Osteoarthritis (OA) of the hip is a very common condition that affects around 1 in 9 people over the age of 45! OA is sometimes referred to as ‘wear and tear’ but can also develop after previous injury or fracture. Whilst increasingly prevalent in the later years of life, arthritis of the hip can also affect younger people where injury or childhood conditions (like Perthes Disease) have caused damage to the joint. Arthritis of the hip does not mean that you’ll always ending up needing joint replacement surgery as physiotherapy management can be very effective. Physiotherapy which can involve exercise, manual therapy and hip injections provide effective relief of pain for many.
Do I have arthritis of my hip?
There are a few clues that might point to arthritic hip pain such as:
- groin and buttock pain which can spread down towards the knee
- deep seated pain
- gradual onset of pain and stiffness
- pain on weight-bearing (walking, standing)
- transition pain – moving after being in one position (i.e. getting out of chair/car)
- increasingly troublesome at night
- occasional ‘giving way’ or not trusting the leg when walking
- pain when turning in bed
That said, there are a number of conditions that can cause pain in that area (such as hip impingement and ilio-psoas tendinitis) so you should seek expert help to ensure your problem is diagnosed and treated properly.
Can physiotherapy help?
Absolutely! Physiotherapy focuses on restoring the movement lost due to the arthritis and reducing the pain. Physios use manual therapy techniques to improve mobility of the joint and the surrounding areas and exercises to maintain the progress and strengthen the muscles that provide vital support for the joint itself. It is usual for most people to manage their OA hips in this way for many years.
How do hip injections help?
Cortisone, hyaluronic acid and platelet rich plasma (PRP) injections can have an important part to play in managing pain caused by arthritis of the hip. Injections can assist physiotherapy management by reducing pain dramatically and defer the need for a hip replacement, sometimes for prolonged periods. Because the hip is a deep joint, injections should not be attempted without ultrasound or X-ray guidance to ensure accuracy of delivery and patient safety. Paul Hattam has trained over 2000 physiotherapists and doctors in injection skills and performs US guided hip injections at the practice using cortisone, hyaluronic acid or PRP to alleviate pain, enable exercise and restoration of function.
There are also lots of other hip conditions that can benefit from physiotherapy and hip injections. Particularly in the sporting population; tears of the acetabular labrum, impingement and tendon strains can all benefit from hip injections and a solid course of rehabilitation. Of course, we may wish to send you for some specialist imaging before we plan your care, but HA injections are used widely in sports medicine, including the hip.
Hip injections – what is the next step?
As with all treatment here at The Physios, the first part of your journey is a comprehensive assessment and diagnosis. From here, one of our expert team will then make any necessary arrangements such as commencing a course of treatment, scheduling a hip injection or liaising with your GP or consultant about our findings. Simply give us a call on 0114 267 8181 or book online here.
How do I know if surgery is needed?
There are several indicators that help to determine this – the amount of pain and disability are key considerations but that is not always the only indicator as pain can be temporary and responsive to treatment.
Prolonged disability, increasing impact on daily life, difficulty sleeping and confirmed arthritis on X-ray, limitations with mobility and poor response to conservative treatment are all factors that may indicate that its time to think about joint replacement. You can measure the impact on your life by completing the Oxford Hip Score (see below) and this can help us determine the best options for you.
The Physios have excellent links with the hip arthroplasty (hip replacement) team at the NGH, Claremont and Thornbury Hospitals and will be able to refer you to one of the excellent surgeons should you need it. After the surgery we will be able to provide the best care available – starting with aquatic therapy at 2 weeks post-op and working with you to ensure you get a full, pain-free recovery.
What can I do to help myself?
Try to lose weight – if you are overweight this will increase the load on the painful hip which could exacerbate your symptoms so losing weight can make quite a big difference. That said, a painful hip can really limit the amount of normal exercising that you can do (like gardening, walking and cycling) which in turn leads to a more sedentary lifestyle making meaningful weight loss really difficult. We understand that.
Modify your daily routine – identify the activities that provoke the pain and try to limit how much or for how long you do. For example, you might find doing a few shorter walks in the day rather than long walks helps you exercise without flaring up the symptoms
Consider pain-relieving medication – talk to your physiotherapist about appropriate medication to control the pain. There are some effective over the counter medications that can really help with the pain and enable you to exercise more effectively and be less hampered day to day. Rubbing on anti-inflammatory creams and gels (e.g. Ibuleve) will be useless in combatting pain originating from the hip joint.
Help us evaluate your symptoms by completing this questionnaire and report your Oxford Hip Score to your doctor or physiotherapist
See one of our physiotherapist before the problem gets really bad.