Hip pain from arthritis is one of the common conditions seen not just among elderly but also among people, especially women in their 50s and 40s. Arthritis, a progressive disorder, typically starts gradually and gets worse with time. Such patients who often find difficulty in walking feel stiffness, or pain ranging from sharp pain to dull ache in hips more during the winters.
Though joint problems are often neglected until they cause distress, it is important especially during winters to diagnose the condition early for better treatment outcomes. Winters are anyways challenging as joint pain increases due to stiffness of soft tissues. The best way to counter it is to stay warm and avoid sudden change of temperatures especially extreme temperatures i.e. from a warm room to a very cold outdoor area.
To describe it in simple terms, Arthritis occurs when the joint space of your hip is narrowed and the soft tissues surrounding it start to shrink and tighten. The condition may arise due to genetic or hereditary reasons and certain other conditions like wear and tear of joints over time or due to tough training regime, or being obese as well.
In recent times, there has been a surge in cases of hip problems especially Hip AVN (Avascular Necrosis) among the youngsters. Amid the COVID, there has been rampant usage of steroids primarily attributing to the condition. Unrealistic goals set in the gym and wanting a good physique in less time triggers over exercising at the gym. One of the commonest and avoidable causes for these injuries is the wrong posture while working out. The other causes are using excessive weight to build up the muscles and drug abuse, the most common being steroids and hormones.
If we examine the make-up 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 that alleviates pain. Thus, it explains why the hip is one of the most common joints affected by arthritis.
There are different types of arthritis that can affect the hip and its treatment is based on factors such as the type of arthritis, how early the condition is diagnosed, age of the patient, medical history (if any), etc.
Types: There are three main (Most Common) types of arthritis that can affect the hip joint. These are:
· Osteoarthritis – Most often affecting the elderly population.
· Rheumatoid arthritis – Very common among youngsters.
· Ankylosing spondylitis - Very common among youngsters.
Other factors leading to hip joint problems in old age include usage of steroids or supplements during younger age for body building.
This is the most common form of arthritis seen especially in elderly people. Although it is also caused due to structural problems with the hip joint, advancing age, obesity, hip injury, etc. Obesity is one of the major causes of Osteoarthritis and knee-related ailments, where knees undergo 6 times the body weight thereby affecting the joints.
Rheumatoid arthritis (RA) affects your entire body and not just the hip joint. It affects people of all age groups including children and is more commonly seen in women than men. The cause of inflammation in RA is due to an immune system response rather than wear and tear. The condition causes pain and swelling in both the hips unlike osteoarthritis that occurs only in one hip, and eventually, it leads to deterioration of the bone and cartilage of the joint. Besides pain and swelling, RA also causes weakness and fatigue.
It is a chronic inflammation of the spine and sacroiliac joint (the joint where the spine meets the pelvis). The condition may affect people of all age groups, including children, but typically its onset is between the ages of 17 and 35. Unlike RA, Ankylosing spondylitis is more common in men than women.
Symptoms: Common symptoms associated with arthritis of hip are:
· Pain in the hip joint that includes the groin, outer thigh and buttocks.
· Pain is worse in the morning and lessens over the day.
· Difficulty walking.
· Stiffness in the hip.
· Pain over back and radiating to knee through front of thigh.
If you suspect you have arthritis of the hip, get a diagnostic evaluation immediately. This may include:
· Your medical history and physical examination
· X-rays can help in determining abnormalities in the joint.
· Blood tests
What are the available treatments?
Based on your diagnosis, your surgeon will prescribe the type of treatment that is appropriate for your condition.
Non-Surgical treatment for arthritis of the hip may include:
· Anti-inflammatory medications
· Physiotherapy or exercise programs to improve flexibility and muscle strength
· Swimming is an excellent exercise for arthritis
· Weight reduction in case of overweight patients
· Devices such as canes/walkers to make it easier to walk
Many people with arthritis of the hip are candidates for surgery. Surgery can help to reduce pain, enhance quality of life, and improve an individual's ability to perform everyday activities with no restrictions.
Minimally Invasive Hip Replacement Surgery
It is an appropriate treatment option if the hip joint is severely damaged or if pain and swelling reduces motion in joints and affects quality of life. Hip replacement surgery is one of the most successful modern orthopaedic surgical procedures and it is performed with smaller incisions which mean quicker recovery. During a hip replacement surgery, the surgeon removes damaged cartilage and bone from the hip joint and replaces them with man-made parts.
(Dr. Jatinder Bir Singh Jaggi, Associate Director Orthopaedics & Joint Replacement, Max Hospital, Gurugram)