Sometimes called “wear-and-tear” arthritis, osteoarthritis is a common condition that many people develop during middle age or older. It can occur in any joint in the body, but most often develops in weight-bearing joints, such as the hip.
Osteoarthritis of the hip causes pain and stiffness. It can make it hard to do everyday activities like bending over to tie a shoe, rising from a chair, or taking a short walk. Stiffness is a common complaint for osteoarthritis in any joint.
Because osteoarthritis gradually worsens over time, the sooner you start treatment, the more likely it is that you can lessen its impact on your life. Although there is no cure for osteoarthritis, there are many treatment options to help you manage pain and stay active.
Osteoarthritis is a degenerative type of arthritis that occurs most often in people 50 years of age and older, though it may occur in younger people as well.
In osteoarthritis, the cartilage in the hip joint gradually wears away over time. As the cartilage wears away, it becomes frayed and rough, and the protective joint space between the bones decreases. This can result in bone rubbing on bone. To make up for the lost cartilage, the damaged bones may start to grow outward and form bone spurs (osteophytes). The loss of cartilage also reduces the natural joint fluid that lubricates the joint.
Osteoarthritis develops slowly. Some times osteoarthritis can be exacerbated for days to weeks at a time and then decrease, especially after an injury. The natural course of osteoarthritis is chronic with worsening join and pain over time without therapy.
Osteoarthritis has no single specific cause, but there are certain factors that may make you more likely to develop the disease, including:
- Increasing age
- Family history of osteoarthritis
- Previous injury to the hip joint
- Improper formation of the hip joint at birth, a condition known as developmental dysplasia of the hip
- Improper kinetic mechanisms including FAI
Even if you do not have any of the risk factors listed above, you can still develop osteoarthritis.
The most common symptom of hip osteoarthritis is pain around the hip joint. Usually, the pain develops slowly and worsens over time, although sudden onset is also possible. Pain and stiffness may be worse in the morning, or after sitting or resting for a while. Over time, painful symptoms may occur more frequently, including during rest or at night.
Additional symptoms may include:
- Pain in your groin or thigh that radiates to your buttocks or your knee
- Pain that flares up with vigorous activity
- Stiffness in the hip joint that makes it difficult to walk or bend
- "Locking" or "sticking" of the joint
- Grinding noise (crepitus) during movement caused by loose fragments of cartilage and other tissue interfering with the smooth motion of the hip
- Decreased range of motion in the hip that affects the ability to walk and may cause a limp
Although there is no cure for osteoarthritis, but there are a number of treatment options that will help relieve pain and improve mobility.
As with other arthritic conditions, early treatment of osteoarthritis of the hip is nonsurgical. Your doctor may recommend a range of treatment options.
Lifestyle modifications. Changes in your daily life can protect your hip joint and slow the progress of osteoarthritis.
- Minimizing activities that aggravate the condition, such as climbing stairs.
- Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) will put less stress on your hip.
- Losing weight can reduce stress on the hip joint, resulting in less pain and increased function.
Physical therapy. Specific exercises can help increase range of motion and flexibility, as well as strengthen the muscles in your hip and leg. Your doctor or physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.
Assistive devices. Using walking supports like a cane, crutches, or a walker can improve mobility and independence. Using assistive aids like a long-handled reacher to pick up low-lying things will help you avoid movements that may cause pain.
Medications. If your pain affects your daily routine, or is not relieved by other nonsurgical methods, your doctor may add medication to your treatment plan.
- Acetaminophen is an over-the-counter pain reliever that can be effective in reducing mild arthritis pain. Like all medications, however, over-the-counter pain relievers can cause side effects and interact with other medications you are taking. Be sure to discuss potential side effects with your doctor.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) may relieve pain and reduce inflammation. Over-the-counter NSAIDs include naproxen and ibuprofen. Other NSAIDs are available by prescription. These medications can irritate the stomach lining and cause internal bleeding. They should be taken with food. Consult with your doctor before taking over-the-counter NSAIDs if you have a history of ulcers or are taking blood thinning medication.
Injection may be beneficial for this condition. They may include:
- Cortisone (Corticosteroid)
- Hyaluronic Acid (Viscosupplement) Treatment
- Platelet Rich Plasma (PRP)
- Trigger Point Injections
Your doctor may recommend surgery if your pain from arthritis causes disability and is not relieved with nonsurgical treatment.
There are several different procedures that can be done to restore the hip joint. These may include:
- Osteotomy. Either the head of the thigh bone or the socket is cut and realigned to take pressure off of the hip joint. This procedure is used only rarely to treat osteoarthritis of the hip.
- Hip resurfacing. In this hip replacement procedure, the damaged bone and cartilage in the acetabulum (hip socket) is removed and replaced with a metal shell. The head of the femur, however, is not removed, but instead capped with a smooth metal covering.
- Total hip replacement. Your doctor will remove both the damaged acetabulum and femoral head, and then position new metal, plastic or ceramic joint surfaces to restore the function of your hip.