The Diagnosis and Treament of Hip Arthritis

Hip pain
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Hip arthritis is a common condition that causes problems with the ball-and-socket joint at the junction of the pelvis and lower extremity. When arthritis occurs, the normal joint becomes inflamed and painful. There are many different types of arthritis that can cause pain in the hip joint.

Osteoarthritis is the most common type of hip arthritis. Also called wear-and-tear arthritis or degenerative joint disease, osteoarthritis is characterized by progressive wearing away of the cartilage of the joint.

As the protective cartilage is worn away by hip arthritis, bare bone is exposed within the joint.

Hip arthritis typically affects patients over 50 years of age. It is more common in people who are overweight, and weight loss tends to reduce the symptoms associated with hip arthritis. There is also a genetic predisposition to this condition, meaning hip arthritis tends to run in families. Other factors that can contribute to developing hip arthritis include traumatic injuries to the hip and fractures to the bone around the joint.

Other types of hip arthritis including rheumatoid arthritis and other types of autoimmune spondyloarthropathies. While some of the conditions may have particular nuances to their treatments, many of the principles of treatment are the same.

Signs of Hip Arthritis

Hip arthritis symptoms tend to progress as the condition worsens. What is interesting about hip arthritis is that symptoms do not always progress steadily with time.

Often patients report good months and bad months or symptom changes with weather changes. This is important to understand because comparing the symptoms of hip arthritis on one particular day may not accurately represent the overall progression of the condition.

The most common symptoms of hip arthritis are:

  • Pain with activities
  • Limited range of motion
  • Stiffness of the hip
  • Walking with a limp
  • Pain in the groin, thigh, or knee

Evaluation of Arthritis

People who are suspected to have hip arthritis will often be evaluated by either a primary physician or an orthopedic surgeon. The usual evaluation includes assessing the function of the hip joint in terms of mobility and strength. In addition, your examiner will want to evaluate your gait as well as basic functions such as getting up from a seated position and maneuvering. It is important to also evaluate the lumbar spine and entire lower extremity as treatment of hip pain may require treatment of these associated parts of the body. Lastly, prior to progressing with any treatment, it is important to assess the nerve function and vascular supply to the extremity. Issues with the neurovascular function may alter the treatment options.

Imaging studies to assess for hip arthritis typically can be completed with routine x-rays of the hip joint. If x-rays are inadequate to fully assess the problem, other tests such as CAT scans, MRI, bone scans can be performed, but typically these studies are not necessary.

Hip Arthritis Treatment

Treatment of hip arthritis should begin with the most basic steps, and progress to the more involved, possibly including surgery.

Not all treatments are appropriate for every patient, and you should have a discussion with your doctor to determine which treatments are appropriate for your hip arthritis.

  • Weight Loss
    Probably one of the most important, yet least commonly performed treatments. The less weight the joint has to carry, the less painful activities will be.
  • Activity Modification
    Limiting certain activities may be necessary, and learning new exercise methods may be helpful.
  • Walking Aids
    Use of a cane or a single crutch is the hand opposite the affected hip will help decrease the demand placed on the arthritic joint.
  • Physical Therapy
    Strengthening of the muscles around the hip joint may help decrease the burden on the hip. Preventing atrophy of the muscles is an important part of maintaining functional use of the hip
  • Anti-Inflammatory Medications
    Anti-inflammatory pain medications (NSAIDs) are prescription and nonprescription drugs that help treat pain and inflammation.
  • Joint Supplements (Glucosamine)
    Glucosamine appears to be safe and might be effective for treatment of osteoarthritis, but research into these supplements has been limited.
  • Hip Replacement Surgery
    In this procedure, the cartilage is removed and a metal & plastic implant is placed in the hip.
  • Hip Resurfacing Surgery
    An alternative to hip replacement, some patients are opting to pursue hip resurfacing surgery.

A Word From Verywell

Hip arthritis is exceedingly common, and only becoming more common. As people are staying active later in life and living longer, osteoarthritis of the hip joint is becoming more and more common  In addition, as our population is becoming more obese, we are also seeing increased rates of arthritis. Treatment of hip osteoarthritis typically begins with some simple steps and progresses to more invasive treatments over time. On a positive note, this excess of treating hip arthritis is generally very good and most patients are able to find relief.

Sources:

Nho SJ, Kymes SM, Callaghan JJ, Felson DT. "The burden of hip osteoarthritis in the United States: epidemiologic and economic considerations" J Am Acad Orthop Surg. 2013;21 Suppl 1: S1-6.

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