“Osteo” means bone “Arthro” means joint and “itis” means inflammation and dysfunction. Hence Osteoarthritis means joint inflammation and dysfunction. It is the most common form of joint disorder and is often referred to as a “wear and tear” arthritis or an age-related arthritis. It will happen to you, if you are lucky enough to live past the age of 20, much like grey hair and wrinkles! Osteoarthritis can occur at any joint in your body and one of the most common joints it affects is your hip joint.
Osteoarthritis in the hip joint usually presents as pain and stiffness. The main specific signs and symptoms of hip osteoarthritis are:
- Pain around the hip joint – most commonly referring to your groin and inner thigh region that can radiate into the buttocks or knee.
- Stiffness in the hip joint.
- Pain and stiffness that is worse in the morning or after periods of rest/inactivity.
- Pain that flares up with vigorous activity.
- Stiffness can reduce the range of motion in your hip joint making certain activities difficult e.g. bending your hip to put shoes and socks on.
- Stiffness symptoms tends to subside in less than 30 minutes with gentle activity.
- The pain can develop slowly and worsen over time or can have a sudden onset.
- In more severe hip osteoarthritis there can be pain with rest or inactivity and the patient may develop a limp or compensatory gait
What is Osteoarthritis of the hip?
During your everyday activities and movements your joints are exposed to constant low-level damage. The majority of time your body will repair the damage itself and you remain below the threshold where you experience any pain or symptoms. But with osteoarthritis the protective cartilage around the ends of your bones at your hip joint start to break down. Often the body’s protective response is to form bony growths around the area (osteophytes) to try and restore stability. This can make the joints stiff and painful. In more advanced cases the formation of bone growths can create even more friction in the hip joint and lead to more lesions associated with pain.
What causes Osteoarthritis of the hip?
We know that Osteoarthritis of the hip is a degenerative process manifested by progressive loss of articular cartilage with reactive bone formations and osteophyte growth as described above. However, in primary osteoarthritis we don’t know the exact reason why this occurs. In secondary osteoarthritis we know this results from conditions that change the cartilage environment Eg trauma, congenital hip abnormalities and disorders that affect the normal structure and function of the hips hyaline cartilage.
Although we don’t know the exact cause of primary osteoarthritis we do know a number of risk factors which can be either local risk factors that act on the joint level or more general risk factors such as:
- Age: >60 years is a considerable risk factor for developing OA
- Sex: prevalence is higher among men younger than age 50 years, whereas women have the highest prevalence over the age of 50.
- Obesity: Excess weight produces increased load on the joint, but there is growing evidence for a metabolic contribution to osteoarthritis as well.
- Genetics have an important role in the development of hip OA, and a twin study reported on a 60% risk for hip OA attributable to genetic factors.
- Occupation: heavy manual work and high-impact sports activities are linked to OA in the hip and other joints later in life e.g. farmers.
- Trauma: fractures of the articular surface of the hip joint can lead to secondary post-traumatic arthritis.
How does physiotherapy help with hip osteoarthritis?
Physiotherapy is the mainstay of treatment especially in the early and mild stages of hip osteoarthritis. Although there is no absolute magic bullet cure for hip osteoarthritis we can manage the symptoms and get you back to doing what you love! Often with osteoarthritis just like with other injuries often there can be periods flare ups and periods where it feels settled. Our job here at Fixio is to work out what is driving the flare ups of arthritis and collectively come up with solutions for you.
Generally this is done in two steps, the first being to reduce your osteoarthritis flare up that is causing you pain and stiffness in your hip. We can help do this by utilising a number of treatment modalities such as:
- Advice regarding avoiding aggravating activities.
- Soft tissue massage around tight and overactive hip and upper limb musculature.
- Dry Needling (link).
- Heat or Cold therapy to reduce pain and swelling.
- Hip passive mobilisation.
- Pain medications options for you (done in conjunction with your G.P)
- Gentle active range of motion exercises for your hip joint
After the pain has begun to settle, we can focus on a long-term strategies to improve strength, endurance and function of your Hip muscles. Often patients with hip osteoarthritis respond really well to low impact strengthening exercises, this could include swimming, hydrotherapy or our very own Pilates classes right here at Fixio (include link to landing page). This of course depends on your personal preference and exactly what your goals are. We will also give you specific physiotherapy exercises to address any muscle imbalances or strength deficits we have identified during your assessment.