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Buttock Pain After Hip Replacement

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Is Riding A Stationary Bike Good After Hip Replacement

Hip Joint Pathologies causing back, groin, buttock, & knee pain

Using a stationary bikeBiking can improve leg and hip muscle strength and increase the new hip’s range of motion. Biking on a stationary bike eliminates the risk of falling and injuring the new hip. Adjusting the bike seat higher than usual can help avoid uncomfortable, excessive bending at the hip.

Osteoarthritis Of The Spine

The bones in your spine are separated by spongy discs, which act as shock absorbers. With age, these discs can wear or shrink, which narrows the space between the spinal joints, or facet joints. The facet joints are a series of small joints in the lower back that contain the same type of cartilage that is found in your knees, explains Louw. Disc changes can lead to more strain on the joints, which can cause the cartilage to wear down and the facet joints in the vertebrae to rub against one another, leading to the pain and stiffness of OA. It is not uncommon for these joints to refer pain into the buttocks, especially with prolonged standing or even walking, says Louw.

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How Long Does Glute Pain Last After A Hip Replacement

Symptoms after hip replacement, including glute pain, may last several weeks. Neither is it uncommon to continue to have discomfort for two months, though it should be mild.

Pain in the buttocks can lead to trouble sitting, standing, walking, and exercising. When pain starts interfering with daily life, thats a sign you need to address it.

Most glute pain after surgery should go away by at least the 3 months after the surgery mark. On some occasions, it can last longer so dont be alarmed if this is you.

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Buttock Pain After Hip Replacement

If you had a posterior hip replacement your surgeon may or may not have cut through the gluteus maximus muscle to access the hip. The gluteus maximus is also known as the buttock or bum cheek. Note that the major muscle belly portion of the buttock is left untouched and only the area near the incision is affected.

If your surgeon did indeed cut through the muscle then you will have some pain from the healing in this region. Even if they did not cut the muscle directly, by moving tendons and muscle around during surgery the area will be irritated causing pain.

The pain in your buttock can also be attributed to the long incision itself directly or possible referred pain from the incision into the buttock. Referred pains are pains that are not actually caused by the area of pain itself but from another area.

You can also get pain in your bum cheek after hip replacement by simply walking and standing after surgery. You should be full weight bearing on your new hip and be able to walk using a cane or walker. Simply putting body weight on your hip can cause bum cheek or buttock pain after surgery.

Finally, starting your physical therapy exercises after hip replacement can cause buttock pain. Doing proper squats and balance activities prescribed by your physical therapist will force your hip to be used. This in turn will likely cause some pain and should be expected.

Summary Of Hip Arthritis

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  • Osteoarthritis of the hip is common and can result in severe hip joint pain and disability. as a result of this condition, several hundred thousand people each year in the U.S. undergo total hip replacement.
  • Most people with osteoarthritis of the hip can be managed without surgery.
  • The cause of osteoarthritis of the hip is not known but some risk factors include obesity, severe hip trauma, and acquired conditions in adulthood, such as osteonecrosis and genetics.
  • There are many other kinds of arthritis that can affect the hip. It is important to make sure that the correct diagnosis is made as some of these other conditions are treated very differently.
  • The diagnosis of osteoarthritis of the hip is usually very straightforward and is made in almost all cases by a physician taking a thorough history, performing a physical examination, and getting x-rays with the patient standing up.
  • Patients usually seek care for the typical symptoms of hip arthritis, including pain located in the groin thigh or buttock. The pain associated with osteoarthritis of the hip is generally worse with weight bearing or twisting. Stiffness and leg-length inequality are other symptoms.

