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Hip

The hip is a simple ball and socket joint. Normally, the parts of the hip joint work together and the joint moves easily without pain. However; disease, arthritis, or injury can disturb the normal function of the hip joint. This can result in hip pain, groin pain, muscle weakness, and limited movement. Longer life expectancies and greater activity levels as people age have lead to joint replacements being performed in greater numbers of patients.

human bones radiography

How does the Hip Work?

This ball and socket joint acts much like a car’s ball joint connecting the wheel to the axle allowing you to turn in different directions while supporting the body. The ball (femoral head) is at the upper end of your thigh bone (femur) and this fits into a socket (acetabulum). Cartilage (a layer of smooth soft tissue) covers the ball and lines the socket allowing the ball to move easily in the socket. You are given only one coating of this cartilage in your lifetime; when it is damaged or worn out it cannot repair itself.

Hip Pain

There are several causes of hip pain. They generally can be broken down into three categories: primary hip problems, secondary hip problems, and referred pain from other areas. Primary hip pain typically results from problems inside the actual hip joint, which includes the femoral head (the ball at the top of the thigh bone), the hip socket (acetabulum), and the labrum (soft tissue that surrounds the socket). This pain can be due to wear of the cartilage of the femoral head or socket (arthritis), labral tears, abnormalities of the shape for the ball and socket (femoroacetabular impingement), inflammation of the tissues inside the joint (synovitis), fracture (stress fractures or injury), or infection. Secondary hip problems are caused by injury, weakness, or inflammation of the structures surrounding the hip, specifically the muscles, tendons and soft tissue. Hip pain can be related to injury to any of the muscles or tendons (muscle strains/tears, tendon strains/tears) or inflammation of these same muscles, tendons or soft tissues. Interestingly, weakness of the muscles surround the hip can also result in pain. Referred pain is pain that comes from other areas of the body that radiate to the hip or feel like pain is in the hip. These areas include the low back (pinched nerve), sacroiliac (SI) joint (inflammation of a joint in the pelvis), muscular weakness, knee (arthritis or injury), and others. The treatment of hip pain would require an evaluation by a physician. This would include investigating the timing and location of the pain, a physical examination and x-rays of the area that is painful. This would help determine the cause and treatment options available.

Hip Arthritis

Arthritis simply refers to the inflammation of a joint that causes pain, swelling, stiffness, instability and often deformity. Severe hip arthritis and hip pain can interfere with a person’s activities and can limit his or her lifestyle. If you are experiencing hip pain caused by hip arthritis, it is important to know that there are treatments available. There are multiple types of arthritis that can affect a joint. The most common ones that are seen are osteoarthritis (degenerative joint disease), rheumatoid arthritis, psoriatic arthritis, and lupus. Rheumatoid, psoriatic, and lupus arthritis are often associated with other conditions that may require treatment from a rheumatologist or other medical doctor. Osteoarthritis or Degenerative Joint Disease is the most common type of arthritis that occurs most commonly in hips, knees, ankles, and foot joints. Osteoarthritis is also known as “wear and tear arthritis” since the cartilage simply wears out. When cartilage wears away, the bone is subjected to higher degrees of stress, which causes pain, stiffness and disability. If the arthritis is severe and all of the cartilage wears away, the bones can actually rub together, causing what some people refer to as “bone on bone arthritis”.

Hands holding a stethoscope and word

Causes and Risk Factors The most frequent reason for osteoarthritis is genetic, since the durability of each individual’s cartilage is based on genes. If your parents have arthritis, you may also be at risk of suffering from degenerative joint disease. In addition, osteoarthritis may be a result of a past trauma, metabolic conditions like gout, […]

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Symptoms

Symptoms Pain is the most frequent symptom for patients with hip osteoarthritis. The pain from hip arthritis is usually described as being in the groin or thigh. The pain is frequently worsened with activity and relieved by rest. It may occur at night and, in severe cases, prevent sleep. Patients with hip arthritis also tend […]

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Diagnistic form with Diagnosis and stethoscope. Medicine concept.

Diagnosis

Diagnosis  Doctors diagnose osteoarthritis by speaking with the patient regarding their medical history and symptoms, performing a physical examination, and performing x-rays of the affected area. It is typically unnecessary to get an MRI to diagnose arthritis, since x-rays almost always reveal the presence and extent of the problem.

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Treatment

There are multiple options for treating hip osteoarthritis. Treatments depend on the amount of pain that you are in and how severe your osteoarthritis is.

Non-operative treatment 

The first line of treatment often involves methods other than surgery.

Options for nonsurgical treatment include:
1).  Non-steroidal anti-inflammatory medicines or acetaminophen.
2).  Hip injections, which may have some limited benefit, and may also be beneficial when trying to sort out exactly where the pain is coming from (for instance, differentiating between back and knee pain). Hip injections may last for several months, but it is generally not recommended to get repetitive hip injections.
3). For some patients, use of a cane or crutches may help to unload the painful joint.
4). A stretching or physical therapy program has been advocated by some, but relief is less likely when arthritis is at an advanced stage.

Operative treatment 
If non-operative treatment fails and the hip pain persists, the best option may be a total hip replacement.