Primary Osteoarthritis Versus Secondary Osteoarthritis
In primary OA, the disease is of idiopathic origin and usually affects multiple joints in a relatively elderly population. Secondary OA usually is a monoarticular condition and develops as a result of a defined disorder affecting the joint articular surface . or from abnormalities of joint eg acetabular displasia. Pistol grip deformities are seen in some cases, mostly linked with slipped upper femoral epiphysis. Although seen as a specific condition, it is often linked with metabolic abnormalities.
- Aggravated – movement when hip is loaded wrong or too long cold weather
- Eased with continuous movement
- Commonly in groin/thigh, radiating to buttocks or knee. According to new systematic review published in the Archives of Physical Medicine and Rehabilitation, thigh/groin pain and constant back/buttock pain are better indicators of hip OA than stand-alone tests.
- End-stage: Constant pain, night pain
- Osteophytes on hip x-rays
- Joint space narrowing on x-rays
Managing Osteoarthritis Of The Hip
Theres no cure for osteoarthritis, but there are things you can do for yourself that can make a difference to how the condition affects you. There are also some treatments available that could significantly reduce your pain and improve your mobility. Its likely that youll need to use a combination of different things to get the best results.
How Can A Physical Therapist Help
Your physical therapist will explain what hip OA is, how it is treated, the benefits of exercise, the importance of increasing overall daily physical activity, and how to protect the hip joint while walking, sitting, climbing stairs, standing, carrying loads, and lying in bed.
Testing will reveal any specific physical problems you have that are related to hip OA, such as loss of motion, muscle weakness, or balance problems. Addressing the problems in surrounding body regions, such as the spine and the lower extremity, is important to the treatment of hip OA.
The pain of hip OA can be reduced through simple, safe, and effective physical activities like walking, riding a bike, or swimming.
Although physical activity can delay the onset of disability from hip OA, people may avoid being physically active because of their pain and stiffness, confusion about how much and what exercise to do, and not knowing when they will see benefits. Your physical therapist will be able to guide you in learning a personal exercise program that will help reduce your particular pain and stiffness.
Your physical therapist will work with you to:
- Reduce your pain.
- Improve your leg, hip, and back motion.
- Improve your strength, standing balance, and walking ability.
- Speed healing and your return to activity and sport.
Read Also: Rheumatoid Arthritis Redness
Exercise And Physical Therapy
Exercise is essential for reducing the risk of osteoarthritis and slowing its progress. Exercise not only helps you manage your weight, but it also improves strength, flexibility, and mobility.
Low-impact exercises are less likely to put strain on a damaged joint. Experts strongly recommend tai chi for people with hip osteoarthritis.
Other options include:
Regular stretching can help relieve stiff, achy, or painful joints. Here are some tips to help you stretch safely:
- Start by asking a physical therapist for suggestions and guidance.
- Do all stretches gently and build up flexibility slowly.
- Stop if you feel pain.
- Increase intensity slowly.
If you dont feel pain after the first few days of an activity, gradually spend more time on it. At first, you may find it hard to stretch very far, but your flexibility will increase over time, as you practice.
Here are a few possible stretches:
Start with your feet shoulder-width apart or sit in a chair. Slowly lean forward, keeping your upper body relaxed. You should feel the stretch in your hips and lower back.
Lie on your back. Pull your bent knee up toward your chest until you feel a stretch. If your body allows it, use your other leg to deepen the stretch.
Extended leg balance
This is the same exercise as the knee pull, but you start from a standing position. Place one hand along the wall for support.
Here are some other stretches you can ask your healthcare provider about:
- standing hip flexors
Conditions With Similar Symptoms
A number of conditions that are not actually related to the hip joint can cause hip joint pain and symptoms in the “hip” area. These include:
Spinal stenosis This condition most commonly causes pain in the buttock, low back, and back of the upper thigh . Spinal stenos is a lower-back problem, not a hip problem. Spinal stenosis causes pain in the buttock area that some identify as part of the “hip.”
