Hip pain is commonly caused by arthritis. Arthritis is a progressive condition that usually starts gradually and gets worse over time. The term arthritis plainly means inflammation of the joint.
There are over 100 types of arthritis that can make carrying out everyday activities difficult, causing joint pain and stiffness. There is no cure for any form of arthritis, but there are ways to treat the pain and other associated symptoms.
The type of arthritis you have can affect your treatment options. Types of arthritis that commonly affect the hip include:
Osteoarthritis
Osteoarthritis is the most common form of arthritis in the hip. It is more likely to develop in people over the age of 50 due to wear and tear. However, it can occur at any age due to the cartilage that protects your bones wearing away. Osteoarthritis develops slowly and gets progressively worse. It can affect any joint but is most likely to occur in your hands, knees, spine or hips
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a systematic disorder that affects the entire body and not just the hip. It is a chronic autoimmune disease, meaning the immune system attacks its own tissue. This form of arthritis affects joints symmetrically, usually occurring in the same joint on both sides of the body, typically causing swelling and eventually causing the bones and cartilage of the joints to deteriorate. Rheumatoid arthritis can occur in people of all ages, including children (known as juvenile rheumatoid arthritis) and is more likely to develop in women than men.
Ankylosing Spondylitis
Ankylosing spondylitis is a chronic inflammatory disease of the spine and sacroiliac joint that can sometimes cause inflammation of the hip joint. Ankylosing spondylitis typically develops in early adulthood. It can occur in people of all ages and is more common in men than women. It is typical for people with ankylosing spondylitis to experience flares with the disease. There is no cure for ankylosing spondylitis; however, there are treatments available to ease your symptoms and in some cases slow progression of the disease.
Systemic Lupus Erythematosus
Systemic lupus erythematosus (lupus) is a systemic autoimmune disorder that can affect any area of the body, including the hip joint and is most common in women aged 15 – 35. The immune system typically fights off dangerous infections and bacteria. An autoimmune disease occurs when the immune system attacks the body, mistaking it for something unwanted. If lupus attacks the hip, inflammation and damage to the joint can develop. There is currently no cure, but symptoms can be eased with treatment.
Psoriatic Arthritis
Psoriatic arthritis is a type of arthritis related to people that suffer with the skin condition psoriasis. Similar to psoriasis, psoriatic arthritis is a long-term condition that can get progressively worse. Psoriatic arthritis causes pain, swelling and stiffness and can affect any joint in the body. The majority of people with psoriatic arthritis firstly have the skin condition (scaly red patches of skin) however; it is possible to develop psoriatic arthritis prior to the skin condition. If psoriatic arthritis is diagnosed and treated quickly, the progression can be slowed and permanent joint damage can be minimised or prevented.
Causes and Risk Factors
The hip joint is a ball and socket joint made up of the ball-shaped end of the thighbone (femoral head) which fits into the hip socket (acetabular socket). It is lined with smooth cartilage to help the joint move freely and absorbing the pressure when you move or add stress. If this smooth cartilage wears away, the remaining rough surfaces of the bones grind against each other, causing pain. Factors that may increase your risk of developing arthritis include:
Genetics
You may be more likely to develop arthritis if your parents or siblings suffer from the disease.
Age
Many types of arthritis become more common with age.
Gender
Many forms of arthritis are more commonly found in women. However, gout, a type of arthritis, develops more frequently in men.
Joint Injury
Trauma or injury can make a joint more prone to arthritis.
Obesity
Excess weight adds stress to the joints, particularly your knees, hips and spine. Carrying excess weight may contribute to the development and the progression of arthritis in the hip.
Symptoms of Hip Arthritis
Experiencing problems carrying out one particular task, such as putting on socks or shoes, is a common sign that hip arthritis is affecting your life. Hip arthritis can develop and deteriorate range of motion quickly. Regardless of the type of arthritis, other symptoms of hip arthritis include:
- Pain in the hip joint, groin or thigh that radiates to your knee or buttocks
- Pain that is worse after not moving for an extended period such as in the morning
- Increase in symptoms following vigorous activity
- Difficulty walking or limping
- Grinding sensation during movement
- Increased pain in rainy weather
- Locking of the hip joint or limited range of motion
With rheumatoid arthritis or lupus, fatigue and weakness can also be a symptom. Arthritis often occurs in flares with remission; however, some people experience a relatively steady level of pain without flares.
