Hip osteoarthritis
Arthritis describes inflammation of any joint in the body, causing a destructive process to the joint in the long term. Osteoarthritis occurs when inflammation causes damage and eventual destruction to the cartilage layer, disrupting the normally smooth surface that eases joint movement. This typically happens over a long period – usually years or decades in response to wear and tear with use.
The hip is a ball-and-socket joint through which significant forces are transmitted when standing, walking, running, and jumping. As a weight-bearing joint, it's particularly vulnerable to this progressive damage of the smooth cartilage surface layer. Once this cushion is eroded, the ball part of the hip - the top of the femur (thigh) bone - cannot move smoothly, and instead, it jars against the socket of the pelvic bones, causing a great deal of pain and loss of function.
Age is one of the biggest factors in the development of osteoarthritis. Still, any injury or overuse from sports or work, or stresses such as obesity, can accelerate the destructive process.
Pain and stiffness are the most common feature of hip osteoarthritis. Pain can be felt deep in the hip's outer edge, groin, buttock, or knee. Pain is usually worse after prolonged activities such as long walks or exercise and at the end of the day. You may notice a reduced range of motion of your hip joint compared to the previous range and develop a limp with severe pain.
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How can I improve symptoms?
Osteoarthritis is a common condition and can be managed with simple measures to improve symptoms and your quality of life, especially in the early phase.
Being overweight is a big risk factor for developing osteoarthritis and worsens symptoms as the joint is put under more strain. Weight loss will significantly improve pain and mobility. It is important to remain active and continue participating in gentle exercise - although avoid any activities that cause pain. Exercise will help overall fitness and muscle tone, and specific exercises can help strengthen the muscles around your hip to protect it from injury or damage.
If pain makes walking difficult, a walking stick held in the hand opposite to the affected leg will improve your pain and balance. Avoid carrying heavy loads, as this adds strain to the hip joint. If you need to carry something like a shopping bag, it should be held in the same hand as the affected leg.
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Simple painkillers can help reduce your pain. Acetaminophen is a good start to relieve pain from arthritis. One to two acetaminophen tablets up to four times a day can help - leave a 4 to 6 hour interval between doses. Acetaminophen is generally well tolerated and safe for most. Do not take more than 4 grams per day.
For more severe pain, your doctor can prescribe stronger pain medications.
Topical gels such as Voltaren work by absorbing through the soft tissues. Gels don't usually interact with other medications and can be used alongside other pain relief medications. They also avoid the gut if you get indigestion or have a risk of ulcers.
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When should I see my doctor?
If your symptoms are severe or have failed to improve with these simple measures, book a routine appointment with your doctor. They may advise you further on specific exercises or stretches, offer additional painkillers or refer you to a physiotherapist. Suppose your symptoms fail to improve or are causing a significant decrease in quality of life. In that case, you may be referred to a specialist, where treatment options will depend upon further investigations.
What will the specialist do?
An X-ray is usually used to confirm osteoarthritis. If this shows significant destruction in the joint and this tallies with significant symptoms, your specialist may recommend a total hip replacement. This is where the ball and socket joint is replaced with a prosthetic implant. This surgery can be very effective but would only be considered a last resort after all simple measures have been exhausted.
You should keep fit and active and work on strengthening the muscle around your hip while awaiting any operation. This puts you in the best position to recover from surgery and make the most of your new hip.
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