Shared Decision Making

Transcription

1 Deciding what to do about Osteoarthritis of Hip This short decision aid is to help you decide what to do about your hip osteoarthritis. You can use it on your own, or with your doctor, to help you make a decision about what's right for you at this time. There are five main options if you have Osteoarthritis of Hip. The choices are:, including weight loss and exercise management, including physiorapy and occupational rapy Treatments to manage pain, including tablets you take by mouth, injections into joint and self-help Complementary, including acupuncture and nutritional supplements, including hip resurfacing and total hip replacement. is usually for people with severe symptoms who have tried or first. Updated February 2017 Page 1 of 9

2 What are my options? What is? Lifestyl e change s Including weight loss and exercise. Management Including physiorap y and occupational rapy. Treatmen t to Manage Including tablets, you take by mouth, injections into joint and self-help. Complementar y Treatments Including acupuncture and nutritional supplements. Total hip replacemen t surgery is usually for people with severe symptoms who have tried or first. What is effect on wher your Hip Arthritis gets worse? If you are overweight, losing some of this excess weight will help relieve some of strain on your joints. This may help avoid furr Managemen t rapy does not prevent your hip arthritis getting worse. Strengnin g your muscles may protect joint from damage. Treatment to Manage such as paracetamol, NSAIDs, corticosteroi d injections and self-help will not stop your hip arthritis getting worse. Effective pain Complementar y Treatments There is no evidence that complementary can stop your hip arthritis from getting worse. There hasn't been much research in this area. is usually for people who have severe symptoms and have tried or s without success. replaces damaged Updated February 2017 Page 2 of 9

3 damage to your hip joint. can stop your pain from getting worse. joint or its surface. The new joint will age and may eventually need to be replaced. can improve position of joint which can relieve stress on or joints in body. What is effect on pain?, such as taking more exercise and losing weight, may help to reduce pain and increase your ability to Management Physiorapy, occupational rapy, and mobility aids can be helpful for reducing pain of arthritis. But re s not evidence to show this. Treatment to Manage Many types of medicine can lessen pain of osteoarthritis, including paracetamol and NSAIDs. Corticosteroid injections into joint help some people. However Complementary Treatments Some patients say that y benefit from complementary, while ors say that y provide no pain relief. Some studies have suggested acupuncture may help relieve pain of hip and knee osteoarthritis. [8] Hip replacement usually helps reduce pain a lot, or gets rid of it altoger. Not everyone is satisfied with results. Updated February 2017 Page 3 of 9

4 get round. But re s not evidence to show this. medication will not work for everyone and some people have pain despite. Self-help programmes, such as cognitive behavioural rapy (CBT) may help you to manage pain better. What is effect on your qualit y of life? Using selfmanagemen t techniques can help you feel more in control of your arthritis. Exercising and losing weight will benefit your overall health too. Managemen t Some patients say se improve ir quality of life and help m to be independent Treatment to Manage Medication can be effective at relieving pain and this can have a big impact on quality of life. These do not work for everyone and can have side effects. Self-help Complement ary Treatments Some patients say se improve ir quality of life. There is not evidence to say wher complementa ry work. can improve quality of life for people with hip osteoarthritis. [10] Updated February 2017 Page 4 of 9

5 programmes may help improve quality of life What is effect on how easily you can get around? We don t know if lifestyle can improve how easily you can get around. Management Around 30 in 100 people find walking and or aids help m get around more easily. Treatment to Manage medications can ease pain of osteoarthritis which, in turn, can help you to move around more easily. Selfhelp programmes may help you keep more active. Complementary Treatments There is not evidence to say wher any complementary help you get around more easily. A hip replacement usually makes it much easier to get around, compared with how you were before operation. What are unwanted side effects and complication s? Lifestyl e change s Generall y, taking exercise and eating a Manageme nt These are generally safe with few risks. Treatment to Manage NSAIDs can cause stomach bleeds. Opioid painkillers Complemen tary Treatments Complement ary can have side effects and may If you are overweight or you smoke, you are more likely to Updated February 2017 Page 5 of 9

6 healthy diet is safe. Physiora py can be uncomforta ble and may hurt at first. This should soon ease. can cause constipation. Some people who take opioid painkillers for a long time become dependent on m. This means y get withdrawal symptoms when y try to stop taking m. react badly with or medicines. There is a risk of infection from acupuncture. develop side effects after surgery. You may want to discuss with your health professional getting to lose weight or to stop smoking prior to considering surgery. can cause complication s including blood clots, infections, bleeding, and a risk of death. There is also a chance that surgery will not work. Your recovery may also take longer than expected due to complication s, such as infection or Updated February 2017 Page 6 of 9

7 blood clots. Sometimes patients need to have furr surgery or because of se complication s. It is likely that you will feel some discomfort while recovering from surgery. What is time you will spend in hospital or on? require daily commitmen t. You won t need to spend time in hospital for this. Managemen t You may need to go to hospital to have physiorap y and occupational rapy sessions. But you won t need to stay in hospital. You will need to attend a number of Treatment to Manage You can buy simple painkillers, such as paracetamol, from your pharmacy. Your GP may also prescribe pain medication. You might need to take medicines every day to manage your Complementa ry Treatments Often, complementar y rapists recommend a course of. These can vary in length and be expensive. Most people go home about three to five days after operation. For first four to six weeks after operation you will need a walking aid, such Updated February 2017 Page 7 of 9

8 sessions. pain. Selfhelp programmes vary in length. as crutches, to help you. You will need about six weeks off work. Most people are able to get back to ir normal activities within two to three months. [10] What are pros and cons of each option? People with hip osteoarthritis have different experiences about health problem and views on. Choosing option that is best for patient means considering how consequences of each option will affect ir life. Here are some questions people may want to consider about for osteoarthritis of hip: D o y find pain from ir hip intolerable? D o y want be able to do more everyday things than y can at present? Are y willing to spend time in hospital, or having? Are y willing to take risk of side effects or complications from? How do I get to help me make a decision that is right for me? Updated February 2017 Page 8 of 9

9 People using this type of information say y understand health problem and choices more clearly, and why one is better for m than anor. They also say y can talk more confidently about ir reasons for liking or not liking an option with health professionals, friends and family. References 8. Witt CM, Jena S, Brinkhaus B, et al. Acupuncture in patients with osteoarthritis of knee or hip: a randomized, controlled trial with an additional non-randomized arm. Arthritis and Rheumatism. 2006; 54: Lievense AM, Bierman-Zeinstra SM, et al. Influence of obesity on development of osteoarthritis of hip: a systematic review. Rheumatology (Oxford). 2002; 41: Updated February 2017 Page 9 of 9