Hip Osteoarthritis and How to Listen to Your Body

Living with hip arthritis begins with listening to your body. If an activity is painful, it is best to choose another one that does not cause pain. There is no evidence that continuing to be active will wear out a hip joint any faster than sitting still. In fact, patients who are able to remain active feel better in the long run than those who become “couch potatoes.”

Low-impact exercises are less likely to cause pain. Maintaining a healthy weight also puts less stress on the hip joint and can keep pain from worsening. For those who are overweight, losing 10 percent of body weight has been shown to significantly decrease hip pain, but even a few pounds of weight loss can help. Over-the-counter remedies such as acetaminophen or ibuprofen are helpful for pain. Check with your doctor about how often you should take these medications, because they can interact with other medicines and can cause damage to the liver, kidneys or stomach if used regularly over a long period of time. 

Osteoarthritis of the hip is an inflammation of the hip joint that leads to wear and tear damage of the smooth cartilage inside. This cartilage coats the ball on the end of the femur and the inside of the acetabulum, or socket of the hip. Much like knee osteoarthritis, it can wear away to the point that there is no longer a smooth surface for your joint to move, only bone rubbing against bone. Patients with hip osteoarthritis commonly experience pain in the groin area where the ball and socket meet, but sometimes feel pain in the buttock. They can also experience pain in the knee that is referred from the hip joint. Everyday activities such as cutting toenails and putting on shoes may become difficult as the hip joint becomes stiff.

It is not clear what causes hip osteoarthritis, but many patients have subtle abnormalities of the shape of the bones in the hip joint that cause them to wear improperly. This situation is very similar to having a wheel out of alignment on a car, which leads to uneven tire wear. Unfortunately, there is currently no cure.

Good days and bad days are normal with hip arthritis, but if you find you are having many more bad days than good days, you should check with your doctor about other treatments that may be available. Interventions such as physical therapy and prescription strength medication may help when over-the-counter remedies do not. Cortisone injections may be an option, but these are not as reliable as they are in the knee joint.  They also are much harder to give accurately in the office because the hip joint is deeper in the body, so they are usually given in the Radiology department.  When these interventions do not work, then surgery may be recommended, although this should be a last resort. Hip replacement can be a very successful way to treat pain and improve motion once everything else has failed.

Harold Rees, MD, is a joint replacement surgeon. He sees patients at the Loyola Center for Health in Burr Ridge. He is an assistant professor in the Department of Orthopaedics Surgery and Rehabilitation at Loyola University Chicago Stritch School of Medicine. When not seeing patients he enjoys exercise, art history and architecture.