Greater trochanteric bursitisThis causes pain over the point of the hip . It also causes tenderness and sensitivity to pressure. Although this seems like a hip problem, it is a problem well away from the joint itself and is related to an inflammation in a lubrication point called a bursa. Greater trochanteric bersitis is not a joint problem .
Non-orthopedic conditionsVery occasionally, non-orthopedic conditions can cause pain in the groin that masquerades as hip joint symptoms ovarian cysts, hernias, and other intra-pelvic conditions can sometimes cause pain that is mistaken for hip joint pain.
Other types of arthritisOther forms of arthritis can cause similar symptoms to osteoarthritis of the hip in particular, post-traumatic arthritis and avascular necrosis are almost indistinguishable in many cases from osteoarthritis of the hip.
The diagnosis of osteoarthritis versus rheumatoid arthritis can be made by a physician with experience in treating conditions of this type.
You May Like: Best Way To Relieve Arthritis Pain
Do You Suffer From Hip Arthrosis
Here we show you some tips to relieve your symptoms. First lets see what it is and how it is produced.
Arthritis means inflammation of the joints, and this causes pain and swelling in the joints of the body, such as the knees or hips. There are many types of arthritis, but osteoarthritis is the most common. Also known as degenerative joint disease or age-related arthritis, osteoarthritis is more likely to develop in older people.
This occurs when inflammation and damage cause a rupture of the cartilage tissue. In turn, the rupture causes pain, inflammation and deformity. The cartilage is a firm material, which covers the ends of bones in normal joints.
It is composed mainly of water and proteins. The main function of the cartilage is to reduce friction between the joints and serve as a shock absorber. The shock absorbing quality of normal cartilage comes from its ability to change shape when compressed.
Cartilage can do this because of its high water content. Although the cartilage can undergo some repair in case of damage, the body does not create new cartilages after the injuries in these.
What Are The Symptoms Of Spinal Arthritis
Symptoms of spinal arthritis may differ from person to person. In general, they may include:
Back and neck pain, especially in the lower back
Stiffness and loss of flexibility in the spine, such as being unable to straighten your back or turn your neck
Swelling and tenderness over the affected vertebrae
Feeling of grinding when moving the spine
Pain, swelling and stiffness in other areas of the body
Whole-body weakness and fatigue
Pain and numbness in your arms or legs if the nerves are affected
Although back pain is a common symptom, not all people have it, even those with advanced spinal arthritis. On the other hand, some may experience pain even before arthritis can be seen on an X-ray.
In certain types of spondyloarthritis, eye inflammation may occur, causing pain, watery eyes and blurred vision.
Don’t Miss: How To Deal With Arthritis
Which Stage Of Hip Osteoarthritis Are You In
Do you have arthritis? A lot of your friends and family members probably have arthritis too. As a matter of fact, osteoarthritis is diagnosed by physicians more often than any other joint disease or disorder.
However, not everyone experiences osteoarthritis in the same way. You may only feel some pain when you get out of bed in the morning, or after sitting for a long period of time. And you might feel fine once you get going.
Although there are many different types of arthritis, there is a good chance you are suffering from osteoarthritis, which is the most common type. In fact, you can have signs of arthritis on your X-rays even though you have no pain at all.
Why doesnt everyone who has osteoarthritis experience the same problems? The answer to this question becomes clearer when you understand that osteoarthritis is a progressive disease meaning that the longer you have it, especially if you dont change some of your habits, the worse it can get.
The reason you might experience hip arthritis differently than your best friend or your family member is because you are probably in a different stage of the disease than they are. Osteoarthritis can be classified into four different stages, and the stage you are in will determine your best choice of treatment.
So, which stage of hip osteoarthritis are you in? Your orthopedic surgeon is most qualified to identify this for you, but here are some general rules of thumb.
