In Many Cases, Hip Replacement Also Eases Back Pain

In Many Cases, Hip Replacement Also Eases Back Pain

THURSDAY, July 9, 2020 (HealthDay News) — If you have a bad hip and lower back pain, a new study suggests that hip replacement surgery may solve both issues at once.

Researchers at the Hospital for Special Surgery in New York City focused on 500 patients who underwent hip replacement surgery and followed up with them one year after the operation.

Over 40% reported pain in their lower back prior to hip surgery. Of that group, 82% saw their back pain vanish after surgery.

It was “completely gone,” said study author Dr. Jonathan Vigdorchik, a hip and knee surgeon at the hospital.

He said that experts in his field have studied the connection between the hip and back for years.

A hip replacement is a surgical procedure to replace a worn-out or damaged hip joint with an artificial one. On average, it is a highly successful operation, with 95% of patients experiencing pain relief, according to the Hospital for Special Surgery.

“It’s an outstanding procedure,” said Dr. Craig Della Valle, a professor of orthopedic surgery at Rush University Medical Center in Chicago. “There are very few things in medicine that are close to hip replacement in terms of how good of a medical procedure it is.” He wasn’t part of the study.

But Vigdorchik added that patients who have undergone some types of spinal surgery before a hip replacement face five times the rate of complications compared to the general population — for which the complication rate is less than 1%.

This knowledge prompted him to dive deeper into the hip-back interplay.

“We noticed that there are certain conditions where a hip condition can actually put undue stress on the back,” Vigdorchik explained.

He and his fellow researchers wanted to find out how effective a hip replacement can be in eliminating low back pain, and determine which patients are more likely to benefit.

The patients whose low back pain resolved after the surgery were those with “flexible spines,” according to Vigdorchik. When a person’s spine is flexible, a stiff or poorly functioning hip can drive the spine to move more than usual, causing pain.

Those with normal flexibility in their spine were also highly likely to have their pain resolved.

“Those are the patients whose back pain went away completely after their hip replacement, because their back pain was probably caused by their hip not functioning properly to begin with,” said Vigdorchik.

But the back pain in patients with stiff spines did not go away. Patients with stiff spines already have serious arthritis of the spine, and replacing the hip is unlikely to relieve their pain.

But how can you know if your back pain could be resolved with a hip replacement?

It’s not easy to figure that out on your own, according to Vigdorchik. “It really relies on a good physical exam, and then good X-rays,” he said.

Before a patient undergoes a hip replacement, surgeons will typically take an X-ray of the patient lying down.

In this study, researchers took X-rays of their patients standing up and sitting down, both before and after the surgery.

These X-rays allowed them to see how the hip and spine moved in relation to each other, and assessed the flexibility of their spine, as the patient switched from a standing position to a seated position.

Vigdorchik encouraged other surgeons to utilize these X-rays to identify patients whose ailing backs may be relieved by a hip replacement.

He also advised surgeons in the field to “look beyond just the hip.”

“Anytime they’re looking at the hip, they should also look at the back, and anytime they’re looking at the knee, they should also look at the hip,” Vigdorchik said.

The existence of an interplay between the hip and back is well known to experts, but Della Valle said that this study showed how consistent it is.

He said the study gives surgeons in the field “some tools to try to predict which patients you can tell, ‘Yeah, your back pain will get better,’ and others, well, maybe it won’t.”

The study was published online recently during a virtual meeting of the American Academy of Orthopaedic Surgeons.

More information

There’s more about low back pain at the U.S. National Institutes of Health.

SOURCES: Jonathan Vigdorchik, M.D., orthopedic surgeon, hip and knee replacement, Hospital for Special Surgery, New York City; Craig Della Valle, M.D., professor, orthopedic surgery, Rush University Medical Center, Chicago; AAOS 2020 Virtual Education Experience, March 26, 2020, online

Copyright ©2020 HealthDay. All rights reserved.
Working From Home? Posture, Ergonomics Can Make It Safe

Working From Home? Posture, Ergonomics Can Make It Safe

FRIDAY, June 19, 2020 (HealthDay News) — If you’re working from home because of the coronavirus pandemic and expect to keep doing so, you need to be sure your work station is set up properly, an orthopedic specialist says.

