There are several different types of arthritis which can cause hip pain, but osteoarthritis is the most common. Osteoarthritis occurs when the cartilage cushioning the bones begins to wear down and be damaged with age.
Arthritis affects about 10 million people in the UK. It is more common in women than men. The most commonly affected joints are the ones that bear weight — the hips and the knees.
About 50% of the risk of developing osteoarthritis comes from hereditable factors, which means your family history of the condition. Professor Wilkinson advises that anyone with a family history of osteoarthritis wanting to reduce their risk “eat healthily and get regular exercise.”
“Even if you have arthritis, doing exercise is actually good for it. There's this general misconception that if you've got arthritis, you shouldn't exercise. Well, actually, that’s the last thing you want to not do. Because if you don't exercise you put on weight and your joints aren't kept moving. You've got to keep arthritic joints moving as much as you can.”
Rheumatoid arthritis, on the other hand, is an inflammatory condition that occurs when the body mistakenly attacks healthy joints, causing pain and inflammation.
Arthritis in women
Asked why postmenopausal women are most at risk of osteoarthritis, Professor Wilkinson said:
“There's a number of reasons for that. First, the loss of oestrogen means that the joint is less protected against some of the chemical messengers that are bad for joint health. When you go through the menopause, you also put on weight and that is a key element. And when you put on fat in particular, there are chemical messengers in fat that are actually bad for bones, and they increase the amount of inflammation in joint tissues…
“Extra weight also increases the mechanical loading on the joint. So there's increased pressure, there are changes in the chemical signals, and changes in the hormones [...] when you add them all together, it's like a triple whammy of negative consequences for women.”
Some women experience joint stiffness in perimenopause (the years of irregular periods leading up to the menopause). In some cases, it is self-limiting, which means that the symptoms end once they no longer have periods.
Hip arthritis treatments
For most cases of arthritis, Professor Wilkinson recommends trying to lose weight as a first response.
“The core treatment for arthritis in anybody, whether it's hip or knee or any other site, is to reduce your weight if you’re overweight.”
It is best to avoid surgery unless the hip pain is having a significant impact on your mobility and quality of life, since surgery comes with its own set of risks.
Non-surgical treatments for hip arthritis
Non-surgical treatment options for improving hip arthritis include:
- Losing weight with a healthcare provider’s support if you are overweight
- Increasing your overall fitness by doing gentle exercises, such as swimming and yoga, which do not strain the joints
- Seeing a physiotherapist
- Taking painkillers when necessary
- Using a walking stick
The important thing to remember about exercising with hip arthritis is to do low impact activities.
“Running is a bad idea, because that's pounding all the time. That's high impact exercise. Try low impact exercises, like walking, swimming, cycling,” Professor Wilkinson advised.
He also noted that “there's no specific magic about physiotherapy, it's just that it helps you exercise and build up muscle strength,” which will reduce the strain on your hips. “What you're really trying to do is build up the quadriceps muscles because muscle strength seems to be an important factor in [limiting the progression of arthritis].”
While people can take paracetamol on a regular basis, Professor Wilkinson found that it is not often effective. Anti-inflammatory medications such as ibuprofen can be harmful if taken long term, but anti-inflammatory gels are available. Crucially, there is no evidence that injectable hyaluronic acid has any effect — it simply “does not work,” he states.