Essentials about hip arthritis

 

INTRODUCTION


Osteoarthritis (OA) occurs in the hip when the shock absorbing cartilage lining the ball and socket of the joint becomes worn. This process develops naturally as you get older with 10-20% of people over the age of 65 showing X-ray signs of OA in the hip or knee. OA can also occur in younger people, sometimes as a result of hip problems in childhood or adolescence or following significant trauma to the hip.


Pain is the most common symptom from hip arthritis and this is often felt as a dull ache in the groin, the outside of the hip, the buttock, thigh or knee. Stiffness and loss of flexibility may also be noted and can this can cause difficulty with normal daily activities such as walking, cutting toe nails or putting on socks and tights.


In 2008, the National Institute for Health and Clinical Excellence recommended that everyone with OA should be provided with advice on three essential treatments:


1.Information, advice and education

2.Exercise

3.Weight loss if  you are over weight or obese


Details of these treatments and also on other additional measures that can help you manage the symptoms from your hip are given below.


ESSENTIAL MANAGEMENT OF HIP ARTHRITIS

1.INFORMATION

Good information should help you to understand what is happening to your hip and give you confidence to manage the symptoms effectively. You will find a list of organisations that can provide good quality information about OA below, but if you remain concerned about your situation or have any questions, your GP, Physiotherapist and Consultant .are there to help and reassure you.


2.EXERCISE

A combination of different types of exercise is recommended for treating symptoms of OA:


Aerobic exercise which increases your breathing and pulse rate will help you to keep fit, help keep your weight down, improve the circulation to your joints and stimulate your body and brain to produce its own natural pain killing chemicals.  Provided that you start to exercise gradually and repeat it regularly, your confidence and ability should increase without aggravating your symptoms.


Swimming, aquarobics and cycling are ideal forms of aerobic exercise as they place little stress on the hip, but you can continue almost any form of exercise that you enjoy within the limits of your pain, although high impact exercise such as running or high impact aerobics is best avoided. Local leisure centres often provide exercise classes in the gym or pool specifically for people with joint problems.


Specific exercise for the hip may help you to retain the flexibility in your hip joint, maintain your balance reactions and improve the strength of the muscles supporting the hip. However, certain exercises may be too painful to carry out.


Your Physiotherapist can give you further advice on exercise.



3.KEEP TO YOUR IDEAL WEIGHT

Being overweight increases the stress on all the joints in your legs including the hip joint, so stick to a healthy diet and combine this with regular exercise to keep to your ideal weight. If you are overweight, aim to lose weight steadily over a period of time.  A helpful leaflet entitled Your weight, your health- how to take control of your weight is available from the Department of Health (order line 08701 555 455) or via their website (www.dh.gov.uk/publications).


Further help and advice can be obtained on the NHS website or via your GP practice


ADDITIONAL TREATMENTS

4.MEDICATION

Simple painkillers (analgesics) such as Paracetamol can be very effective in controlling pain. Some people find they only need to take painkillers occasionally- perhaps to allow them to exercise comfortably, or before going to bed if their sleep is disturbed. Others find greater benefit from a dose taken regularly through the day. You should never exceed the recommended dose.


Stronger painkillers or anti- inflammatory medication e.g. Codeine, Co-Codamol, Co-dydramol, Tramadol, Ibuprofen, Diclofenac, may be prescribed by your GP if Paracetamol is not effective.


Further advice on painkillers can be obtained from you GP or Pharmacist.


There is no strong research evidence to suggest that supplements such as Cod Liver oil, Glucosamine or Chondroitin have a significant benefit, however some people find them helpful.  They are available from supermarkets, chemists and health food shops but if you have any allergies, other medical problems or are on other medication, please check with your GP or Pharmacist before trying them.



5.HOT AND COLD THERAPY

Applying warmth in the form of a heat pad or hot water bottle to the painful area can be very soothing. Never use excessive heat and regularly check your skin to avoid burning.


Some people find ice packs more helpful. Commercial cold packs are available from sports shops and some chemists, or simply wrap a pack of frozen peas in a towel and apply to the painful area for 10 minutes. Regularly check your skin to avoid ice burns.


6.USE A WALKING STICK

A walking stick or walking pole, used in the opposite hand to your affected hip, can help to reduce the load through the joint and so make walking more comfortable. It is particularly recommended if you have a limp.


Make sure that you are measured for the correct height of stick by the supplier.


7.USE SUPPORTIVE SHOES

Flat shoes with a thick, cushioned sole e.g. training shoes reduce the impact through the hip joint. Shock absorbing insoles and heel cushions can be purchased from sports shops and chemists which have the same effect. 


8.ADAPTATIONS

Aids and adaptations such as gadgets to help you put on shoes and socks can be helpful in keeping you independent. Further information on these is available from an Occupational Therapist or shops specialising in medical aids and equipment.



Other sources of information

•Arthritis Care: www.arthritiscare.org.uk

Tel: 0808 800 4050

•Arthritis Research UK: www.arc.org.uk

                                        Tel: 0870 850 5000

•NHS website: www.nhs.uk