Hip osteoarthritis is a common cause of joint pain of the lower extremity and can cause varying degrees of limitations.
Osteoarthritis is a long term condition that can affect one or more joints in the body and over time cause pain, stiffness, decreased range of movement in the joint and weakness of the muscles around the joint. It happens when there is breakdown of the cartilage in the joint which causes joint space narrowing. Some people report mild symptoms whereas other people may find their symptoms are severe. Osteoarthritis can affect people of all ages but is more common with people aged 40 and over.
Symptoms of hip osteoarthritis
Pain in or around the hip joint and groin area is the most common symptom of hip osteoarthritis. Additionally, pain in the groin or thigh that moves into the buttocks or knee is another symptom. Pain may develop over a gradual period initially and can worsen over time.
Morning pain and stiffness can happen with this condition. Also after a period of rest, pain and stiffness may follow.
A reduction in the “smoothness” of a joint during movement may also be an indicator of hip osteoarthritis. These symptoms may include “locking”, “sticking” or “grinding” (crepitus) in the joint and may cause a reduction in the hips range of movement.
People often experience some difficulty with tasks such as walking, getting up from a chair and getting in and out of a car.
How common is hip osteoarthritis
Osteoarthritis causes the cartilage which covers the end of bones to break down resulting in it becoming thin and roughened. The bone underneath the cartilage can then react and grows larger causing swelling and reduced range of movement in the joint. The body’s natural inflammation process is the main cause for these changes within the joint as it attempts to repair the injured area.
The exact cause of osteoarthritis is unknown, however, it is likely that a combination of factors may contribute such as:
- Previous joint injury – overusing the joint when it’s not had enough times to heal. Repetitive activities and physical jobs can also increase the risk.
- Age-related changes – the risk of getting osteoarthritis increases as you get older.
- Family history – osteoarthritis may run in families due to people inheriting certain genetics from their parents.
- Being overweight – this increases the load which goes through the joint and puts extra strain on them.
- Female gender – osteoarthritis is more common in woman than men.
What can help with hip osteoarthritis?
There is no cure for hip osteoarthritis however there are many strategies that can be tried to manage and help your symptoms. The good news is that these can be really effective.
Helpful tips
- Footwear: The use of appropriate footwear may help with shock absorbency of the hip joint which can help reduce pain. High heels or wedge typed footwear are discouraged due to not allowing for an even weight distribution.
- Positioning: Avoid sitting in low chairs as this can be more difficult to stand up from. Crossing legs is not advised due to causing a strain in the hip joint. Placing a pillow or cushion in-between your legs in side sleeping can help relieve pain by maintaining a neutral position. Similarly placing a pillow under your knees when lying on your back may also increase comfort.
- Assistive devices (walking aids): There are many different walking aids available which can aid a person struggling with their mobility. A physiotherapy assessment will help to provide the correct walking aid for you, for example, a walking stick or crutch can help ease the pressure of hip pain when walking.
Timescales/Prognosis
Osteoarthritis is a long term condition that many people are able to self-manage. Osteoarthritis can be variable and it is normal to have good and bad periods.
Pain activity ladder
By following the pain activity ladder you can identify activities that you would consider severely painful, moderately painful and mildly irritating and act to change your habits.
The pain scale, most often used in healthcare, measures pain from 0-10 (zero being no pain and 10 representing the worst pain you could imagine).
If you can identify the level of pain you are experiencing, you will find out if you are in the green, amber or red zone. The best way to move down to the green zone is by pacing and spacing your activity.
When you are completing your rehabilitation exercises it is often best to work within the green (and sometimes amber zones depending on what you deem is an acceptable level of pain) both during the exercises and within 48 hours of completing your exercises. If you find yourself in the red zone you are likely pushing yourself too hard and may flare up the pain.
Pacing and spacing
Pacing and spacing methods can help you manage your pain better.
Pacing is the term used for breaking down an activity or task. This can be done by taking regular breaks. Prioritising daily activities can also help. This can prevent “over stimulating” your pain system.
When completing challenging tasks or activities, it may be useful to set a “baseline”. This is the amount you can manage on a good or bad day without increasing your symptoms. Therefore, you can plan rests and set achievable goals.
Lifestyle adaptions
With any ongoing conditions, you may need to make some changes to your regular activities to make life easier. Here are some suggestions:
Non-slip bat mats, rails, bath boards or seats may make getting washed easier. If you struggle to get on and off the toilet a raised toilet seat or grab rail may be of use. Consider the layout of your toiletries and avoid having to stretch to reach items.
When drying hair you could try supporting your arm on a table if you are bothered with overhead activity and struggle to hold the weight of the hairdryer.
Getting dressed is easier in a seated position. There are various tools on the market that may help with dressing for example a long-handled shoehorn.
If you have one side that is painful try to avoid sleeping on the affected side especially with neck, shoulder or hip pain. You might find it helpful to use extra pillows to support your arms or legs.
If sitting try not to spend too long in one position. We recommend moving every 20 minutes. Consider the height of your chair and sit in a higher chair if you struggle to get up from sitting. Armchairs may be better than a sofa as you will have arm support.
Try not to attempt too many tasks in one day. Avoid spending too long doing repetitive activities such as cleaning windows and hoovering. You could try sitting down to iron.
In the garden try to vary the jobs so you don’t spend too long in one position.
If appropriate to you take a trolley rather than a basket even if you are only needing a few items as this will give you more support and avoid you having to carry heavy objects.
Try to break up longer journeys, get out and stretch your legs regularly.
When to speak to a professional
If your symptoms continue to persist or get worse after considering this advice, it may be appropriate to speak to your GP or Physiotherapist for further advice and management on your condition.
If after following the above advice, your symptoms have not improved within 6 to 12 weeks, a referral to a physiotherapist may be beneficial. Speak to your GP about a referral.