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Hip osteoarthritis

Hip osteoarthritis is a common cause of hip pain and stiffness. We look at its symptoms and available treatments for osteoarthritis

The hip is commonly referred to as a ‘ball and socket’ joint. It is formed where the ball-like upper part of the thigh bone (femur) fits into the cup-like part of your pelvis (the acetabulum). This structure gives the hip joint a good amount of mobility.

The hip also plays an important role in retaining balance of the body.

The hip is normally hard to damage through injury because it is a deep and stable joint, covered by soft tissue, muscle and cartilage. However, because of the hip joint’s mobility, it is susceptible to natural wear and tear as well as disease. Any pain symptom in the hip can have a major impact on your ability to carry out everyday tasks, such as shopping or exercising.

While there are many causes of pain or stiffness in the hips, the most common type of arthritis, known as osteoarthritis (OA), is one of the main culprits. Osteoarthritis affects the articular cartilage on the surface of the bones, causing them to breakdown. Arthritis is a condition that affects the joints of the body. It affects millions of people in the UK, and while arthritis becomes more likely as we age it can occur in people of all ages, including children.

While osteoarthritis is the most common cause of hip pain, treatments and medical support are available for other types of arthritis as well, such as rheumatoid arthritis. There is currently no known cure for arthritis, but a range of treatments can help reduce symptoms and manage pain.

While the specific causes of osteoarthritis of the hip remain unclear, there are several factors known to increase the risk of developing it. These include: 

  • Previous joint injury: This can increase the possibility of developing osteoarthritis in the hip joint at a later date.   
  • Age: While osteoarthritis can develop at any age, it is more commonly seen in the over 50s.      
  • Gender: Women are more likely to develop osteoarthritis than men. It often begins to develop after menopause, although the exact reasons for this are not yet fully understood. ·       
  • Weight: Obesity increases the risk of developing osteoarthritis. It increases the load placed on your weight-bearing joints like the knees and hips.
  • Family history (genetics): You may be at an increased risk of developing arthritis if there is a history of it in your family.

The main symptoms of osteoarthritis in the hip include:    

  • Pain: Most people first become aware of a problem when they experience hip pain due to osteoarthritis. This may be an indication of the early stages of osteoarthritis. While occasional aches and pains are part of everyday life, you may notice that you only feel pain in your hip when you move your leg in a certain way, or when carrying out some activities. Osteoarthritis hip pain is often generalised over the whole hip rather than a localised pain. You also may experience pain in the groin or down the leg. You may feel osteoarthritis hip pain at night or early in the morning. Pain is usually the first noticeable stage of osteoarthritis of the hip.        
  • Stiffness: You may feel increased stiffness in your hip when moving your leg. As the joint becomes stiffer, it can have the effect of making your movements feel slower.       
  • Reduced range of motion: As osteoarthritis develops in the hip joint, it will start to limit and reduce your movements more. As a result some movements may become more difficult.     
  • Weakness: You might feel like you have lost some strength in your hip or thigh. The muscles surrounding your hip may look thinner than usual.   
  • Swelling: You may have swelling in your hip as a result of inflammatory changes within the joint. This is known as synovitis and will often settle naturally over time. If it becomes significantly painful, you should see a doctor for advice.       
  • Grinding: Known as ‘crepitus’, this is a grinding, creaking or cracking felt or heard within the hip joint when it is moved.

It is important to note that these symptoms are not exclusively caused by osteoarthritis. Other illnesses, injuries and diseases can also show similar symptoms. However, they are often a good indicator that something is not quite right with your hip. If you have any of these symptoms you should see a doctor who will be able to help give you an accurate diagnosis.

Nobody knows your hip pain better than you. When you first see your doctor, they will talk with you about your medical history and what you have been doing to manage the pain.

The doctor will examine your hip, thigh and lower back, assessing your range of movement in the joint and the extent of any problems. Hip pain can sometimes occur due to a problem in your back, so this will also be looked at in order to rule out the possibility of referred pain.

Depending on your medical history and the examination, your doctor may arrange for you to have some diagnostic tests to help diagnose osteoarthritis as well as treatment options. These tests may include:

  • X-rays: Where arthritis in the hip joint is suspected, your doctor will usually arrange for you to have an osteoarthritis hip X-ray as this can show clear signs of osteoarthritis in the joint. ·      
  • CT scans: A CT scanner uses a combination of x-rays and computer technology to generate a detailed view of your hip joint from multiple angles. A CT scan is good at showing subtle signs of osteoarthritis that may be missed on a standard x-ray and can also be helpful when planning hip surgery.      
  • MRI scans: An MRI scan provides your doctor with high-quality images of your hip joint. It is good for showing tendon damage, which can be a common problem with hip osteoarthritis. The images from any diagnostic scan you have will be examined by a radiologist (a specialist in interpreting diagnostic images). The radiologist will send their report to your doctor as soon as it is done.

