Physical Therapy for Osteonecrosis
Osteonecrosis, also known as avascular necrosis, is a disorder in which the bone does not receive enough blood, resulting in small breaks that can eventually cause it to collapse. Insufficient blood flow to a bone may occur as a result of a fracture or dislocation, excessive alcohol use, extended use of corticosteroids, or certain diseases that impede blood flow, such as sickle cell anemia, diabetes, lupus, Gaucher disease and HIV. Medications taken for osteoporosis or bone cancer, called bisphosphonates and radiation therapy also increase the risk of a patient developing osteonecrosis. The condition can occur in numerous joints, but it most commonly affects the hip.
Physical therapy may be useful during the early stages of osteonecrosis. The goal of physical therapy is to preserve function, reduce further damage to the bone, and treat pain. Rehabilitation efforts may include:
- Exercises to maintain range of motion
- Electrical stimulation of the affected area
- Limiting weight-bearing activities
A physical therapist creates tailored exercises to strengthen the muscles around the affected bone. Ultrasound, joint mobilization and heat may be used to increase bloody supply to the area and help decrease pain. If necessary, physical therapists can also assist patients with the use of a cane or walker, to decrease the pressure that is put on the joint.
While physical therapy cannot cure osteonecrosis, in some cases it may help to restore movement, slow the progression of the disease, and decrease any related pain.