What is hip osteoarthritis?

Osteoarthritis of the hip may cause pain and stiffness in the affected joint.

Osteoarthritis is the name given to age-related arthritis which causes the affected joint to become painful and stiff. The process of osteoarthritis involves wearing or thinning of the smooth cartilage joint surfaces as well as stiffening to the soft tissue surrounding the joint. These aspects combine to produce swelling, inflammation and pain.

Several factors normally combine to cause symptoms of osteoarthritis:

  • Previous joint damage
  • Increased bodyweight
  • Age (risk increases with age)
  • Family history (genetics)

General exercise such as walking, cycling and playing sports does not increase the risk of developing or increase the rate of deterioration of hip osteoarthritis.

Hip osteoarthritis

Common symptoms

Most commonly the pain is felt in the groin region. Sometimes the pain may also be felt in the buttock or outside of the hip. Some individuals may suffer from referred pain radiating into the thigh and knee area. The presence of hip osteoarthritis does not always cause pain so it is quite possible to have reasonably advanced arthritis with mild pain. In addition, the hip undergoes a ‘wear and repair’ cycle so pain can improve.

Pain on walking is often the main aggravating activity. If hip osteoarthritis becomes more severe the movements of the hip may become increasingly stiff which may cause a problem with activities of daily living such as sitting, lying in bed, getting out of a car or putting on shoes.

How is hip osteoarthritis diagnosed?

Hip osteoarthritis can be reliably diagnosed by your doctor or physiotherapist by taking a history of your condition and by conducting a physical examination.

The main feature on examination is often a reduced range of movement.

X-rays are not routinely required, but may be requested if symptoms are severe enough that total hip replacement surgery is being considered.

How is hip osteoarthritis treated?

Non-surgical management

In the majority of cases, the symptoms of hip osteoarthritis can be managed effectively by non-invasive measures as described below. The most effective are exercises and in those who are overweight, weight loss.

Weight loss

An ideal BMI is less than 25. You can use a BMI calculator to advise if it might be advisable for you to try to lose some weight.Losing weight reduces the load on your joints as you move about. Evidence shows that weight loss can result in improved mobility. There is also evidence to suggest that weight loss alone may actually help to reduce pain. However, in combination with exercise, the results can significant.

For many people, losing weight feels like an uphill struggle. However, there is lots of support and advice available.

You can find some excellent ideas, including recipes and advice on making healthy food choices, on the NHS Change 4 Life website, which also has information about activities local to you.

Exercises

Regular exercises to maintain flexibility and strength to the affected hip joint:

3×10 repetitions 3-4x per week

3×10 repetitions 3-4x per week

3×10 repetitions 3-4x per week

Using painkillers when needed

Over-the-counter analgesia is available through pharmacies when needed. Paracetamol is most commonly prescribed. Anti-inflammatories, such as Ibuprofen, are also used, but as there is little or no inflammation involved in osteoarthritis these are best avoided without discussing with your GP. Side effects are even more common than with paracetamol so please ensure to take appropriate medical advice. There is a good booklet on the Arthritis Research UK website with information about the various drug options.

Using a walking stick when needed

Apos Therapy trial

For patients with advanced osteoarthritis who satisfy the referral criteria for surgery but wish to avoid it, Apos Therapy provides a treatment option. The concept is based around a shoe-like biomechanical device which can help to distribute the forces more evenly through the joint and aid in strengthening the joint. Your clinician will discuss this with you if this option is suitable.

Surgical management

Total hip replacement (THR) surgery is an effective option for patients with advanced stage hip osteoarthritis who:

  • Have trialled a course of non-surgical management without success
  • Have consistent, disabling pain significantly limiting mobility and/ or affecting sleep pattern
  • Have a Body Mass Index (BMI) within a normal range or have made lifestyle changes to lose excess bodyweight

You may be asked to complete a questionnaire called an Oxford Hip score. This can help the clinician assess the impact of your symptoms which can be useful in assessing suitability for surgery.

Further information about OsteoarthritisArthritis Research UK