Arthritis describes inflammation of any joint in the body, causing a destructive process to the joint in the long term. Osteoarthritis occurs when inflammation causes damage and eventual destruction to the cartilage layer, disrupting the normally smooth surface that eases joint movement. This typically happens over a long period of time – usually years or decades in response to wear and tear with use.
The hip is a ball-and-socket joint through which significant forces are transmitted when standing, walking, running and jumping. As a weight-bearing joint, it's particularly vulnerable to this progressive damage of the smooth cartilage surface layer. Once this cushion is eroded, the ball part of the hip - the top of the femur (thigh) bone - cannot move smoothly and instead it jars against the socket of the pelvic bones, causing a great deal of pain and loss of function.
Age is one of the biggest factors in the development of osteoarthritis, but any injury or over-use from sports or work, or stresses such as obesity, can accelerate the ageing process.
Pain and stiffness are the most common feature of hip osteoarthritis. Pain can be felt deep in the outer edge of the hip, in the groin, buttock or knee. Pain is usually worse after prolonged activities such as long walks or exercise and at the end of the day. You may notice a reduced range of motion of your hip joint compared to the previous, and you may develop a limp with severe pain.
Osteoarthritis is a common condition and can be managed with simple measures, especially in the early phase, to improve symptoms and your quality of life.
Being overweight is a big risk factor for developing osteoarthritis, and makes symptoms worse as the joint is put under more strain. Weight loss will significantly improve pain and mobility. It is important to remain active and continue to participate in gentle exercise - although avoid any activities that cause pain. Exercise will help overall fitness and muscle tone, and specific exercises can help strengthen the muscles around your hip to protect it from injury or damage.
If pain is making it difficult to walk, a walking stick held in the hand opposite to the affected leg will improve your pain and balance. Avoid carrying heavy loads, as this adds strain to the hip joint. If you do need to carry something like a shopping bag, it should be held in the same hand as the affected leg.
Simple painkillers can be helpful in reducing your pain. Paracetamol is a good start to relieve pain from arthritis. One to two paracetamol tablets up to four times a day can help - leave a 4 to 6 hour interval between doses. Paracetamol is generally well tolerated and safe for most.
For more severe pain, codeine-containing combinations with paracetamol such as co-codamol are the next step up.
Topical gels such as Flexiseq work by absorbing through the soft tissues. Gels don't usually interact with other medications and can be used alongside other pain relief medications. They also avoid the gut if you get indigestion or have a risk of ulcers.
If your symptoms are severe or have failed to improve with these simple measures, book a routine appointment with your doctor. They may advise you further on specific exercises or stretches, offer additional painkillers or refer you to a physiotherapist. If your symptoms fail to improve or are causing a significant loss in quality of life, you may be referred to a specialist where treatment options will depend upon further investigations.
An X-ray is usually used to confirm osteoarthritis. If this shows significant destruction in the joint, and this tallies with significant symptoms, your specialist may recommend a total hip replacement. This is where the ball and socket joint is replaced with a prosthetic implant. This surgery can be very effective but would only be considered as a last resort after all simple measures have been exhausted.
You should still keep fit, active and working on strengthening the muscle around your hip, while awaiting any operation. This puts you in the best position to recover well from surgery and make the most of your new hip.
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