Hip osteoarthritis

What is hip arthritis?

hip external rotation

Hip Osteoarthritis is a painful joint condition that involves articular cartilage and bone.
Hip Osteoarthritis is characterized by degeneration, wear and tear and inflammation.
Cartilage is crucial to cover articular surfaces to avoid friction from rubbing bones and it is also a shock absorber.
Osteoarthritis is a chronic degenerative disease that affects any joint in the body, mainly weight bearing joints like knee, hip and spine.
In the first stage of the disease, symptoms are moderate and intermittent, while at the last stage you can feel hip pain even at night.
Over the years the disease slowly worsens, the cartilage becomes rough and reduces until the bones are denuded of joint surface.
The problem is Articular joint cartilage doesn’t regenerate, so the subchondral bone react by becoming hypertrophic and forming osteophytes.
Hip osteoarthritis maybe unilateral, but tipically it is bilateral and affect both knees.
The doctors classify osteoarthritis in two groups:
the primary osteoarthritis has no known cause, it is related to aging.
The secondary osteoarthritis is caused by another disorder such as congenital abnormalities, fractures, surgery to the joint structures, rheumatoid arthritis , gout and some hormone disorders.

Pain maybe debilitating and can cause function loss.

 

Who Gets Osteoarthritis?

Osteoarthritis is the most common causes of hip pain in the world, usually affects people over 50 years of age.
All races are almost equally affected, but it crops up more frequently in females but women have more chances of developing this disease.
About 55% of people over 65 years old have osteoarthritis in one joint or more.

 

Causes

Primary hip osteoarthritis has no known causes, but several factors can increase the chances:
There is an important genetic factor, the doctor must look at the family history of osteoarthritis.
Overweight produces joint overload.
Aging, osteoarthritis affects more people over 45 years old because it is a wear process.
Sex, females are more affected.
Associated diseases such as infections and rheumatoid arthritis can causes joint damage.
repetitive trauma during the sport activities or work.

 

Signs and Symptoms

Test of internal rotation of the hip

Symptoms maybe intermittent, above all in the first stage of this disease.
Hip osteoarthritis causes pain in the morning when you wake up, sitting for a long time and after repetitive exercise, besides the hip doesn’t function normally.
You can experience a severe stiffness, crepitus on movement because the bones friction and muscle contracture.
During the final stage, pain is severe and constant like an aghony.

The symptoms aggravate moving the lower leg and pressing around the damaged region.

Pain and stiffness reduce after 30 minutes from wake up, moderate movement and lying down alleviate the symptoms.
The signs include typical inflammation sings: swelling, redness and warmth as a result of inflammation of the synovial membrane (Synovitis).

Diagnosis
The doctor must look at the medical history, observe the joint and assess the signs and symptoms of injury.
He or she need to know the onset of the pain to understand the causes.

Physical examination
First of all, the doctor must press on the affected joint to determine the exact position of symptoms and swelling.
There is no single test to determine if you suffer of knee osteoarthritis.

 

Diagnostic procedures

X-rays standing up is useful to show loss of cartilage, reducing of the joint space between the bones and ostheophytes formation.
MRI scan may be necessary to exclude any soft tissue damage.
Blood test are useful only to exclude other pathologies such as rheumatoid arthritis.

 

Tac dell'anca

Tac hip

Therapy of hip Osteoarthritis

There is no specific treatment to repair damaged cartilage, but today some orthopedists perform cartilage transplant.
The mission of the treatment is knee pain go away to ease the pain and inflammation, to recover range of motion and to restore joint function.

Pharmacologic therapy

There are Several types of drugs to treat osteoarthritis.

Analgesics such as Tylenol and aspirin ease the pain, but don’t decrease inflammation, it is a good therapy for moderate osteoarthritis, above all among old people.
Generally, treatment starts with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen to control pain and reduce inflammation.
Side effect of Nonsteroidal anti-inflammatory drugs are stomach irritation, ulcers, bleeding, liver and kidney damage, so it is better to not take them for more than 10 days.
Oral corticosteroids or narcotics are rarely recommended by doctors.

Physical and occupational therapy
Magneto therapy and T.E.CA.R. Therapy are very good to reduce inflammation and pain, the effects arec deep in the hip joint.
The duration of therapy is 10 day to achieve long-term effects.

TENS has no long-term effects, I never saw a patient healed after this treatment.
Low impact exercises such as swimming, cycling and sweet movement are useful to increase range of motion and strength.

Warm water therapy permit you to perform exercises without stressing the joint because water support body weight.
It is hugely beneficial to regain range of motion and strength, but the problem is that many people don’t like swimming pool and can’t swim, so they can’t perform this therapy.

Self care
Some devices like cane and walker are helpful to decrease stress on the hip.
As Osteoarthritis affects mainly weight-bearing joint, you have to reduce your weight and to avoid activities that cause stress on the joint.
Don’t exceed over 48 hours of bed rest because it increases stiffness and prolongs recovery.

 

Surgery

The surgical options are: osteotomy, arthroscopy, and arthroplasty.
Surgery may be performed to remove bone spurs, shave damaged cartilage and replace the joint.

 

Complementary Treatments

There are many complementary treatments to reduce pain.
These treatments are used in addition to standard medical treatments, not in place of them.
Not all people will have the same results with any treatment even people with the same condition.
Acupuncture and massage therapy are examples of popular complementary treatments.

 

Read also:
 

Tendinitis

Achilles tendinitis

De Quervain

Lateral epicondylitis, tennis elbow

Medial epicondylitis or golfer’s elbow

Patellar tendinitis

Plantar Fasciitis

Pubalgia

Quadriceps tendinitis

Supraspinatus tendinitis – shoulder tendinitis

Osteoarthritis

Hand Osteoarthritis 

Knee Osteoarthritis 

Hip Osteoarthritis 

Fractures

Pelvic fracture

Ribs fracture

Wrist fracture

Fingers fracture

 

Dr. Massimo Defilippo Fisioterapista Tel 0522/260654 Defilippo.massimo@gmail.com
P. IVA 02360680355

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