Managing Hip Surgery Recovery: Overcoming Pain and Mobility Challenges

Hip joint surgery

Hello Doctor: My mother-in-law fell a year ago and had her left hip joint replaced.
After the surgery, she was afraid of pain and, due to her weight (92 kg), she has been reluctant to move around.
She spends all day sitting in a chair and is unwilling to participate in rehabilitation.
In recent months, she frequently complains of foot pain and has difficulty walking.
Whenever she needs to move, she asks family members to drive her to the clinic for pain injections.
She keeps saying that she has tendonitis and that she will be able to walk once the inflammation subsides.
However, she refuses to return to a major hospital for follow-up.
Doctor, what should we do? Could she be experiencing muscle weakness or adhesions?

Shen Tai Tai, 40~49 year old female. Ask Date: 2020/04/14

Dr. Shi Guozheng reply Orthopedics

You might consider undergoing rehabilitation at a general physical therapy clinic.
Inflammation can be alleviated with medication or injections.
After hip joint surgery, you can actually start walking quite quickly.
Initially, you will need to rely on a walker, but you should be able to completely discontinue its use in about two to three months.

Reply Date: 2020/04/14

More Info

Managing recovery after hip surgery can be a challenging journey, especially for elderly patients who may have additional health concerns. In your case, your mother-in-law's reluctance to engage in rehabilitation and her ongoing pain are significant issues that need to be addressed. Here are some insights and recommendations based on her situation.

Understanding the Recovery Process
1. Pain Management: Post-surgical pain is common, but it should gradually decrease over time. If your mother-in-law is experiencing persistent pain, it may indicate that her recovery is not progressing as expected. Pain can stem from various sources, including inflammation, muscle tightness, or even complications such as adhesions or improper healing of the surgical site.

2. Mobility Challenges: After hip replacement surgery, mobility is crucial for recovery. Weight-bearing activities help strengthen the muscles around the hip joint and improve overall function. If she is avoiding movement due to fear of pain, this can lead to muscle atrophy and decreased mobility, creating a vicious cycle.

3. Muscle Weakness and Adhesions: Prolonged inactivity can lead to muscle weakness, particularly in the hip and surrounding areas. Additionally, adhesions (scar tissue) can form after surgery, which may restrict movement and cause discomfort. This is particularly concerning if she is not participating in physical therapy, as rehabilitation exercises are designed to prevent such complications.

Recommendations for Improvement
1. Encourage Rehabilitation: It is essential to encourage your mother-in-law to participate in physical therapy. A physical therapist can tailor a rehabilitation program to her specific needs, focusing on gentle exercises that promote mobility without exacerbating pain. This can include range-of-motion exercises, strength training, and balance activities.

2. Pain Management Strategies: Discuss with her healthcare provider about effective pain management strategies. This may include adjusting her pain medication regimen, exploring non-pharmacological approaches such as heat or cold therapy, and considering alternative therapies like acupuncture or massage.

3. Education and Support: Sometimes, fear of pain can be alleviated through education. Providing her with information about the recovery process and what to expect can help reduce anxiety. Additionally, involving family members in her rehabilitation journey can provide the emotional support she needs to overcome her fears.

4. Regular Follow-ups: If she is hesitant to return to the hospital for follow-up appointments, consider scheduling a home visit from a healthcare professional. This can help assess her condition without the stress of traveling. Regular check-ups are crucial to monitor her recovery and address any complications early.

5. Nutritional Support: Given her weight concerns, it may be beneficial to consult a nutritionist. Proper nutrition can aid in recovery and help manage weight, which is vital for reducing stress on the hip joint.

6. Addressing Psychological Barriers: If her fear of pain is deeply rooted, it may be helpful to involve a mental health professional. Anxiety and depression can significantly impact recovery, and addressing these issues can lead to better outcomes.

Conclusion
Your mother-in-law's situation is not uncommon, but it is crucial to take proactive steps to encourage her recovery. Engaging in rehabilitation, managing pain effectively, and providing emotional support can significantly improve her mobility and quality of life. If her condition does not improve or worsens, further evaluation by her healthcare provider is essential to rule out complications such as muscle weakness or adhesions. Ultimately, a collaborative approach involving healthcare professionals, family support, and her willingness to participate in her recovery will lead to the best outcomes.

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