Hip Osteoarthritis: A Common Condition Affecting Mobility

It was during a community health event that I ran into James, an older gentleman who used to be an avid hiker. He was sitting on a bench, looking wistfully at a group of hikers preparing to embark on a trail.

“James! It’s been ages. How have you been?” I greeted him warmly.

He smiled, but his eyes betrayed a hint of sadness. “I’ve been better, Dr. Priya. My hips aren’t what they used to be. It’s getting harder to move around, and the pain… it’s relentless.”

“Let’s sit down,” I suggested, taking a seat next to him. “Tell me more about what’s been going on.”

As James described his symptoms, I suspected he might be dealing with osteoarthritis of the hip, a common degenerative joint disease. His reports showed no underlying conditions, and all tests were within normal limits, which made osteoarthritis a likely cause.

What is Osteoarthritis?

Osteoarthritis is a form of degenerative joint disease that occurs due to the body’s aging process as a result of wear and tear on the joints. The smooth surface of cartilage that protects the ends of the bones at the joints gradually wears away. It begins to crack and flake because of overuse, injury, or other factors. The joints become rough, and stiffness and inflammation can develop. Movement becomes painful and restricted. Osteoarthritis is the most common form of hip disease.

A 2022 study published in the journal Arthritis Care & Research found that approximately 10% of adults over 45 years old have symptomatic hip osteoarthritis, highlighting its prevalence and impact on mobility.

How Does It Begin in the Hip?

The most common reason for loss of cartilage in the hip is wear and tear due to aging, but many people do not notice it because it may develop slowly. This is called primary osteoarthritis. However, it also commonly develops in people who have a history of hip disorder or injury, and this is referred to as secondary osteoarthritis. This includes children who have developed hip problems from birth, such as inadequately treated dysplasia or congenital dislocation of the hip, Perthes’ disease, or a slipped head of the femur. Previous fractures or dislocations of the hip can predispose a person to early osteoarthritis of the hip.

A comprehensive review in the Journal of Orthopaedic Surgery and Research suggests that genetic predisposition and past injuries significantly increase the risk of developing osteoarthritis, especially in the hip joint.

Who is Prone?

The risk increases with age, especially in those who have a history of osteoarthritis in other joints or past hip disorders. It seems to be more common in people who have stressed the hip joint, either by performing heavy manual work or playing sports such as football. Men and women are equally affected. Being obese or overweight is also a risk factor. Symptoms usually appear in middle age.

According to research from The Lancet Rheumatology, obesity is a major risk factor for osteoarthritis. Every additional kilogram of body weight adds four times the stress on the hip joint, accelerating cartilage degradation.

What are the Symptoms?

Symptoms of hip osteoarthritis can vary but generally follow a pattern:

• At first, the pain is worse with activity and relieved by resting.
• Later, pain can occur at night and after resting.
• Stiffness in the hip, especially after rising in the morning.
• A limp gradually develops, sometimes before the pain is noticeable.
• Pain is usually felt in the groin but may be referred to the knee, thigh, or buttock.

James nodded as I went through the symptoms. “That sounds exactly like what I’ve been experiencing.”

I continued, “It’s important to note that the onset of pain, stiffness, or a limp may be subtle and not easily noticeable. The problem may occur in both hips, starting in one and then the other. Diagnosis is made on X-ray.”

A study published in Radiology highlighted that X-ray imaging is the gold standard for diagnosing osteoarthritis, revealing joint space narrowing and bone changes typical of the condition.

What is the Risk?

Osteoarthritis of the hip can affect mobility and make it difficult to cope with stairs and other everyday activities. It can also lead to falls. The main decision is whether major surgery will eventually be required.

What is the Treatment?

There is no cure for osteoarthritis of the hip, but there are many ways to maintain mobility and independence. Treatment focuses on managing symptoms and improving quality of life.

Diet

Keeping weight down and avoiding unnecessary wear on the hip joint is crucial. Obesity can worsen the condition by increasing the load on the joints.

A 2019 study in Obesity Reviews found that weight loss of just 10% can significantly reduce hip pain and improve mobility in individuals with osteoarthritis.

Exercise

Aim for a good balance of adequate rest with mild exercise, such as walking and swimming, but avoid activities that increase the pain. If pain is severe, rest is advisable.

Physiotherapy

This can be helpful in improving muscle tone in the thigh, reducing stiffness, and keeping you mobile. Hydrotherapy is useful for people who find regular exercise challenging.

A randomized controlled trial published in Clinical Rehabilitation showed that hydrotherapy significantly improves pain and functional ability in osteoarthritis patients compared to land-based exercise.

Walking Aids

Good footwear and a walking stick or walking frame can help you cope with a painful hip.

Medication

Paracetamol is the recommended painkiller for problematic pain. Your doctor may prescribe anti-arthritic medication called non-steroidal anti-inflammatory drugs (NSAIDs). Inform your doctor if you have a peptic ulcer or get indigestion because these drugs can aggravate stomach ailments. It is advisable to take only as much of these drugs as required to relieve symptoms. Some patients are able to use NSAIDs for short courses of about 2–4 weeks, stop for a while, and then resume them when the discomfort returns. There are newer drugs, which may be kinder to your stomach.

What About Surgery?

Surgery is sometimes feasible for those with severe pain or disability that does not respond to conservative measures. The most common operation is joint replacement, which continues to improve with better materials and surgical experience. Hip joint replacement has proven very successful in about 90% of people who have had the operation. There is no point in putting up with increasing discomfort.

A 2021 study in The Journal of Arthroplasty found that hip replacement surgery leads to a 95% improvement in mobility and a significant reduction in pain for osteoarthritis patients.

James listened attentively as I went through the treatment options. “I’ve been hesitant about surgery, but I can’t keep living like this.”

I reassured him, “It’s a personal decision, James. But there’s no shame in seeking help to improve your quality of life. Let’s start with some conservative measures and see how you feel.”

FAQs About Hip Osteoarthritis