Any type of arthritis can affect more than one joint in the body; therefore, a person with osteoarthritis in the hands may also develop the condition in the hip. If you have arthritis of the hip, you can expect to see the symptoms get worse gradually over time. In the beginning, symptoms can be sporadic and related to certain activities, but the hip joint typically continues to deteriorate.
Diagnosis of Hip Arthritis
If you suspect you have arthritis, a successful diagnosis is the first step towards a successful treatment plan. Your doctor will carry out a physical examination to check your joints for swelling, warmth and inflammation, as well as how well you can move your hip. Depending on the type of arthritis the doctor suspects, they may suggest the following tests:
Laboratory Tests
Laboratory tests are a medical technique that performs an analysis of different types of body fluids to help identify the type of arthritis you may have. Fluids typically analysed include blood, joint fluid and urine.
Imaging Tests
Imaging tests can reveal problems within your joint that may be causing your symptoms.
X-rays
X-rays are a helpful tool in diagnosing a wide range of conditions. X-rays may not detect early signs of arthritis, but they are often used to track development of the disease.
Magnetic resonance imaging (MRI)
An MRI scan is a safe and painless diagnostic tool used to produce a detailed picture of the tissue and organs inside of your body.
Ultrasound
This technology uses high-frequency sound waves to create an image of the cartilage, soft tissues and fluid-filled structures near the joints. Ultrasound may also be used to guide needle placement for joint aspirations and injections.
Treatment of Hip Arthritis
Hip arthritis can be managed in a number of different ways depending on the severity of arthritis and the patient’s age. Treatment may consist of nonsurgical, surgical methods, or a combination of both.
Nonsurgical Treatment
Healthy Lifestyle
Painful symptoms may have caused you to reduce the level of activity you participate in. It is important to maintain a healthy, active lifestyle to ease symptoms of arthritis and prevent further damage. Carrying excess weight can add stress to the joints, which can increase pain.
Hot and Cold Therapy
Hot and cold treatments are effective methods for easing painful arthritic symptoms. Heat therapy can recover circulation and ease stiff joints and sore muscles. Cold therapy restricts blood vessels, which causes circulation to slow, reducing swelling, and numbing pain. Heat therapy can loosen stiff joints and release achy muscles.
Medication
Some examples of medications that your doctor may suggest include:
- Analgesics are medicines used for pain control
- NSAIDs (Non-steroidal anti-inflammatory drugs), such as aspirin and ibuprofen to relieve pain and reduce fever
- Corticosteroids, used to decrease inflammation
- Disease-modifying antirheumatic drugs (DMARDs) work by altering the disease, slowing or stopping inflammation and reducing pain.
Your doctor may suggest surgery as a last resort technique if the symptoms are not relieved with nonsurgical treatment, your quality of life is affected or because of pain and limited mobility. Knee surgery to relieve arthritis pain is considered elective surgery (it is up to the patient to decide).
Surgical Options
Joint replacement (also referred to Hip Arthroplasty)
A total hip replacement is a surgical procedure, where a severely damaged hip joint is replaced with an artificial material (a prosthesis).
Partial Joint Replacement
This technique involves replacing one side of the hip joint (femoral head), instead of both sides. This is a common procedure carried out in older people following a hip fracture.
Osteotomy
Osteotomy surgery may be more appropriate in less severe cases, if the patient is young and the arthritis is located in a small area of the hip joint. During an osteotomy, the surgeon will cut and reposition the joint surfaces so that it allows the healthy part of the joint to bear the majority of the body’s weight. The advantage of this technique is that you can retain your own hip and potentially provide years of pain relief without a prosthetic hip.
Joint Repair
In certain cases, joint surfaces can be smoothed or readjusted to decrease pain and recover function. This type of procedure is often carried out arthroscopically — through small incisions over the joint.
Joint Fusion (Arthrodesis)
In this treatment technique, the pelvis and the femur are surgically fused with bins and rods to immobilise the joint, creating one solid bone.
Outlook
Arthritis is a disease that doesn’t have a cure however; with treatment, the outlook is positive. Do not ignore symptoms of pain and stiffness as the sooner you speak with a doctor, the sooner you can receive a diagnosis and start managing and treating pain and stiffness, and improve your quality of life.
Need Help?
If you are experiencing pain which you think could be hip arthritis, you can be seen by a Consultant Orthopaedic Hip Surgeon at One Ashford Hospital, usually within 48 hours. One Ashford Hospital is well placed to see patients with knee injuries from Ashford, Maidstone, Canterbury, Folkestone, Dover and all surrounding villages. To book an appointment, call the hospital direct on 01233 364 022 or email here.
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