Hip Joint Arthritis
Pain and stiffness in the hip joint can happen from normal “wear and tear” or other arthritic conditions. Luckily, there are many treatment options.
Arthritis of the hip joint is a disease in which the cartilage on the femoral head (the top of the thigh bone) and the acetabulum (the concave part of the pelvis) wear away, so that the two bones scrape against each other.
When this occurs, the joint becomes pitted, eroded and uneven. This results in pain, stiffness and instability. In some cases, it may greatly restrict hip motion.
Osteoarthritis: wear and tear of the hip joint
Osteoarthritis of the hip is the most common cause of arthritis. It is caused by “wear and tear.” It typically occurs in patients over the age of 50, but it may also occur at any age, especially if a joint is in some way damaged.
Osteoarthritis is usually confined to the large, weight-bearing joints of the lower extremities, including the hips and knees, though it may affect the spine and upper extremity joints as well. Patients with osteoarthritis often develop large bone spurs (osteophytes) around the joint, further limiting motion.
Although the degenerative wearing of the joints may happen faster for people with previous hip injuries, many cases of osteoarthritis of the hip joint occur when the hip simply wears out. Some experts believe people who develop osteoarthritis of the hip may have a genetic predisposition for it. Abnormalities due to previous fractures or childhood disorders may also lead to a degenerative hip.
Symptoms
The first and most common symptom of osteoarthritis is pain in the hip or groin area during weight-bearing activities such as walking. People with hip joint pain usually compensate by limping or reducing the force on the arthritic hip. As a result of the cartilage degeneration, the hip loses its flexibility and strength, resulting in the formation of bone spurs. Finally, as the condition worsens, the pain may be present all the time, even if the person is not putting weight on it.
Treatment
Osteoarthritis of the hip is the most common cause for total hip replacement surgery.
Before considering total hip replacement surgery, consult your doctor to determine if you are a candidate for non-surgical therapies. An appropriate weight reduction program may be beneficial in decreasing forces across the hip joint. However, weight reduction can be difficult for people with hip arthritis since the arthritis pain prevents them from increasing their activity and burning calories.
A special exercise program may improve the strength and flexibility of the hip and other lower extremity joints. People can modify their lifestyle and activity to minimize the activities that are associated with hip pain. Finally, various medications such as non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen) and/or nutritional supplements (chondroitin, glucosamine) may help reduce pain and inflammation associated with the disease.
Assistive devices such as a cane or crutch can help reduce the forces transmitted through the hip joint while walking and may help decrease hip arthritis pain. If non-surgical treatment is unsuccessful, you and your surgeon may decide that a total hip replacement is the best available treatment option.
Rheumatoid arthritis of the hip: a painful disease
Unlike osteoarthritis, which is a "wear and tear" phenomenon, rheumatoid arthritis of the hip joint is a chronic inflammatory disease that results in joint pain, stiffness and swelling. The disease process leads to severe, and at times rapid, deterioration of multiple joints, resulting in severe pain and loss of function.
Although the exact causes of rheumatoid arthritis are unknown, some experts believe that a virus or bacteria may trigger the disease in people who have a genetic predisposition to rheumatoid arthritis. Many doctors think rheumatoid arthritis is an autoimmune disease in which ones own immune system attacks the synovial tissue of the joint. The onset of rheumatoid arthritis occurs most frequently in middle age and is more common among women.
Symptoms
The primary symptoms of rheumatoid arthritis of the hip are similar to osteoarthritis and include pain, swelling and loss of motion. In addition, other symptoms may include loss of appetite, fever, energy loss, anemia, and rheumatoid nodules (lumps of tissue under the skin). People suffering with rheumatoid arthritis commonly have periods of exacerbation or "flare ups,” during which multiple joints may be painful and stiff.
Treatment
Treatment of rheumatoid arthritis may involve medications such as NSAIDs, aspirin and analgesics. Physicians may prescribe corticosteroids such as prednisone, which are effective in decreasing the inflammation associated with rheumatoid arthritis. (Side effects can occur with the use of corticosteroids, so close monitoring by a physician is essential.)
Researchers have made progress in the treatment of rheumatoid arthritis, and newer prescription drugs are now available. If non-surgical measures fail, you and your surgeon may decide that total hip replacement is the best treatment option to relieve your pain and help you return to an improved functional level.