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The First 2 Weeks After Surgery

  • It is normal to experience some post-operative discomfort and swelling in the groin, thigh, lower back and buttock regions. Some degree of pain or ache can persist for up to three months following your surgery. This is all part of the healing process. On average, 70-80% of patients report an improvement in their symptoms, 10-15% report no significant improvement and 5% may find their hip is worse.
  • You may require crutches for a few days and possibly longer .
  • You will be reviewed by Mr Singh at approximately 10-14 days post-surgery to remove the stitches from the wounds. This appointment will be made prior to your surgery and will be documented on your confirmation of surgery form. The details of the surgery will be discussed with you at this appointment and Mr Singh will guide you through your recovery
  • Arrangements for any physiotherapy or rehabilitation can be made at your two week appointment. This is also a good time to ask for any medical certificates that you might require to be completed.

What Treatment Options Exist

The best way to avoid groin pain after hip replacement is to avoid hip surgery altogether. Hip replacement surgery has been associated with significant complications which include pseudotumors , hip dislocations, strokes, metal toxicity due to wear particles, and an increased incidence in falls . In a recent study that followed 51 patients after hip replacement, activity level, and sleep were not improved at 6 months .

Treatment for groin pain after hip replacement depends upon the underlying source. Infection, a loose implant, and pelvic fracture require prompt surgical evaluation and may require additional surgeries. Conservative care in the form of rest, safe NSAIDs, stretching and PT are the initial treatment of choices for Iliopsoas tendonitis. When unsuccessful, steroid injections are often recommended. Steroids are powerful anti-inflammatory agents that are toxic to orthopedic tissue, and should be avoided. In addition, steroids also reduce local stem cell numbers and compromise immune system activity. Surgery is also an option if pain persists. In some cases, the Iliopsoas tendon is cut thereby relieving the pressure on the tendon. Unfortunately, this also significantly changes the biomechanics of the hip and lower extremity as the Iliopsoas tendon is a major stabilizer.

Are there new, natural treatment options? YES!

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Alternative Remedies And Treatments

Nutritional supplementation is helpful to some patients though the science on this is not entirely supportive of their effectiveness.

There are some studies to suggest that acupuncture can decrease the pain associated with osteoarthritis of the hip.

Although there is little hard science on this point, most hip surgeons and rheumatologists believe that patients with osteoarthritis of the hip should consider avoiding impact sports such as running in order to avoid increasing the rate at which the disease progresses.

It is important that patients with osteoarthritis of the hip avoid decreasing their activity level and it is important that they remain fit. However this often does require some modification of exercise programs running and walking programs are usually poorly tolerated by patients with osteoarthritis of the hip. Stationary bike, swimming and water aerobics usually are well-tolerated and they are recommended.

Getting To The Bottom Of Buttock Pain

Total Hip Replacement – Exercises 4-6 Weeks After Surgery

Getting to the bottom of buttock pain can sometimes prove a diagnostic dilemma, due to the number of potential local sources of nociception and relative complexity in anatomical relationships within the posterior hip region. This is compounded by pelvic structures and more remote sources within the lumbar spine. Perhaps this conundrum sometimes leads health and exercise professionals to oversimplify the differential diagnosis of buttock pain and identifying the associated impairments.

The most common things that patients are told when attending for treatment of buttock pain:

  • Its related to your sacro-iliac joint your pelvis is out of place
  • Your glutes are overactive/underactive
  • You have piriformis syndrome .
  • We owe it to those disabled by buttock pain, often unable to sit, sleep well or undertake physical activity, to expand our knowledge in this space, increasing awareness of a larger spectrum of possible diagnoses and their presentations optimising your Test Kit if you like. We are often focused on gathering tools for our treatment tool kit along our professional journey. However, the tools will only be effective if we have an understanding of the person we are treating and the mechanisms and impairments underpinning the condition with which they are suffering.

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    What To Do After Hip Replacement Surgery

    As with any new surgery, any post-surgery care is important and depends on the extent of your problems.

    For example, if you have severe arthritis and/or osteoarthritis, you will need to take a multidisciplinary approach to your rehab. For example, you may need to do physical therapy, acupuncture, spinal exercises, and/or medication.