When To Consider Hip Replacement
An appropriately prescribed hip replacement fixes the mechanical issues you may be experiencing. And its the only treatment option that does such.
The hip replacement experience has drastically improved over the past 20-30 years. Many improvements are directly tied to the way in which pain is managed post-operatively. Many surgeons use a multi-modal pain regimen that targets different pain receptors in the brain and the site of the surgery. Patients are getting up faster and are leaving the hospital sooner. Thirty years ago, many patients spent up to two weeks in the hospital after surgery. Today, many people go home within 1-2 days and in some centers in the country are even going home the same day.
If you have tried alternative treatment methods for your hip arthritis, it may be time to discuss the next step. Your doctor may suggest a hip replacement as the best option for you. If so, contact our doctors at Tuckahoe Orthopaedics today to discuss whats next for you.
Recommended Reading: What To Do For Arthritis Pain In Hands
How Does Arthritis Affect The Hips
The hip is commonly affected by arthritis, particularly osteoarthritis . You may notice pain in your hip, groin, buttock and/or thigh areas, felt as sharp pain or an ache. It is often most noticeably when you walk, climb stairs, stand up from a seated position, squat and/or first get out of bed in the morning.
There are many things that can help you manage arthritis of the hip. The first steps are regular exercise, weight loss and using medicines wisely
What Are The Stages Of Oa And Treatment Options
STAGE 0 Joint is healthy and there are no signs of OA.
STAGE 1 Some development of bony growths within the joint. At this stage, there is only minor wear on joint components and you rarely experience pain or discomfort.
- Treatment: If there are minor symptoms, or you have other factors putting you at an increased risk of OA, oral supplements and an exercise regime may be recommended to slow the progression of the disease. Weight loss, bracing to ensure joint stability, and oral pain relief medication may be prescribed at any stage. A Platelet-Rich Plasma Injection, which uses plasma from your own blood to stimulate your body to heal itself, may also be recommended to help repair damage during this early stage.
STAGE 2 This is considered mild OA. X-rays will show larger bone spurs, but cartilage is still thick enough to prevent the bones from rubbing against one another. Synovial fluid, which helps lubricate and cushion joints, is typically still present at sufficient levels for normal joint motion. Its often at this stage where you may first begin experiencing symptoms. They could include pain after a long day of walking or running, greater stiffness in the joint when its not used for several hours, or tenderness when kneeling or bending.
For more information on Image-Guided Pain Therapy injections, please speak to your health care practitioner.
Recommended Reading: How To Deal With Arthritis
I Have Osteoarthritis: Now What
Mayfair Dec 06, 2018
Osteoarthritis is the most common form of arthritis and its affecting more and more Canadians every year. Its estimated that by 2035, one in four Canadians with be diagnosed with osteoarthritis a disease of the whole joint that leads to the breakdown of joint cartilage and the underlying bone.
Osteoarthritis is sometimes described as degenerative or wear-and-tear arthritis. Recent studies suggest there may be an inflammatory component to OA, so it may not just be age-related or caused by overuse. In normal joints, cartilage the tough elastic material that covers and protects the ends of bones acts as a cushion and provides a smooth, gliding surface for joint motion. OA causes the cartilage to break down, leading to pain, swelling, and problems moving the joint. As it worsens over time, the cartilage wears away and bone rubs against bone, causing joint damage and increased pain.
Risk Factors Of Osteoarthritis
The risk factors associated with osteoarthritis include:
- Previous injury to the hip joint
- Structural problems with the hip joint, such as hip dysplasia and femoroacetabular impingement
- Family history of osteoarthritis
However, osteoarthritis of the hip may develop in people without these risk factors. If left untreated in the early stages, this condition can progress to the end-stage within 15 years.
