Pain Management Modalities for Hip Fracture
Hip fractures can occur due to several reasons like falls, hip injury, osteoporosis, loss of muscular strength, cancer and other stress injuries. A common injury affecting older adults, a hip fracture occurs when the top of the thigh bone close to the hip joint cracks or breaks down. Most hip fractures happen due to a fall or an injury to the side of the hip. Medical conditions such as osteoporosis (weak and fragile bones), loss of muscular strength, cancer, and stress injuries can weaken the bones and make the hip more susceptible to breaking. Leading multispecialty healthcare centers in Brooklyn, NYC offer a slew of pain management modalities and rehabilitation services for hip pain. Reports from the Centers for Disease Control and Prevention (CDC) (2017 statistics), suggest that about 95 percent of fractures of the hip are caused by falling sideways. It is estimated that about 300,000 elderly people aged 65 and older are hospitalized for hip fracture. If left untreated or poorly managed, the pain from a broken hip can get worse and cause delirium, depression, and poor sleep, and also reduce the response to the treatment for other medical conditions.
Symptoms Patients with a hip fracture experience pain over the outer upper thigh or in the groin. They also experience significant discomfort with any attempts to flex or rotate the hip. Other common symptoms include – Leg turning outwards more on the injured side Stiffness, bruising and swelling in and around the hip area Not being able to lift, move or rotate (turn) the leg Inability to move immediately after a fall Being unable to stand or put weight on the leg A shorter leg on the injured side Pain Management Interventions for Hip Fracture As hip fractures generally occur at the upper end of the thigh bone (femur), initial diagnosis is generally made through an X-ray of the hip and femur. If the patient complains of severe pain in the hip area (which may not be seen on a regular X-ray), a detailed evaluation will be conducted through an MRI scan, which will usually reveal a hidden fracture. A detailed treatment plan will be developed based on this evaluation. Hip pain treatment in Brooklyn involves a combination of therapies such as physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDS), transcutaneous electrical nerve stimulation (TENS), systemic analgesics and nerve blocks.
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Physical therapy (PT) – PT helps maintain mobility, function and strength. The program would include therapeutic exercise programs like stretching, strengthening, isometric and aerobic exercises to improve balance, strength and pain.
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Nonsteroidal anti-inflammatory medication (NSAIDs) – Patients will be prescribed medications such as ibuprofen [Advil/Motrin] or naproxen [Aleve]) to manage chronic pain, stiffness and swelling associated with the condition.
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Transcutaneous Electrical Nerve Stimulation (TENS) – TENS uses low voltage electrical currents to relieve pain.
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Nerve blocks – Anesthetics (such as bupivacine) are injected into the regional nerves to prevent the generation and conduction of nerve impulses to the spinal column and brain. Additional medications used with nerve blocks include clonidine, morphine, fentanyl and sulfetanil.
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Systemic analgesics – Systemic analgesic drugs may be used only when necessary and as a last resort.
Surgery will be considered as a last option for hip fractures that are not stable. The type of surgery to be done will depend on the location and severity of the fracture, age of the patient, and level of mobility before the injury, and other underlying bone and joint conditions. Preventing Hip Fracture Taking steps to maintain bone density and avoiding falls can help prevent hip fracture to a great extent. Patients can reduce the risk of falls by using walking aids, assessing your home for hazards (like loose carpeting) and doing exercises to improve your balance. Leading pain management centers in Brooklyn, NYC offer slip / fall prevention programs that involves a comprehensive evaluation of several physical and environmental fall risk factors and modification of these risks with exercise, gait and balance training sessions. In addition, regular exercise (to strengthen bones and improve balance), avoiding smoking/excessive drinking, and increasing intake of calcium and Vitamin D supplements can help keep bones strong and healthy.
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