Hip osteoarthritis

What are the symptoms of hip osteoarthritis (OA)?

• Pain, stiffness and difficulty with movements of the joint are typical. The stiffness tends to be worse first thing in the morning but tends to loosen up after an hour or so.
• Pain, stiffness and weakness around the hips can lead to problems walking, putting on shoes and socks, and activities such as getting in or out of the car. Eventually it can disturb your sleep.
• A locking or cracking sensation around your hip is fairly common.

You may experience all or some of these symptoms. Your symptoms may vary for no apparent reason with bad spells lasting a few weeks or months broken by better periods.

Is my pain coming from my hip joint?

Usually you feel OA of the hip in the groin but it can also affect the front of your thigh and travel towards your knee. Any pain in your buttock, side of your thigh or below the knee is unlikely to be coming from the hip joint itself. OA of the hip does not cause altered sensation, pins and needles or cramp.

How do you diagnose osteoarthritis?

We usually diagnose OA based on your symptoms and the physical signs we find when your hip is examined. X-rays are usually used to confirm the diagnosis.

What you can do to help yourself

There is no cure for arthritis - however there are many things you can do to manage your symptoms, allowing you to maintain an active lifestyle.

Reduce stress on the joint

• Keep to your ideal weight. Extra weight on your joint can make symptoms worse.
• Wear footwear with cushioned soles or insoles.
• Try not to overstress your joint by doing too much in one day. For example, spread household chores throughout the week.
• Avoid being in one position for too long when possible, to help prevent stiffness.
• Use a walking stick or walking poles if you find this useful.

Exercise

It is important to find the right balance between rest and exercise. Exercise in moderation can help to reduce pain, maintain function and possibly delay the need for a hip replacement.

Activities that avoid impact such as cycling can be helpful. Swimming and aqua-aerobics can be particularly beneficial because the water supports your body’s weight so that less force goes through your joints as you exercise, causing less pain.

See Waiting well exercises - including High Life Highland classes and programmes.

Medication

If you still have pain after trying the above you can speak to your doctor who may discuss medication for pain relief. There are several different types of pain relief that your doctor can prescribe before thinking about having a hip replacement.

Surgery

Surgery for hip OA is usually with a total hip replacement. Your healthcare team should always try other non-operative measures before suggesting a hip replacement. These may include weight loss, painkillers, use of a walking stick and activity modification. Surgery is usually only performed in patients with moderately severe or severe arthritis on their X-rays.

Not everyone with OA of the hip will feel their symptoms are severe enough to consider a hip replacement. If your symptoms are still manageable and your medication is effective then you may prefer to wait. If you don't want surgery for your hip OA at this time then you don't need a referral to hospital to see an orthopaedic surgeon.

If your hip has significant OA and your day-to-day quality of life is significantly affected by pain, stiffness and disability, and despite trying all the advice, we may consider you for a hip replacement.

Please note that 5 to 10% of patients who have hip replacement surgery are not satisfied with their hip replacement and a small number can develop serious complications as a result of the surgery.

More information

• Hip fracture 
• Learn to stand, walk and sit with crutches - mobilising with crutches and using stairs - from NHS inform
• Osteoarthritis of the hip - from Versus Arthritis
• OrthoInfo - Patient Education - from the American Academy of Orthopaedic Surgeons