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Osteoarthritis of the hip

The hip joint is a ‘ball and socket’ joint. The top of the leg bone is rounded and fits into a cup shaped socket in the hip bone. There also normally is a thin, smooth covering of cartilage over the bones in the joint that allows normal, smooth and painless motion.

In the case of osteoarthritis, the smooth cartilage of the joint becomes damaged, rough, torn or thin.

Usually the pain is felt in the groin area. It is worse with standing and walking. When the hip is at rest there is less pain, but it usually will feel stiffer after a period of rest or inactivity. When moved again, it is more painful. In advanced hip osteoarthritis there may be grinding or creaking noises when the hip is moved. The increasing pain and stiffness of osteoarthritis is usually a gradual process.

Osteoarthritis is sometimes called ‘wear and tear’ arthritis. It may be caused by previous overuse or abnormal use, or due to an injury in the past which damaged the cartilage. Over months or years the damage to the cartilage worsens, and symptoms start.

Along with a history about hip symptoms, a thorough hip examination often suggests osteoarthritis is the diagnosis when pain is felt as the hip is moved and rotated. The normal hip range of motion may be reduced. X-rays are helpful in showing osteoarthritis. An x-ray often shows narrowing of the space between the bones in the joint.

The treatment of osteoarthritis depends upon the severity of the pain. Efforts to rebuild joint cartilage are still in the early research stages. Initial treatment to reduce pain often consists of weight loss (if necessary) and exercises to strengthen the hip muscles and reduce the stiffness in the joint. Water exercise classes may be especially helpful. For more severe pain, medications may be recommended. These may include over the counter medications such as Tylenol (generic = acetaminophen) Aleve (generic = naproxen), Motrin (generic = ibuprofen) or aspirin. Various prescription medications which belong to a group of medications called ‘non-steroidal anti-inflammatory medications (or ‘NSAIDs’ for short) often are recommended. Some of the more commonly prescribed of these include medications such as Celebrex, Motrin, Naprosyn, Mobic, Voltaren, Relafen and Lodine. (a complete list is available at the reference below). More recently, a medication of a different class called Cymbalta has been approved to treat the pain from osteoarthritis.

More severe pain may be treated with injections of cortisone-like medications into the joint. If the arthritis is severe, the hip joint may be replaced with surgery.

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