What is hip osteoarthritis?
In hip osteoarthritis, the cartilage of the hip gradually wears away, becoming rough and damaged. As cartilage disappears, the leg and hip bones rub directly on each other and become damaged. The damaged bones may even change shape and cause bone spurs. All of this can cause pain, stiffness, decreased range of motion, and difficulty in daily tasks like bending over or walking.
Despite recent advances in medical therapies, there is no cure for osteoarthritis. If you seek help early, you can help to reduce its impact on your life. There are many treatments for arthritis that do not involve surgery.
Causes
It is common for the hip joint to experience wear and tear as you get older. The cause of arthritis is usually a combination of the following factors:
- Joint injury. This may result from repeated movements or damage during sports.
- Joint overuse. For example, putting too much stress on the hip joint could be related to a job that requires heavy lifting, bending a lot, or standing for long periods.
- Increasing age. Wear and tear on joints builds up over the years.
- Being overweight. Extra weight puts added pressure on your hips and can break down cartilage faster.
- Genetics. The shape and development of your hip joint may predispose you to problems
Diagnosis & Tests
Not all hip pain comes from the hip joint. Hip bursitis and referred pain from low back problems often present as a hip problem. Your healthcare provider will ask about your medical history, including your activity level. They will ask about your symptoms and do a physical examination to look for:
- Range of motion for your leg
- Pain in the hip from specific movements
- Problems with the way you walk
- A grating sound or sensation within the joint, called crepitus
- Any injury to the tendons, ligaments, and muscles around the hip
Your healthcare provider may also want to do imaging tests to better examine the hip joint. An x-ray can show if the joint space is normal or has narrowed due to osteoarthritis, if the bones have changed, or if there are any bone spurs. If the problem cannot be diagnosed with simple x-rays, an MRI is occasionally necessary to further diagnose the problem.
Treatments
Non-Surgical
- Medicines that help reduce inflammation may cut down on your arthritis pain. These include over-the-counter medicine, such as ibuprofen, naproxen, or acetaminophen, or corticosteroids.
- Physical therapy can help you increase your flexibility and range of motion and strengthen your leg muscles.
- Assistive walking devices, such as a cane or walker, can help you get around more easily. Soft, accommodating shoes will lessen the impact to a sore hip.
- Modifying your activity can help slow down the progressions of hip osteoarthritis. Switching from high-impact activities, such as jogging or tennis, to low-impact activities, such as swimming, can put less stress on your hip joint.
- Weight loss will always help a painful hip. Sometimes just 5-10 lbs. can make a significant difference.
- Injections are less common in the hip but can be used to reduce pain and inflammation.
Surgical
If you have serious hip damage that is causing a disability and are not able to find relief with medicine and physical therapy, you may be considering surgery.
- Hip replacement. In a traditional total hip replacement, the surgeon removes the entire head of the thigh bone as well as the damaged bone in the hip socket. These bones are then replaced with a new head and socket made of titanium. Total hip replacement can be done on many kinds of patients of all ages. Because there are many options for hip surgeries with important differences in the procedures, you need to work with an experienced hip surgeon who can educate you on the pros and cons to each. Your healthcare provider will discuss options and recommend the treatment that fits your situation best.
- Hip preserving procedures. Arthroscopic surgery has made dramatic improvements in the last decade. Many patients may benefit from a surgery that does not involve replacing the whole joint.