Studies show that one in four people will develop hip arthritis over the course of their adult life. Many factors play a role in the onset of hip arthritis, including genetics, advancing age, gender, excessive weight, losses in bone density, previous repetitive use or traumatic hip injury, muscle weakness, and joint laxity. Although joint replacement is called for in the most severe cases, hip arthritis treatment includes non-surgical options as well.
What is Hip Arthritis?
Hip arthritis is, by definition, a wearing away of cartilage between the bones that form the hip joint. Cartilage is the amazing material that lines and lubricates our human joints. Because cartilage is smoother than any man-made bearing and has no nerve endings, healthy joints with intact cartilage move easily and without pain.
However, in an arthritic joint where the cartilage has worn away, the underlying bone—which does have nerve endings—is exposed. Any movement that causes the joint’s bones to brush against one another produces significant pain. It also generates debris, which causes an inflammatory response that accelerates the destruction of the joint.
Non-Surgical Options for Treating Hip Arthritis
At OrthoEdge, we always treat hip arthritis with conservative measures prior to recommending surgery. Our goal is to control cartilage loss and its associated discomfort by reducing stressors on the hip joint. Recommended treatments include:
- weight loss
- the use of walking aids
- heat therapy
- activity modifications
- oral medications
- physical therapy
While these treatment options won’t alter or reverse the underlying condition of the impaired joint, they can help alleviate the symptoms associated with hip pain and help you postpone more dramatic interventions, such as joint replacement surgery.
Because of the way your muscles act across the hip joint, normal walking causes a force across the hip approximately three to five times your body weight. That means if you are 20 pounds overweight, the compressive load on your hip joint is an additional 100 pounds! This significant extra force increases joint destruction as well as pain.
Weight loss can have a dramatic effect on the relief of joint pain. (That’s why it’s our first Prescription for Joint Health.) Any effort at weight loss will also decrease the force around the hip, and slow down the destruction of the hip joint. Losing weight reduces the stress on the affected joints, and can mean the difference between needing surgery or not.
Restricting the number of calories you consume is the most effective way to lose weight. This concept is even more critical for patients who have pain that limits weight-bearing exercise. It is important to cut back on both dietary fat and total calories. While reducing dietary fat can help reduce calories and is heart-healthy, this method alone—without reducing calories—will not produce weight loss.
A diet that reduces fat and total calories will lead to consistent weight loss when the energy available in food consumed is less than the energy expended. Most modern diets stress ample vegetables, salads, and lean meats along with complex carbohydrates like oatmeal and whole grains. People who have not had success with diets may want to consider bariatric surgery, such as laparoscopic or gastric bypass, before pursuing joint replacement surgery.
Another way to decrease stress on a painful hip joint is to use a cane or other assistive device. This decreases the required muscle function around the hip during walking and reduces the force on the joint. Walking aids can also help offset any instability caused by impaired sensation or reduced strength in the affected joint. You can find tips for selecting the proper walking aid here. Remember to hold the cane in the opposite hand from the side with the hip pain.
Heat therapy is an easy and inexpensive way to loosen stiff joints and relieve pain. Heat—whether applied via a hot water bottle, warm compress, heating pad, or whirlpool spa—encourages your blood vessels to expand, which increases the flow of oxygen and nutrients to the muscles around the joint. Warmth also increases the pliability of the muscles and connective tissues, which helps improve joint flexibility. Superficial heat—such as that provided by liniments and ointments—does not deliver the heat deeply enough to be beneficial. To be effective, heat therapy must penetrate down into the affected muscles and tissues, so sessions of 30 minutes or more are most beneficial.
Physical activity keeps joints flexible and maintains or improves muscles surrounding your joints. People who exercise regularly despite their arthritis will typically have less pain and better function than those who are inactive.
However, it’s important to avoid high-impact activities that put significant loads on your hips, such as tennis, racketball, jumping, jogging, and heavy lifting. Also, avoid walking long distances on hard surfaces. Instead, choose low-impact exercises such as walking on a treadmill with no incline, stationary biking, freestyle swimming, pool therapy, yoga, and tai chi.
Also, consider working with a trainer to help you implement a strength-training workout that is safe and reflects your needs. Strength training (also known as resistance training) helps build and maintain bone mass. You can read more about following an effective workout regimen in our post Prescriptions for Joint Health: Exercise.
Oral non-steroidal anti-inflammatory drugs (known as NSAIDS) are an important non-surgical option for hip arthritis. You probably already have the most commonly used NSAID in your medicine cabinet: Aspirin. But many people cannot take aspirin because of either allergy or gastrointestinal issues. There are many aspirin substitutes currently available that may have fewer side effects and more convenient dosage frequencies, but they are considerably more expensive. Some of these include Ibuprofen (Motrin, Advil), Naproxen (Aleve, Naprosyn), Meloxicam (Mobic), Celebrex, Feldene, Bextra, and Nambiutone (Relafin). Some patients can manage their joint pain with intermittent use of anti-inflammatory medications, thus decreasing the chance of toxicity.
If you’re considering trying one of these medications, monitor any side effects during two weeks of continuous dosage, and discontinue the drug if side effects occur. Chronic long-term oral medication use requires careful monitoring by your doctor, including regular blood and urine tests. You can find more information on the benefits and risks of NSAIDS on the FDA’s website.
Physical therapists are movement experts. They use non-invasive and non-medical tools to help improve total body function. Therapists work with your orthopedic surgeon to target treatment specifically for your condition.
This can include strengthening muscles around the hip to take pressure off the joint, improving balance so as to decrease your chances of falling, and increasing flexibility to reduce joint stiffness and lessen pain.
OrthoEdge works with multiple local physical therapy clinics to ensure that treatments can be scheduled at a location that is convenient for you.
Corticosteroids are powerful anti-inflammatory medications that are similar to the hormones your body naturally produces to help reduce swelling. When injected directly into the joint space of a painful arthritic hip, these medications decrease inflammation and reduce pain. Results are often immediate, and can last weeks and even months. Corticosteroid injections are done under fluoroscopy as an out-patient procedure.
Final Thoughts on Hip Arthritis Treatment Options
It’s an unfortunate truth that once you have developed hip arthritis, it will never get better. The discomfort and reduced mobility associated with hip arthritis will generally worsen as time passes. But, importantly, the rate of deterioration varies greatly from person to person. If your symptoms are mild, these non-surgical options for hip arthritis may help you manage your symptoms for months or even years. You might never need to consider more invasive procedures.
On the other hand, if your hip pain is keeping you up at night, it’s time to schedule an appointment with the arthritis experts at OrthoEdge in Jacksonville, Florida. Dr. Richard Grimsley, Dr. Stanton Longenecker, Dr. Michael Adams and Dr. Wilbert Pino will evaluate your condition and recommend a treatment plan to manage your symptoms and alleviate your hip pain. Call (904) 204-5000 today or use our online appointment request form.