Early/mild arthritis

Overview

Hip osteoarthritis is a common condition that occurs when the protective cartilage in the hip wears down, while bone around the joint grows or loses its normal smooth contours. Hip osteoarthritis symptoms may develop slowly or come on relatively quickly. Common symptoms include:

  • Pain. Your hip may hurt during or after movement
  • Stiffness. Hip stiffness may be most noticeable when you wake up in the morning or after a period of inactivity
  • Loss of flexibility. You may not be able to move your hip through its full range of motion
  • Grating sensation. You may hear or feel a grating or catching sensation when you stand up, walk, or climb stairs

The cause of hip osteoarthritis is not well understood, but risk factors include:

  • Older age
  • Female gender
  • Obesity
  • Certain occupations or sports that place high stress on the hips
  • Genetics
  • Altered shape of the ball and socket joint

The diagnosis of hip osteoarthritis starts with a careful history and physical examination. Imaging is often recommended, starting with plain radiographs (X-rays). Sometimes, your provider will recommend more advanced imaging, such as MRI. Occasionally, blood tests or joint fluid analysis are used to rule out other types of arthritis related to inflammatory or infectious conditions. When the diagnosis remains unclear, a diagnostic injection of local anesthetic into the hip joint may be helpful.

Hip osteoarthritis symptoms can usually be effectively managed, although the underlying process cannot be reversed. Staying active and maintaining a healthy weight may slow progression of the disease and help improve pain and joint function.

Medications may be recommended for the treatment of hip joint pain. These typically include over-the-counter pain relievers such as anti-inflammatories or acetaminophen. Physical therapy is often recommended as well, including stretching and strengthening exercises. A cane may be helpful for some patients.

When conservative treatments are inadequate, a hip joint injection with corticosteroid may be recommended. There are many alternative injections that may help with hip osteoarthritis pain, including hyaluronate (lubricant), platelet-rich plasma (PRP), or bone marrow aspirate concentrate (BMAC). However, these injections are still considered experimental by the FDA and are usually not covered by medical insurance.

When nonoperative management options have been exhausted, surgery may be considered. In cases of mild osteoarthritis that is associated with ball and socket abnormalities and/or labral tears, arthroscopic hip surgery may be an option. With more advanced osteoarthritis, a total hip replacement (arthroplasty) may be the best option.

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