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Osteoarthritis of the Hip

 

Osteoarthritis of the Hip - Why does this happen?

The hip is a ball and socket joint. The round head of the femur sits in a deep socket (acetabulum) in the pelvis.  The joint surfaces are covered with cartilage and synovial fluid.  The cartilage and fluid help absorb shock in the joint on weight bearing and allow movement in the joint by reducing friction when under pressure.
 
 
 
  
 

Osteoarthritis is a degenerative condition which affects the surface of the bones in the hip joint.  The cartilage wears and there is a loss of synovial fluid.  This causes the soft bone underneath to become roughened from the pressure of weight bearing.  Bony spurs (osteophytes) grow around the joint causing the joint space to narrow. On weight bearing, the head of the femur and the acetabulum rub together causing pain, swelling and stiffness.

 

 

Osteoarthritis of the hip is common as part of the ageing process and can occur from the age of 40+.  It is more common in women.  Repetitive weight bearing activities, previous injury and excess weight all contribute to developing Osteoarthritis of the hip

 
 
  
What are the symptoms?
 
  •  Pain in the groin, the front of thigh and/or the knee.
  • Pain is worse on exercise or weight bearing activities.
  • Pain is relieved after a period of rest.
  • Disturbed sleep due to the pain.
  • Stiffness in the hip, particularly in the morning and after periods of rest.
  • Poor range of hip movement.
  • A change in walking pattern as a result of the pain.
 
  
 
Diagnosing Osteoarthritis of the Hip
 

Your GP or Physiotherapist can usually diagnose Osteoarthritis of the Hip by simply by examining your hip and hearing where the pain is and how it started.

 

X-rays and other tests are not usually necessary but can be used in certain cases.

 
 
 
What is the treatment?
 
Pain due to Osteoarthritis of the Hip will usually improve with some simple changes to activity and exercise.  Try to avoid or reduce the activity which aggravates your pain.  
 
Stay active but balance rest with activity.  Changing activities to ones which involve less weight bearing on the hip, such as swimming instead of running, are important to reduce the stress placed on the joint.  
 
Managing your weight is important as any extra weight places extra stress on the hip joint. 
 
Painkillers and anti-inflammatory medications  -  These may be prescribed by your GP if the pain is costant.  This is a temporary measure to break the pain cycle, but can continue as required.
 
Exercise  -  Exercise is important to help regain hip and knee movement.  Once the pain has settled it is important to strengthen the surrounding muscles and work on your balance to help reduce stress placed on the joint.  Click here for a list of exercises suitable for Osteoarthritis of the Hip  
 

Biomechanical Analysis  -   If there are significant mechanical problems insoles or specific shoes may improve your leg position and help to reduce stress on the hip joint.  A biomechanical assessment by a Podiatrist or Physiotherapist will determine whether insoles or specific shoes would be of benefit.

 

Physiotherapy  -  If exercise alone does not improve symptoms then physiotherapy treatment may be required.  A physiotherapist can use specific treatments including, ultrasound, deep friction, massage, interferential, acupuncture or taping to help relieve pain and aid recovery. Click here for more information about Physiotherapy.
 
Hydrotherapy  -  Exercise in water is very helpful.   The buoyancy of the water allows you to work on movement and strength without placing stress on the hip.
 
Injections  -  In some cases your GP or Consultant may recommend an injection.  These can be used to reduce inflammation and pain when the symptoms are severe and constant.  This is not a 'cure' and it is important to follow the exercises and modify activities.  A 'Cortisone Injection' can help reduce inflammation in the tendon, whilst a 'PRP Injection' (Platelet Rich Plasma) can help to stimulate healing.
 
Surgery  -  When symptoms are persistent, surgery is an option in severe cases of Osteoarthritis of the Hip.   Surgery for Osteoarthritis of the Hip would only be considered when all other options have been unsuccessful.    
 
Remember an important part of treatment for Osteoarthritis of the Hip your home exercises and modifying activities.