of movement, muscle atrophy can occur, leading to weakness and instability when trying to stand or walk.

4. Improper Weight Bearing: If your father was advised to avoid putting weight on the affected leg too soon, this could lead to complications or prolonged pain when he does attempt to stand.

Recommendations for Management
1. Follow-Up with the Surgeon: It is crucial to maintain regular follow-up appointments with the orthopedic surgeon. If your father is experiencing persistent pain, it may be necessary to reassess his condition through imaging (like X-rays) to ensure that the bone is healing properly and that there are no complications such as malunion or nonunion of the fracture.

2. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can provide exercises tailored to your father's condition, focusing on strengthening the muscles around the hip, improving balance, and gradually increasing weight-bearing activities. This can help alleviate pain and improve function.

3. Pain Management: While pain medications can help, they should be used judiciously. If the current pain management plan is insufficient, discuss alternative pain relief options with the doctor. This might include adjusting the dosage of pain medications, trying different medications, or exploring non-pharmacological options such as heat therapy, ice packs, or transcutaneous electrical nerve stimulation (TENS).

4. Gradual Weight Bearing: If the doctor has indicated that your father is ready to start bearing weight on the affected leg, it should be done gradually. Using assistive devices like a walker or crutches can help provide stability and reduce the risk of falls.

5. Home Modifications: Ensure that the home environment is safe for your father. This includes removing tripping hazards, ensuring adequate lighting, and possibly installing grab bars in the bathroom or other areas where he may need support.

6. Nutrition and Hydration: Proper nutrition plays a vital role in recovery. Ensure that your father is consuming a balanced diet rich in calcium and vitamin D to support bone health. Staying hydrated is also important for overall recovery.

Conclusion
In summary, while it is not uncommon for patients to experience pain and difficulty standing after hip surgery, persistent pain warrants further evaluation. Collaborating closely with healthcare providers, including the orthopedic surgeon and physical therapist, will be essential in managing your father's recovery effectively. Encourage him to be patient with the healing process, as recovery can take time, and gradual progress is often the key to regaining strength and mobility.

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