The most common complaint from people with osteoarthritis is pain. This can have an impact on mood and psychological wellbeing, as well as physical activity. Significantly reducing it, is an important step in any hip osteoarthritis treatment, which will help you to manage life with the disease.

Non-surgical treatments for hip arthritis

Unless your osteoarthritis is at an advanced stage, your doctor will usually start with non-surgical treatments first.

Pain relief: Over-the-counter pain medication, such as paracetamol, can help with hip arthritis pain relief. Analgesia is the medical term for pain relief. As osteoarthritis develops, the pain relief you get from paracetamol may decrease, and your doctor may suggest using a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen for osteoarthritis pain relief. As well as relieving pain, these can also help to reduce inflammation. Some NSAIDs can be purchased over the counter from your local pharmacy, while others will need a prescription for certain osteoarthritis medications.

Physiotherapy: Often, people struggling with hip pain discover that an easy way to reduce the pain is by lowering their activity levels. However, this can actually add to the problem, as less activity leads to the hip becoming stiffer. As the joint tightens in this way, movement becomes more difficult. A physiotherapist can help to strengthen the muscles around your hip to compensate for the effects of osteoarthritis. Physical therapy may help to restore and maintain function and mobility in the hip for longer than would otherwise be achieved. This can help to delay the need for hip replacement surgery to treat severe arthritis.

Exercise: While hip osteoarthritis causes pain and stiffness in the joint, it is important that you continue to use the hip in order to stop it seizing up completely. There will be limits to what you can do safely and without causing further pain, but hip osteoarthritis exercises are beneficial for long-term health as well as for helping keep your hip moving. Swimming is one of the best exercises for osteoarthritis, as the buoyancy and support provided by the water reduces the stress (also known as the ‘load’) placed on the joint.

Weight loss: If you are overweight, then losing weight can help to reduce the pain you feel in your hip as a result of osteoarthritis.

Steroid injections: As osteoarthritis progresses in the hip joint, pain and stiffness usually becomes worse. Painkillers may be less effective in managing the pain. Steroid injections (also known as corticosteroid injections) can be helpful. These anti-inflammatory medicines help to reduce swelling in the hip joint and the surrounding area, reducing pain and stiffness.

Surgical treatments for hip arthritis

When hip osteoarthritis progresses to the extent it is no longer being successfully managed by non-surgical means, your doctor will talk with you about the possibility of surgery, such as hip resurfacing.

Should osteoarthritis in your hip joint develop to the point you are in constant discomfort and have extremely limited movement, a total hip replacement may be advised as the best treatment for you. Hip replacement surgery can be a life-changing procedure for many people.

During total hip replacement surgery, the damaged and worn bones of the hip joint are replaced with a metal implant. This new artificial hip joint removes the problems caused by the worn articular cartilage of osteoarthritis and is designed to provide friction-free movement. This improves the mobility of the joint, while also helping to reduce the pain and stiffness in the hip joint.

Specialists offering Hip osteoarthritis

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Mr Arjuna Imbuldeniya

Consultant Hip, Knee and Trauma surgeon

MBBS, B.Med.Sci(Hons), MSc, DIC, FRCS (Tr& Orth)

The Clementine Churchill Hospital 1 more Syon Clinic

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Mr Bilal Al-Obaidi

Consultant Trauma and Orthopaedic Surgeon

MBChB, FRCS (Tr & Orth), Diploma in Computer-Assisted Orthopaedic Systems (Navigation and Robotic System)

Circle Reading Hospital 2 more Bishops Wood Hospital The Clementine Churchill Hospital

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Mr Alastair Davidson

Consultant Orthopaedic Surgeon

MBChB, FRCS(Ed), FRCS(Tr&Orth)

The Princess Margaret Hospital

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Mr Stephen Blair

Consultant Orthopaedic Surgeon

FRCS (Trauma and Orthopaedics)

Thornbury Hospital

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Mr Vivek Gulati

Consultant Orthopaedic Hip & Knee Surgeon

BA(hons) MA MBBChir(Cantab) MRCS MRes Dip(IC) FRCS(Tr&Orth)

The London Independent Hospital

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Mr Jay Smith

Consultant Orthopaedic & Trauma Surgeon

MBBS, BSc (Hons), Dip S&E Med, MRCS, FRCS Tr & Orth

Bishops Wood Hospital 1 more The Clementine Churchill Hospital

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