Also Check: How To Deal With Arthritis
Stage 4 Hip Osteoarthritis
Since osteoarthritis is a progressive illness, eventually you may experience Stage 4 osteoarthritis in one or both hips. At this point, the cartilage would have become so thin and brittle and the synovial fluid so diminished that you experience pain and stiffness most of the time, even when youre not moving. Sometimes the pain can be very severe and can make it difficult for you to complete even the simplest of tasks, and can keep you awake at night too.
Hopefully by this stage you have been seeing an orthopedic surgeon, because your quality of life can greatly improve with the help of the right physician. They can review your options with you, which may include surgery to replace some or all of the arthritic hip. The surgical procedures available today are very successful, with faster and easier recoveries than ever before, and you can be left with a hip free of arthritis and free of pain.
How Do Doctors Assess Severity Of Ra
There have been many proposals as to how to assess severity. Some have said it is necessary to consider joint swelling, evidence of damage on x-rays, abnormal labs, and disability, as the damage to the joints may make it difficult or impossible to go about one’s daily activities.
In addition, RA can occasionally affect other organs, such as the lungs, the heart, the blood system and the nervous system so, the presence or absence, and the severity, of involvement of the other body systems must also be considered. Of course, disease activity can fluctuate over time. This being said, there is a need for an easy measure of severity.
Many rheumatologists consider rheumatoid arthritis disease activity to be the potentially reversible effects of inflammation:
Elevated sedimentation rate
The most complete method of measuring rheumatoid arthritis severity is based on the American College of Rheumatology standards, whereby the evaluating rheumatologist examines the patient, checks the lab tests and x-rays.
Researchers have found that the amount of joint pain and swelling correlates well with the amount of destruction seen on joint x-rays. The lab test known to many as the sedimentation rate itself correlates with how poorly a patient is doing in terms of muscle strength and general daily activities.
Don’t Miss: Best Thing For Arthritis In Hands
Surgery For Spinal Arthritis
Surgery may be recommended for spinal arthritis if other treatments dont sufficiently relieve pain. The goals of the surgery may include:
Stabilizing the spine by fusing several segments together in a procedure called spinal fusion
These surgeries can be performed as open procedures or with a minimally invasive approach. There are pros and cons to each method. The surgeon will review and discuss the options before the operation.
If Surgery Is Necessary
In severe cases of hip OA, the hip joint degenerates until bone is rubbing on bone. This condition can require hip joint replacement surgery. Physical therapy is an essential part of postsurgical recovery, which can take several months.
If you undergo hip joint replacement surgery, a physical therapist will visit you in your hospital room to help you get out of bed and teach you how to walk, and will explain any movements that you must avoid to protect the healing hip area.
Physical therapists will work with you daily in the hospital and then in the clinic once you are discharged. They will be an integral part of your care and recovery, helping you minimize pain, restore motion and strength, and return to normal activities in the speediest yet safest manner possible after surgery.
Recommended Reading: How To Deal With Arthritis
How Arthritis In The Hips Is Diagnosed
The diagnosis of arthritis in the hips begins with taking your medical history and doing a physical exam of your hip. The doctor will look at where youre in pain and how well you can move the hip . Dr. Vigdorchik says he watches patients walk to assess their gait. If theyre tilting their body over the hip that hurts, thats the bodys response to making it hurt less, he says.
Your doctor will ask questions that can help make sure your pain is indeed coming from the hip and not due to a different problem. Other conditions like a hernia or a pinched nerve in the back can mimic pain from arthritis in the hip.
X-rays of the hips and spine can determine if the joint has any abnormalities and assess where your pain is coming from. They can reveal such changes indicative of arthritis, including:
- Thinning or erosion in the bones
- Loss of joint space
- Excess fluid in the joint
You may need other imaging, such as an MRI or a CT scan, to get a clearer picture if an X-ray doesnt show enough, says Dr. Vigdorchik.
If your doctor suspects that inflammatory arthritis could be responsible for your hip pain, they will order additional blood tests to check for levels of inflammation and the presence of antibodies that may indicate autoimmune disease .