THERAPY AND NON SURGICAL TREATMENT
A “well rounded” treatment plan includes family counseling, physical and occupational therapy, diet and nutrition considerations, as well treatments to treat the hip targeted at containment and supporting range of motion. Here we focus on some of the common non-surgical medical interventions. Consult your medical-surgical team for more info.
The first step may be activity restriction to minimize weight-bearing and protect the hip joint. This involves substituting running, jumping, and other high impact activities for low impact activities such as swimming. Favorite activities may be modified with a little creativity. Some parents have modified the baseball game to accommodate a substitute runner while other children report staying “in the game” by becoming an assistant coach or mentor for younger athletes!
Crutches and wheelchairs may also be recommended and even if they are not prescribed, you might find it helpful to have this equipment on hand for more strenuous events or painful days. After all, these are tools for your child. Put a positive spin on the situation by encouraging your child to use this tool as opposed to being “confined” to it.
Non-steroidal anti-inflammatory drugs (NSAIDs) or pain relievers such as Motrin, or Tylenol can be used to alleviate pain for short term. All substances have certain risks however, so use as directed and discuss all medications and supplements with your medical surgical team. NSAIDs have been associated with poor bone growth, heart failure, and gastrointestinal concerns. Avoid aspirin, particularly in children under 2.
Physical therapy can reduce inflammation, maintain range of motion, and decrease pain. Your physical therapist may recommend therapies such as heat/cold, massage, and transcuteaneous electrical nerve stimulation for muscle training and pain management. Be sure to discuss your child’s overall health with the physical therapist since treatments may be contraindicated in conditions such as diabetes or epilepsy.
Casts and bracing are also used to keep the femoral head contained. The cast is often used for one to two months and maintains the leg in a wide spread abduction. The hip-spica cast and petrie cast are commonly used and keep the legs spread, resembling the letter “A.” Night bracing can be also used to maintain hip flexibility.
With these restrictions, it may be tempting to throw in the towel but it’s important to keep your child active and engaged and to keep your sanity! It will take a little creativity but we’ll help you through it! Thanks to our network of parent volunteers, we have lots of information on handling each of these interventions like Traci’s tips on Surviving the Petrie Cast!