Osteoarthritis of the Hip

Hip Joint This fact sheet has been written for people with hip pain, due to osteoarthritis (OA). It provides general information about hip pain and what can be done to help. It also tells you where to find further information.

This sheet is not meant for people with hip pain from osteoporosis or other causes.

What is OA of the hip?

The hip is a ‘ball and socket’ joint, where the end of the thigh bone (femur) is rounded and fits into a socket (acetabulum) in the pelvis. The ends of the bones are covered with ‘articular cartilage’.

Articular cartilage is a slick substance that helps the joint move freely, but in OA the articular cartilage may be worn away, causing the bones to rub together. Where there was once smooth articular cartilage, there is now frayed and rough cartilage and increased stress on bone.

What are the symptoms?

OA in the hip can be especially painful because of the joint’s weight-bearing role in standing, walking and exercising. The pain may flare when you are active and gets better when you rest. People often see this as a reason to rest more but it is important to remain active by finding the right type and amount of activity, and pacing your activity.

Pain usually develops slowly, starting in the groin and radiating to the to the outside of the hips or the buttocks. The joint may stiffen, making it difficult to rotate (turn) the hip.

OA, if left untreated, may eventually give you pain, even at rest. The hip joint gets stiff and inflamed and movement is restricted. Bone spurs might build up at the ends of the joint, making movement particularly painful.

What causes it?

As with OA in the knee, obesity and a history of repeated trauma to the joint may be causes for the condition.

Get help and more information at www.MyJointPain.org.au 1 However it is important to remember that anyone can develop OA at any time, regardless of their weight or history.

Should I see a doctor?

You should talk to your doctor or other health professional if your pain or other symptoms are bothering you. They will ask you about your symptoms and examine you. They may check for any serious medical problems that could be causing your pain, but these are rare. You should see your doctor if your pain does not settle down after a few weeks, or starts getting worse. What can I do?

1. Talk to your healthcare team. It is common to worry about the cause of your pain and how it will affect you. Talking to your doctor or another health professional about your worries can be helpful. You will usually find there is no serious cause and there are ways you can deal with it.

2. Learn about hip pain and play an active role in your treatment. Not all information you read or hear about is trustworthy so always talk to your doctor or healthcare team about treatments you are thinking about trying. Reliable sources of further information are also listed in the section below. Self- management courses aim to help you develop skills to be actively involved in your healthcare. Contact your local Arthritis Australia office for details of these courses.

3. Learn ways to manage pain. Talk to your healthcare team about ways to relieve your pain. Some people have found massage and acupuncture helpful with hip pain, although this has not been proven by research. There are also medicines that can help with hip pain. It’s best to start with simple analgesics and measure their effect before trying others.

• Paracetamol is a simple pain reliever that can relieve mild to moderate pain from OA. • Anti-inflammatory medicines (NSAIDS) may relieve symptoms of OA.Always talk to your doctor or pharmacist before take these medicines as they are not suitable for all people. • Stronger pain medicine, such as codeine or tramadol, may be useful if simple pain relievers are not effective and anti-inflammatory medicines cannot be used. • A corticosteroid injection into the hip joint may relieve pain.

Always talk to your doctor or pharmacist about your medicines, as even natural and over-the-counter medicines can have side effects. See the following for more information:

• Complementary medicines treatment • Complementary treatments

Get help and more information at www.MyJointPain.org.au 2 • Simple pain relief medicines • NSAIDs treatment • Medicines and arthritis fact sheet • Dealing with pain fact sheet

4. Stay active. Your body is designed for movement and exercise is one of the most important treatments for OA of the hip. It helps to reduce pain and maintain your general health. To protect your sore joints, try low- impact activities, where there is less weight going through your hips. Examples of low-impact activities include cycling and walking. You could also try:

• Water exercise: The buoyancy of the water takes pressure off your hips and you may find you can move more freely than you can on land. You could swim, do a hydrotherapy session with a physiotherapist or join a local warm water exercise class. See the Water exercise sheet for more information. • Strengthening exercises: Physiotherapy exercises to strengthen the muscles around your hip can also help reduce pain from OA. • Tai chi: Studies show that tai chi can help reduce pain and stiffness for people with OA.

See a physiotherapist or other health professional for advice about exercises to keepyour hip moving. See the Working with your healthcare team information sheet for more information about seeing a physiotherapist.

5. Weight loss: Being overweight can lead to more pain and damage to hips and knees affected by OA. Even modest weight loss (eg. five percent reduction in body weight) can noticeably reduce symptoms of knee OA. You may find it useful to see a dietitian for advice about healthy eating and weight loss.

6. Aids or supports. Some people may find using a walking stick helps reduce pain, although there are no studies to prove this claim. Always use the walking stick on the opposite side to your sore joint (if your right hip is affected, use the walking stick in your left hand).

7. Acknowledge your feelings and seek support. It is natural to feel scared, frustrated, sad and sometimes angry when you have pain. Be aware of these feelings and get help if necessary. You can learn skills to recognise and calm anxiety or strong emotions if you find they start to affect your daily life. See the Awareness of thoughts & emotions treatment sheet.

There are many other treatments for hip pain that have not been well-proven. Some unproven treatments may still be useful, however further research is needed.

These treatments include: • herbal medicines

Get help and more information at www.MyJointPain.org.au 3 • transcutaneous electrical nerve stimulation (TENS) • low level laser therapy • heat and cold (eg. hot water bottles, heat packs, ice packs).

Your healthcare team can give you more advice and information about whether any of these or other treatments might be useful for you. Also see the Dealing with pain fact sheet.

Other Resources

State/Territory Arthritis Offices Your local Arthritis Office can provide further information to assist you and will have a range of education and support activities. Click here to find your local office.

Independent Living Centres (ILCs) These centres provide information about products and services to help people remain independent and improve their quality of life. They are located in each capital city. See www.ilcaustralia.org.au or call the National ILC Infoline on 1300 885 886 to find your closest centre and more information. (In Queensland, the Independent Living Centre is called LifeTec).

Page created: 18 March 2013 Last modified: 19 June 2015 Content last reviewed: 18 March 2013

Get help and more information at www.MyJointPain.org.au 4