    You should make sure you are well informed of all your options and that you have your options clearly presented to you. Your primary care doctor can tell you more about your options.

    If you do get some pain after surgery, there are two things you can do.

    First, if you are currently a smoker, quit. You will need to keep using tobacco cessation pills or quit smoking for at least six months after surgery.

    Second, if you have had pain with a hip replacement before, avoid activities that cause pain that cause a loss of strength and endurance. Physical activity should be kept at a moderate level.

    More information on getting back to work after hip replacement surgery can be found on the HIPPA-compliant healthcare providers list.

    HIPPA-Compliant Hip Replacement

    If you have had problems with your hip replacement and would like to know more about HIPPA-compliant procedures, call 1-888-486-3666 to speak with our HIPPA expert.

    HIPPA-compliant procedures involve more stringent safeguards and requirements, including more information being made available on your HIPPA-compliant medical record.

    What Medications Will I Receive Right Before During And Right After The Hip Replacement

    • Antibiotics: Medication to help prevent infection.
    • Anesthesia: An anesthesiologist will meet with you before your surgery. They will explain the various types of anesthesia available to you and the risks and benefits of each with your health history. The spinal, or regional anesthetic block, is the most common method used for orthopaedic joint replacement procedures. Youll also be asked to complete a health questionnaire from the anesthesia department for surgery clearance to ensure your safety.
    • Thromboprophylaxis: Medication to help prevent blood clots .
    • Pain control: Various medications can help control pain, including NSAIDs, narcotic pain medications and peripheral nerve block.

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    Why Do I Have To See The Dentist Before Surgery

    Have your teeth cleaned and make sure you dont have any cavities that might need to be taken care of during the first few months following surgery. Since the blood supply to your hip is increased during healing time, its better to have any routine dental work done either before surgery or three months after. In addition, any emergencies must be taken care of immediately. Your surgeon may recommend antibiotics prior to any dental procedure once you have a total joint replacement.

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    Painful Hip Replacement

    Compression can help relieve hip flexor pain. Using an elastic bandage or heating pad on the infected area will also reduce the swelling. Hot showers and heat patches are also helpful for relieving tightness. Medications should not be taken for more than ten days, as they may lead to bleeding in the stomach. Likewise, people who have strained their hip flexor muscles should refrain from activity for ten to fourteen days.

    Cold therapy can help reduce pain and inflammation. Ice packs can be applied for up to 15 minutes at a time, but heat can also be applied to relieve muscle tightness. You can also use moist heating pads or ice to help alleviate the pain. To reduce muscle tightness, hot showers are recommended. Anti-inflammatory medicines and over-the-counter medications can be effective for pain relief. It is essential to consult a medical professional if these remedies dont relieve your symptoms.

    Home pain relievers can be an effective method of treatment. Acetaminophen and NSAIDs can be used as a temporary solution to help relieve pain and inflammation. However, if your symptoms do not improve, you should see your healthcare provider immediately. Although these measures are effective, they may not be enough. If you have sustained a severe injury to the hip flexors, you should seek professional help.

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    Pain After Hip Replacement: Causes And Tips To Help

    It is natural to think that you will have no pain after your hip replacement surgery, but things may not work that smooth for some people. Pain after hip replacement is more common than you think. In fact, sometimes, the pain you experience is even worse than what you were experiencing before undergoing the surgery. A number of factors may be preventing you from getting the best results after your surgery.

    What Is The Prosthesis Made Of

    The prosthesis is constructed of metal and plastic. Titanium, stainless steel, cobalt-chromium, ceramic and polyethylene are the most common materials. A prosthesis for a total hip replacement consists of four components:

    • Acetabular liner.
    • Acetabular shell.

    They are linked, but flexible, so that the surgeon can adjust for anything unexpected. The prosthetic is then fixed to the remaining bone using either:

    • Fixation to the host bone by relying on a bony ingrowth onto or into the porous surface of the bone that has either been interference-fit or press-fit into the surrounding bone.
    • Medical cement , if the original bones quality is low.

