Hip pain

Making a decision about hip osteoarthritis - NHS

What is it?

Osteoarthritis (OA) is a normal part of aging which can cause joints to become stiff and painful. Hip OA is the second most common joint to be affected after the knee.

OA describes the gradual process of thinning of the cartilage and roughening of the surfaces of the joint. As the cartilage begins to thin, your body starts a repair process by trying to make up for the loss of substance. The process of this repair can cause further pain and stiffness. For example, very small bone fragments can appear at the end of your bones - these are called osteophytes. This can also increase the amount of fluid in the joint which can stretch the joint capsule and cause further discomfort and stiffness.

OA is more common in women than it is in men and usually affects people ages 45 and above. The exact cause of OA is unknown however there are several factors which are known to increase the likelihood of getting OA. These are:

• Being female
• Being overweight
• Family history
• Previous injury to the joint
• Age

How do we treat it?

There is no cure for OA however a lot of people can successfully self-manage their symptoms through the following means.

• Weight management
• Reducing the strain on you hip through lifestyle changes
• Pacing your activities
• Adapting activities that you find difficult
• Wearing supportive footwear
• Heat/Ice (do not use ice directly on the skin and no longer than 10minutes at a time).
• Medication
• Over-the-counter pain relievers can help manage pain and swelling in the first instance. Follow the instructions on the packet and speak to your GP if you are unsure what if safe for you to take. GPs can also prescribe stronger pain relief if appropriate.
• Cortico-steroid injections

Exercise

• Exercise is very important in managing OA. Joints need to be exercised regularly to keep them healthy.
• Exercise can help strengthen the muscles surrounding your hip and help you lose weight- both of which will help with your symptoms
• You should aim to start off slowly and gradually increase how much you do.

Useful resources:

Osteoarthritis (OA) of the hip | Hip pain | Versus Arthritis

I have knee/hip pain - ESCAPE-pain

What is it?

Lateral hip pain, also known as greater trochanteric pain syndrome (GTPS) or greater trochanteric bursitis is a relatively common condition affecting the lateral (outside) part of your hip. It is more common in women than in men and tends to be most prevalent in 40-60 year olds however it can occur at any age. It is usually caused by an irritation to the tendons on the outside of your hip, most commonly gluteus medius and/or gluteus minimus. Sometimes the bursa, which is a fluid filled sac that acts as a cushion between the tendons and the bone is also inflamed. It tends to cause pain when lying on the affected hip at night, getting in and out of cars and when sitting with your legs crossed.

How do we treat it?

There is good evidence to support the use of exercise to help treat GTPS. The exercises aim to progressively load and strengthen the muscles on the outside of your hip over a period of time. It is also important to modify the activities which could be irritating your hip. This could be;

• Avoiding low chairs
• Avoid sitting with legs crossed
• Avoid sleeping on the painful side
• Losing weight if you are overweight.

It is important to know this condition can take up to one year to settle and it is likely that you will go through periods where your pain flares up. If your pain does flare up it would be advised that you slightly reduce the intensity of the exercises you are completing until this settles. If your pain levels are really high and you struggle to complete the exercises due to pain then you may need to see a physiotherapist.

Useful resource: Managing your Hip Pain - St George's University Hospitals NHS Foundation Trust