Dr Jatinder Bir Singh Jaggi
Hip pain due to arthritis is one of the common conditions seen not only in older people but also in people, especially women in their 50s and 40s. Arthritis, a progressive disorder, usually starts out gradually and gets worse over time. These patients who experience difficulty in walking often experience stiffness or pain ranging from sharp to dull ache in the hips more during winters.
Although joint problems are often overlooked until they cause distress, it is important, especially during winters, to diagnose the disease early for best treatment results. Winters are tough anyway as joint pain increases due to soft tissue stiffness. The best way to counter it is to stay warm and avoid sudden changes in temperature, especially temperature extremes, i.e. from a warm room to a very cold outdoor space.
To describe it in simple terms, arthritis occurs when the joint space in your hip is narrowed and the soft tissues around it begin to shrink and tighten. The condition can occur due to genetic or hereditary reasons and certain other conditions such as wear and tear on the joints over time or due to a tough workout regimen, or obesity.
In recent times, there has been an increase in cases of hip problems, especially Hip AVN (avascular necrosis) in young people. Amid COVID, there has been widespread use of steroids primarily attributable to illness. Unrealistic goals set in the gym and the desire to have a good physique in less time trigger exercise in the gym. One of the most common and preventable causes of these injuries is poor posture while working out. Other causes are the use of excessive weight to build muscle and the abuse of drugs, the most common being steroids and hormones.
If we look at the composition of our hip joint, it is a ball and socket joint and is very mobile. During arthritis, when we stretch and move, the hip joint hurts and over time leads to greater stiffness and worsening of the condition which dulls the pain. Thus, this explains why the hip is one of the joints most commonly affected by arthritis.
There are different types of arthritis that can affect the hip and its treatment is based on factors such as type of arthritis, early diagnosis, patient age, medical history (if any), etc.
There are three main (most common) types of arthritis that can affect the hip joint. These are:
Osteoarthritis – Most commonly affecting the elderly population
Rheumatoid arthritis – Very common in young people
Ankylosing spondylitis – Very common in young people
Other factors leading to hip joint problems in older people include the use of steroids or supplements during an early age for bodybuilding.
This is the most common form of arthritis, especially in older people. Although it is also caused by structural problems in the hip joint, advanced age, obesity, hip injuries, etc. Obesity is one of the major causes of osteoarthritis and knee related conditions where the knees experience 6 times the body weight thus affecting the joints.
Rheumatoid arthritis (RA) affects your whole body, not just the hip joint. It affects people of all age groups, including children, and is more common in women than in men. The cause of inflammation in rheumatoid arthritis is due to an immune system response rather than wear and tear. The condition causes pain and swelling in both hips, unlike osteoarthritis which only occurs in one hip, and eventually leads to deterioration of the bone and cartilage in the joint. Besides pain and swelling, rheumatoid arthritis also causes weakness and fatigue.
It is a chronic inflammation of the spine and the sacroiliac joint (the joint where the spine meets the pelvis). The disease can affect people of all age groups, including children, but its onset is usually between 17 and 35 years old. Unlike rheumatoid arthritis, ankylosing spondylitis is more common in men than in women.
Common symptoms associated with hip arthritis are:
Pain in the hip joint which includes the groin, outer thigh, and buttocks
The pain is worse in the morning and decreases during the day
Stiffness in the hip
Pain in the back and radiating to the knee from the front of the thigh
If you suspect you have hip arthritis, get a diagnostic evaluation right away. This may include:
Your medical history and physical exam
X-rays can help determine abnormalities in the joint.
What treatments are available?
Depending on your diagnosis, your surgeon will prescribe the type of treatment appropriate for your condition.
Non-surgical treatment for hip arthritis may include:
Physiotherapy or exercise programs to improve flexibility and muscle strength
Swimming is great exercise for arthritis
Weight reduction in overweight patients
Devices such as canes/walkers to aid walking
Many people with hip arthritis are candidates for surgery. Surgery can help reduce pain, improve quality of life, and improve an individual’s ability to perform daily activities without restriction.
Minimally invasive hip replacement surgery: This is an appropriate treatment option if the hip joint is severely damaged or pain and swelling reduce joint movement and affect quality of life. Hip replacement surgery is one of the most successful modern orthopedic surgical procedures and it is performed with smaller incisions which means faster recovery. In hip replacement surgery, the surgeon removes damaged cartilage and bone from the hip joint and replaces it with artificial pieces.