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    What Can I Do For Hip And Butt Pain

    Treatment options

  • Using cold or heat packs to relieve pain
  • Complete hip and buttock massage is recommended.
  • Using non-steroidal anti-inflammatory medicines that are available over-the-counter . The use of these drugs to make exercise less unpleasant, on the other hand, is not recommended.
  • Resting after a clearly visible injury
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    Interference With Daily Activities And Sleep

    Why Does My Total Hip Still Hurt?

    Before proceeding with hip replacement, your hip arthritis should markedly impact your daily living. Patients who are unable to climb stairs and put on shoes or who need a cane should begin to think about hip replacement. Also, when patients must change their activities or avoid social outings because of hip pain, it may be time to consider this procedure.

    Patients who have hip pain that, at the end of the day, keeps them from sleeping despite the use of pain-relief medications should consider hip replacement.

    In This Section:

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    What To Do If You Have Health Problems Before Hip Replacement Surgery

    If you have problems with hip replacement surgery or other health conditions, you will be advised to see your primary care doctor immediately. While you may be able to get through the surgery without any problems, you could have a worse outcome.

    A lot depends on whether your surgeon, in the process of doing a successful hip replacement, had any concerns about your health in the past.

    There are ways to find out if your surgeons practices are HIPPA-compliant so that you can take action if you have questions or concerns about their HIPPA-compliant practices.

    If you are looking for an accurate answer, consider checking out the results of the survey that was sent out by the American Academy of Orthopaedic Surgeons, a national group of orthopaedic surgeons. You can find it on your doctors website, or on the AAPS website.

    If you have any health concerns before surgery, dont wait until the surgery to start getting treatment. You should consult with your doctor as soon as possible after surgery to discuss treatment options.

    What We Know About Hip Replacement

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    References

    Rosinsky PJ, Bheem R, Meghpara MB, et al. Asymptomatic Gluteal Tendinopathies Negatively Impact Outcomes of Total Hip Arthroplasty: A Propensity Score-Matched Study. J Arthroplasty. 2021 36:242-249. doi:10.1016/j.arth.2020.07.063

    van der Merwe, JM. Metal Hypersensitivity in Joint Arthroplasty. JAAOS. March 2021 5. doi:10.5435/JAAOSGlobal-D-20-00200

    Bosker BH, Ettema HB, van Rossum M, et al. Pseudotumor formation and serum ions after large head metal-on-metal stemmed total hip replacement. Risk factors, time course and revisions in 706 hips. Arch Orthop Trauma Surg. 2015 135:417-425. doi:10.1007/s00402-015-2165-2

    Gofton W, Beaule PE. Serum Metal Ions with a Titanium Modular Neck Total Hip Replacement System. J Arthroplasty. 2015 30:1781-1786. doi:10.1016/j.arth.2015.04.040

    Blizzard DJ, Sheets CZ, Seyler TM, et al. The Impact of Lumbar Spine Disease and Deformity on Total Hip Arthroplasty Outcomes. Orthopedics. 2017 40:e520-e525. doi:10.3928/01477447-20170327-03

    Harding P, Holland AE, Delany C, Hinman RS. Do activity levels increase after total hip and knee arthroplasty?. Clin Orthop Relat Res. 2014 472:1502-1511. doi:10.1007/s11999-013-3427-3

    Chris Centeno, MD

    If you have questions or comments about this blog post, please email us at

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    What Are The Possible Causes Of Buttock Pain After A Hip Replacement

    There are a number of possible causes of buttock pain after a hip replacement. These can include:

    • The build-up of scar tissue around the implant
    • The formation of a cyst or abscess around the implant
    • The looseness of the implant

    If you are experiencing buttock pain after your hip replacement, it is important to consult with your orthopedic surgeon to determine the cause. Treatment will vary depending on the underlying cause of the pain.

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