Hip Arthritis

Hip Arthritis

What causes hip arthritis?

In truth, we don’t fully understand why some people develop arthritis, and others don’t, but there may be a genetic underlying predisposition in some families. Women are more likely to develop osteoarthritis than men, as are people who play a large amount of contact sports (such as rugby, football and martial arts).

Injury to the hip can also predispose us to hip arthritis, as can a poorly formed hip; many people who have hip arthritis may have previously suffered with hip dysplasia (which is where the shape of the hip joint is abnormal), or femoroacetabular impingement, (where the hip joint catches in the socket).

Being overweight stresses the hip joint because of the increase in forces going through the hip, so if you’re beginning to experience symptoms of hip arthritis, it’s important to do all you can to achieve and maintain a healthy weight.

What happens to the hip when arthritis develops?

The hip joint is a ball and socket joint, and the surfaces of the joint are covered in hard, shiny covering, called articular cartilage.

When we’re a young adult, the articular cartilage looks immaculate (like a field of driven white snow) and the polished cartilage joint surfaces glide smoothly on each other.

As the hip joint wears, crevices and divots appear in the cartilage surface (much like the thawing of snow on a ploughed field), exposing the bone underneath. This causes pain and inflammation, and the roughed-up surfaces can cause the hip to catch and grind.

This cartilage loss is permanent, and we don’t yet have a way to halt or reverse the wear.

What does hip osteoarthritis feel like?

Most people who have hip arthritis will describe symptoms that have crept on over many weeks and months. The hip joint is seated deep in the groin (not on the side of the hip), and hip pain is often felt in the groin, it can radiate in a c-shape around the hip and into the buttock, and many people will sense it in the front of the thigh or into their knee.

Hip arthritis pain is a nagging pain, like a nagging tooth ache, but with twisting or sudden movements, it can catch, sting or create a searing, burning pain.

When hip arthritis pain becomes very bad, it can make it difficult to get to sleep (because it’s hard to find a comfortable position) and turning over in bed at night can cause a pain that wakes you.

When the hip wears, the movement in the hip joint declines, and many people will find that the hip feels stiff, it’s difficult to cross legs, and can make it difficult or painful to put shoes and socks on.

Many people will experience pain that comes and goes, and whilst exercise initially helps to ‘warm up’ the joint and ‘get it going’, too much exercise, or impact activities such as running, can inflame the joint after activity.

Hip pain can eventually lead to limping, and sometimes it’s not obvious to the patient until it’s being pointed out by a family member.

If the hip becomes very stiff, it can also significantly impact other areas of the body, often causing lower back pain.

For many people, their hip pain significantly impacts their day-to-day lives, and may even make it difficult for them to work.

How is hip osteoarthritis diagnosed?

It’s often very clear from the symptoms that a person has hip arthritis. When we examine a person who has hip arthritis, they may tend to walk with their leg a little rotated outwards, and they may even limp. Their hip movements will be restricted with less rotation and less flexion range. Compressing the hip up into a deep bend or rotating it, may be painful.

Often an X-ray is all that’s needed to confirm the diagnosis, but occasionally, further tests such as an MRI or CT scan may be needed.

What treatment is there for hip arthritis?

Because it’s not possible to reverse the process of arthritis, our goal is to make you as comfortable and as mobile as possible. It’s all about quality of life.

The hip joint is supported by the action of muscles around the joint, and there’s plenty of research to show that exercise (and physiotherapy) can be very helpful in reducing symptoms and keeping the joint strong.

Swimming and cycling can help maintain hip strength, and pilates and yoga can help with joint mobility, but it’s advisable to limit impact exercise (such as running and football) which may flare up your symptoms.

Painkillers (such as paracetamol) can be helpful, and a short course of NSAIDS (non-steroidal anti-inflammatories) e.g. ibuprofen can reduce hip pain and stiffness, although do check with your GP or pharmacist, as they may not be suitable for you.

Injection treatments, such as a corticosteroid injection may buy you a little bit of time, but they won’t cure your arthritis, and so it’s not a long-term strategy. Sometimes the use of a walking stick or walking aid (used on the opposite side) may help with your pain, because it offloads the painful hip joint.

If you’ve been struggling with your hip arthritis symptoms, despite ‘conservative’ treatments, it may be time to consider hip replacement surgery.

Aren’t I too young to have hip arthritis?

Whilst it’s true that hip arthritis is more common as we age, hip arthritis can affect young people too. Avascular necrosis – a condition affecting the blood supply to the ball of the joint is common in people between the ages of 30 and 50, can lead to arthritis, as can hip dysplasia, which is when the joint is imperfectly formed.

The good news is, you don’t have to suffer on with hip arthritis, and there is much that can be done to help. If you’d like to get expert advice for your hip pain, book an appointment.