Hip Arthritis

Osteoarthritis is the most common cause of hip pain in older adults (older than 50 years of age). Studies have shown up to 27% of adults have hip arthritis. Pain from hip osteoarthritis may be in the front, side, groin or in the buttocks and worse with weight-bearing activities such as walking or stairs. Further, patients often have morning stiffness after wakening that lasts less than an hour and overall range of motion loss compared to the nonpainful hip. 

Radiographs (X-rays) are the most used method of medical imaging for diagnosing hip arthritis, although the diagnosis can be made clinically (based on the patient’s presenting signs and symptoms) without X-rays. 

The natural history of hip arthritis is not entirely understood. Range of motion is reduced and muscle weakness develops with the progression of arthritis. 

Treatment should be tailored to address the specific impairments and limitations of the patient and may include the following: 

• Manual therapy including soft tissue mobilization of areas of muscular restrictions, joint mobilizations to improve the flexibility/mobility of the hip joint and dry needling to reduce muscle stiffness. 
• Flexibility exercises to address impairments in range of motion and muscle flexibility. 
• Strengthening exercises to address specific muscle weaknesses. 
• Functional exercises to prepare the patient for his or her specific goals (i.e., sitting on the ground, hiking, walking up curbs, kneeling, etc.).
• Gait and balance training to improve walking/stairs quality and to reduce the risk of a fall.
• Modalities to reduce pain.

Patients with severe symptoms may need a hip replacement. 

References:

1. Cibulka, Michael T. et al. “Hip Pain and Mobility Deficits—Hip Osteoarthritis: Revision 2017.” Journal of Orthopaedic & Sports Physical Therapy, Vol. 47, No. 6, 2017, pp. A1-A37. Journal of Orthopaedic & Sports Physical Therapy (JOSPT), https://doi.org/10.2519/jospt.2017.0301.

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