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Hip Arthritis

Arthritis simply refers to the inflammation of a joint that causes pain, swelling, stiffness, instability and often deformity. The most common form of arthritis in the hip is osteoarthritis. It is characterized by a degenerative process with gradual wear and tear to the cartilage and bone surfaces of the hip joint. As the condition progresses, and the cartilage wears away, the joint space can narrow and there is eventual wearing down of the bone ends so that the surfaces are no longer smooth. The bone ends may also develop small bony processes called osteophytes (bone spurs). When some or all of these changes occur, the condition is known as hip arthritis.

Signs and Symptoms of Hip Arthritis

Patients with hip arthritis typically develop symptoms gradually over time. The earliest symptom of hip arthritis is stiffness in hips, groin, thighs, and buttocks, especially when waking up in the morning. As the condition progresses, patients experience increasing hip or groin pain with weight-bearing activity, and joint stiffness, particularly after rest or in the morning. The pain flares when patients are active and gets better when patients rest. Severe joint pain, decreased hip flexibility, pain at night, and grinding or clicking sensations during certain movements may also be experienced.

Over time, due to aging, trauma or other factors, the cartilage that cushions the joints starts to break down. When the cartilage wears away completely, bones rub directly against each other. The bone-on-bone action creates pain and stiffness, and can limit mobility. Consequently, patients with hip arthritis may lose the ability to rotate, flex or extend the hip. To avoid the pain, patients tend to become less active and the muscles controlling the hip joint get weak, and individuals may start to limp. If untreated, the hip condition keeps getting worse until resting no longer relieves the pain. The hip joint gets stiff and inflamed. Bone spurs might build up at the edges of the joint.

Hip Arthritis Treatment Options

Currently there exists no cure for hip arthritis. However, the condition doesn’t necessarily get any worse over time, and several treatments are available to help relieve the symptoms. The main goal of these treatments is to reduce the pain and improve the patient's mobility and lifestyle. Part of this goal involves improving the function of the hip and controlling pain. Early nonsurgical treatment may help in managing pain and disability and slow progression of the disease. Surgery can help if the condition is already severe.

Nonsurgical Treatment

Patients with early stages of hip arthritis may be treated with the following:

  • Rest the hip from overuse
  • Exercise and physical therapy
  • Non-drug pain relief techniques to control pain
  • Non-steroidal anti-inflammatory medications
  • Weight loss
  • Over-the-counter supplements that help build articular cartilage
  • Disease-modifying anti-arthritic drugs such as methotrexate and leflunomide
  • Complementary and alternative therapies

Surgical Treatment

Patients with advanced stages of disease experience deformities in the hip joint leading to severe pain, especially when resting in the night. Doctors recommend total hip replacement surgery (arthroplasty) for these patients. Hip replacement surgery involves removal of the damaged, painful parts of the hip and replacing them with a prosthesis (artificial joint). The prosthesis allows the hip joint to move smoothly without experiencing pain and improve the patient’s ability to walk. Although patients may need crutches or a walker initially after surgery, they can enjoy a greater range of pain-free movement.