You also need to take regular breaks to move around, according to Terrence McGee, a physical therapist at Johns Hopkins University School of Medicine in Baltimore.

In an office, many people have ergonomic support and opportunities for physical breaks. You might have walked to the water cooler or coffee machine, attended meetings or walked to co-workers’ desks, he noted in a university news release.

To help you adapt to working at home, McGee has some suggestions to improve the safety and comfort of your workspace.

When sitting at your desk, rest your feet flat on the floor. Use a foot rest if the desk height can’t be adjusted.

Your thighs should be parallel to the ground, with a two-finger space between the back of the knees and the chair, and 3 to 6 inches of space between your thighs and the desk/keyboard.

Place a small pillow or towel roll behind you for lower back support, he suggested. Your head should be level, facing forward, and in line with your torso.

The top of your computer screen should be at or slightly below eye level. The screen itself should be 18 to 28 inches from your eyes, or at arm’s length. If you feel you need to bring your eyes closer to your screen, consider seeing an eye doctor for an eyeglass prescription, or make your screen’s text larger, McGee said.

If you use a dual monitor, swivel your body in your chair rather than constantly turn your head to view the monitors. If you can’t adjust your chair, consider changing the orientation of the monitor from landscape to portrait.

When using the keyboard and mouse, relax your shoulders and place your forearms parallel to floor. Your wrists should rest in a neutral position (hand in line with wrist and forearm). Use soft pads or a wrist rest as needed, and keep the mouse within easy reach and next to the keyboard. Adjust mouse sensitivity for light touch. A cordless mouse is the best option, McGee noted.

Also, use a hands-free headset if you’re on the phone for more than two hours a day, and use a document holder to secure papers when typing.

It’s not good for your physical or mental health to stay seated all day. Stand and move from your chair at least once an hour, McGee advised.

Also, perform desk stretches or chair yoga in between work tasks, he added.

More information

Boston University offers more ergonomic tips for working at home.

SOURCE: Johns Hopkins University, news release, June 16, 2020

Copyright ©2020 HealthDay. All rights reserved.
Which Surgery Works Best for Lower Back Pain?

Which Surgery Works Best for Lower Back Pain?

TUESDAY, June 16, 2020 (HealthDay News) — Patients with lower back problems often worry about how much time they’ll need to recover if they have surgery. A new study finds similar results for two common minimally invasive spine procedures.

Surgery may be recommended for degenerative conditions of the lower spine, such as a herniated disc or spinal stenosis.

Researchers at Hospital for Special Surgery in New York City compared 117 patients who had minimally invasive lumbar decompression surgery and 51 who had minimally invasive lumbar spine fusion surgery. All the procedures were performed by the same orthopedic surgeon.

“Our study is the first of its kind to look at return to activities and discontinuation of narcotic pain medication after single-level lumbar decompression or single-level lumbar spine fusion performed with a minimally invasive technique,” said senior investigator Dr. Sheeraz Qureshi, a spine surgeon at the hospital.

It took the 117 decompression patients a median of three days before they no longer required narcotic pain medication, and seven days for the 51 spinal fusion patients.

Among patients who drove before their surgery, decompression patients took a median of 14 days to resume driving, and 18 days for the fusion patients.

There was no statistically significant difference between the two groups in how long they took to return to work, according to the study.

The findings are important because standard open spinal fusion surgery generally requires a much longer recovery and slower return to activities than standard lumbar decompression, Qureshi noted.

“In our study, all the patients in both groups were able to resume driving and return to work within three weeks of surgery,” he said in a hospital news release.

“When you compare this time frame to that of standard open spinal fusion surgery, it’s really striking. Patients having a standard spinal fusion could take six months or longer for a full recovery,” Qureshi said.

Degenerative conditions of the lower spine are common causes of pain and disability, and surgery may be considered when initial treatments such as medication and physical therapy don’t provide relief.

Lumbar decompression surgery involves removal of a small section of bone or part of a herniated (bulging) disc that is pressing on a nerve. Spinal fusion is a more extensive surgery in which surgeons join two or more vertebrae together, sometimes using screws and connecting rods.

