Hip arthritis, most frequently caused by osteoarthritis, is a progressive condition characterized by the breakdown of the smooth, protective cartilage within the hip joint. This deterioration leads to bone-on-bone friction, causing pain, stiffness, and a noticeable reduction in mobility. Managing this condition involves a stepped approach, beginning with conservative methods and progressing to more invasive procedures as the disease advances. The primary goals of all treatments are to effectively reduce pain and restore functional movement to improve quality of life.
Foundational Management Through Lifestyle and Movement
The first steps in managing hip arthritis involve conservative lifestyle adjustments and targeted movement therapies. Weight management is a foundational strategy, as losing even a small percentage of body weight can dramatically reduce the mechanical stress placed on the hip joint. This helps slow the progression of cartilage wear and significantly decreases pain levels.
Engaging in specific, low-impact exercise is a powerful tool for maintaining joint health and reducing symptoms. Activities like swimming, cycling, or using an elliptical machine are highly recommended because they allow for movement without excessive strain on the damaged joint surfaces. Physical therapy is particularly beneficial, focusing on strengthening the muscles surrounding the hip, especially the gluteal muscles and the core. Stronger muscles stabilize the hip, absorbing shock and reducing painful movements.
Physical therapists also prescribe exercises designed to improve the hip’s range of motion, which helps combat stiffness. Manual therapy techniques, including gentle joint mobilization, can further improve mobility and reduce pain. Integrating a home exercise program is crucial to ensure the benefits of therapy are maintained over time.
Assistive devices can provide immediate relief by offloading weight from the painful hip. Using a cane or a walker transfers a portion of the body’s weight away from the affected joint, reducing compressive forces. The cane should be used in the hand opposite the painful hip to maximize this mechanical advantage. Applying heat can help relax stiff muscles, while cold therapy can temporarily decrease inflammation and acute pain following activity.
Pharmacological Options for Pain Relief
When conservative measures do not provide sufficient relief, medication is introduced to manage both pain and inflammation. Acetaminophen is often the first-line oral analgesic recommended for mild to moderate pain, as it works directly to reduce pain signals. However, it does not address the underlying inflammation in the joint.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen and naproxen, reduce both pain and inflammation. While highly effective, long-term or high-dose use of oral NSAIDs carries risks, including potential gastrointestinal issues and negative effects on kidney and cardiovascular health.
Topical NSAID gels or patches offer an alternative for individuals who cannot tolerate oral NSAIDs or whose pain is localized. This method delivers the anti-inflammatory medication directly to the affected area, providing localized relief with a significantly lower risk of systemic side effects. For more severe pain, a healthcare provider may prescribe a stronger, prescription-strength NSAID or other specialized pain medications.
Targeted Injections and Minimally Invasive Procedures
If foundational management and oral medications fail to control symptoms, targeted interventions deliver relief directly into the joint space. Corticosteroid injections are the most common procedure, involving the injection of a powerful anti-inflammatory drug directly into the hip joint. This can provide effective pain relief lasting from a few weeks to several months. Due to potential side effects on the joint cartilage, these injections are typically limited in frequency.
Another procedure is viscosupplementation, which involves injecting a hyaluronic acid-based solution into the hip joint. The goal is to replenish the fluid, improving joint function and reducing pain. While successful in the knee, its efficacy in the hip joint is debated and often less predictable than corticosteroid injections. Both injection types are temporary solutions, often used to create a window of reduced pain that allows a patient to participate more effectively in physical therapy and delay the need for surgery.
Surgical Interventions for Advanced Arthritis
When non-surgical treatments no longer provide adequate pain relief and quality of life is severely compromised, surgical intervention is necessary. Total Hip Arthroplasty (THA), or total hip replacement, is the most frequently performed procedure for advanced arthritis. This surgery involves removing the damaged femoral head and resurfacing the acetabulum, replacing both with durable prosthetic components. THA reliably eliminates arthritic pain and restores significant function, with modern implants designed to last for 15 to 20 years or longer.
Hip resurfacing is an alternative procedure for younger, active patients with good bone quality. Instead of completely removing the femoral head, the surgeon shaves and reshapes the damaged ball and caps it with a smooth metal covering, while the socket is still replaced. This approach preserves more native bone structure, which can be advantageous should a future revision surgery be necessary. Following either procedure, a structured post-operative physical therapy program is initiated to strengthen muscles and restore range of motion.