What is hip osteoarthritis?
Hip osteoarthritis is the technical name for "hip arthritis" and differentiates this condition from other forms of arthritis, such as rheumatoid arthritis or psoriatic arthritis. Osteoarthritis, or "OA," occurs when the cartilage, which is the shock absorber for the hip has repetitive micro trauma. The micro trauma creates a response that causes the cartilage to swell, soften, and leads to surface damage of the cartilage. In the picture below, you can see on the left a normal hip joint. On the right, you can see the later stages of hip osteoarthritis: irregular surfaces, decreased joint spaces, broken down cartilage, and "bone spurs".
How common is hip osteoarthritis?
Estimates of the prevalence of hip OA vary from 3-33%.
What are the risk factors for hip osteoarthritis?
The likelihood of developing osteoarthritis increases with age, and the incidence appears to be slightly higher in males. There appears to be a genetic factor that may contribute. Other predisposing factors for hip OA include obesity, femoroacetabular impingement (FAI), and repetitive trauma, including occupations requiring prolonged standing or heavy physical exertion (1).
What are the symptoms of hip osteoarthritis?
An early presenting symptom of Hip OA is prolonged stiffness when waking up (less than 60 minutes) and following periods of inactivity (sitting). The patient will often complain of the inability to put their socks on, shave their legs, or climb stairs. Groin, front thigh, and buttock pain are common. The patient will often describe the location of their pain with the “C” sign, demonstrated by placing their index finger over the front of the hip, their thumb over the lateral hip region (2). Referral of pain below the knee is present in up to 47% of cases (3). The pain istarts dull and increases to sharp with standing. Clicking may develop as the condition progresses.
Do I need X-rays for hip osteoarthritis?
Radiographs are indicated for the assessment of hip pain in those over age 65, in cases of severe pain, or in those with a history of trauma, osteoporosis, cancer, corticosteroid use or alcohol abuse (12). Radiographic evidence of hip OA is common in seniors, although not all patients with radiographic degenerative changes will be symptomatic (1).
What are the treatment options for hip osteoarthritis?
Management of hip OA is directed at restoring motion and avoidance of aggravating factors. In recent years, several well-constructed studies have demonstrated that manipulation of the hip is a particularly effective treatment for hip OA (16-29, 30,36-39). A systematic review concluded that manual therapy and exercise therapy are beneficial for people with hip osteoarthritis in terms of reduced pain, improved physical function and improved quality of life (43). Several studies favor manipulation over exercise and some show that manipulation created the greatest and most beneficial gains in range of motion and pain reduction of all therapies studied (22-24, 26,41). Manipulation of contiguous regions, including lumbar, sacroiliac and lower extremity joints, is also appropriate.
What exercises can or should be done with hip OA?
Patients should consider increasing physical activity through swimming, cycling or walking on safe and flat surfaces.
Hip OA patients should be strongly encouraged to participate in a water-based exercise program ranging from formal PT hydrotherapy to classes at their local health club.
Exercises to improve ROM, increase strength and aerobic fitness is beneficial for hip OA patients (24,28,40).
Stretching of the muscles surrounding the hips may be beneficial.
Strengthening the glutes, quadriceps, hip external rotators and core musculature may be beneficial.
At Creekside Performance Center, we are highly trained to treat each of this condition. We are the only inter-disciplinary clinic providing services to Sheboygan, Sheboygan Falls, Plymouth, and Oostburg including chiropractic, manual therapy, myofascial release, ART (Active Release Technique), massage therapy, acupuncture, physiotherapy, rehabilitative exercise, nutritional counseling, personal training, and golf performance training under one roof. Utilizing these different services, we can help patients and clients reach the best outcomes and the best versions of themselves.
Evidence Based-Patient Centered-Outcome Focused
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