The findings were presented online earlier this year at a virtual meeting of the American Academy of Orthopaedic Surgeons. Data and conclusions released at meetings are usually considered preliminary until peer-reviewed for publication in a medical journal.

More information

The American Academy of Family Physicians has more on low back pain.

SOURCE: Hospital for Special Surgery, news release, June 15, 2020

Copyright ©2020 HealthDay. All rights reserved.
Shovel That Snow, but Spare Your Back

Shovel That Snow, but Spare Your Back

SATURDAY, Feb. 1, 2020 (HealthDay News) — Almost everyone gets stuck shoveling snow at some point during the winter. To prevent back pain and strain, one spinal expert has some advice.

Orthopedic surgeon Dr. Srinivasu Kusuma, from the University of Chicago Medicine Medical Group, noted it’s all in the precautions you take before you tackle your snow-covered driveway.

  • Decide if it’s safe to shovel. If you already have back issues and don’t exercise often, or if you are prone to lightheadedness or shortness of breath, maybe you shouldn’t be shoveling. Instead, consider using a snowblower. For those with heart problems or chest pains during exercise, Kusuma urges they check with their doctor about shoveling.
  • Warm up your muscles. “Make sure to warm up before you shovel, just as you would before a workout,” Kusuma said in a university news release. Stretching and strolling can warm up your muscles. If you’re going to shovel bright and early, make sure your muscles are loose before shoveling. Don’t have time to stretch out in the a.m.? You might want to shovel in the evening then.
  • Appropriate winter gear is important. A coat, pants, hat and gloves will keep you warm in frigid weather. Wearing waterproof boots can also give you traction and prevent slips and falls, Kusuma said. Use a lightweight shovel with an adjustable handle.
  • Use proper technique. Push the snow to the side instead of picking it up. If you need to lift the snow, don’t fill the shovel more than halfway. “Bend with your knees and not your back, using your powerful leg muscles instead of core muscles,” Kusuma said. Always keep your shoulders and hips square with the shovel and avoid twisting at the waist.
  • Take your time. “People are usually in a rush to get to work or to get out the door,” Kusuma said. “I see injuries like strains, sprains and herniated disks when people try to do too much too fast.” Stretch your arms and legs every 10 to 15 minutes to stay limber. “You’re less likely to [get] hurt if you plan ahead and take breaks so your muscles stay flexible,” he noted.

More information

The American Academy of Orthopaedic Surgeons has more on safe shoveling.

SOURCE: University of Chicago Medical Center, news release, January 2020

Copyright ©2020 HealthDay. All rights reserved.
Health Tip: Signs of a Herniated Disc

Health Tip: Signs of a Herniated Disc

(HealthDay News) — The bones that form your spine are cushioned by round discs. A herniated disc is a disc that has been pushed out of place, says the American Association of Neurological Surgeons.

The group mentions warning signs of a herniated disc:

  • Low backache.
  • Numbness or weakness in parts of the body.
  • A sharp, electric shock-like pain on one side of the body.
  • Burning or tingling that radiates into the leg or shoulder.

Sometimes, these symptoms can worsen with standing, walking or sitting.

Copyright ©2019 HealthDay. All rights reserved.
Health Tip: The ‘Wall Test’ For Good Posture

Health Tip: The ‘Wall Test’ For Good Posture

(HealthDay News) — Proper posture can prevent pain and injury, says Mayo Clinic. To check if you have proper posture, Mayo suggests the “wall test.”

Here’s what it involves:

  1. Stand so the back of your head, shoulder blades and buttocks touch the wall. Your heels should be 2 to 4 inches apart.
  2. Place a flat hand behind the small of your back. You should be able to slide your hand between your lower back and the wall.
  3. If there’s too much space behind your lower back, draw your belly button toward your spine.
  4. If there’s too little space behind your lower back, arch your back so your hand can slide behind you.
  5. Walk away from the wall while holding proper posture. Return to the wall to check whether you kept the correct posture.
Copyright ©2019 HealthDay. All rights reserved.
Call Now Button