Hip arthritis is defined by the inflammation and progressive degradation of the smooth, protective cartilage within the hip joint. The hip is a large ball-and-socket joint, where the top of the thigh bone (femoral head) fits into a cup-shaped socket in the pelvis (acetabulum). Cartilage acts as a low-friction surface, enabling smooth movement, but its deterioration exposes the underlying bone. When this cushioning breaks down, friction between the bones generates pain and restricts mobility. This joint dysfunction is one of the most common causes of chronic hip discomfort.
Primary Forms and Contributing Factors
The majority of hip arthritis cases are classified as Osteoarthritis (OA). In OA, the cartilage gradually becomes rough and thins out over time, typically starting after age 50. This process leads to decreased joint space, eventually causing bone surfaces to rub against each other and trigger pain and inflammation.
Other forms of hip arthritis include Rheumatoid Arthritis (RA) and Post-Traumatic Arthritis. RA is an autoimmune disorder where the immune system attacks the joint lining (synovium), leading to chronic inflammation that destroys cartilage and bone, often affecting both hips simultaneously. Post-Traumatic Arthritis develops years after a physical injury, such as a fracture or severe hip dislocation, which damages the cartilage or changes the joint’s alignment.
Several factors increase the likelihood of developing hip arthritis, particularly OA. Advancing age is a factor, as the joint naturally accumulates wear over decades. Excess body weight places increased mechanical stress on the hip joint, accelerating the breakdown of cartilage.
Genetic predisposition also plays a role, as a family history of OA can increase risk. Structural issues, such as developmental dysplasia (a shallow hip socket) or femoroacetabular impingement (abnormal bone shape), can lead to uneven wear patterns. Occupations or sports involving repetitive, high-impact stress on the joint may also contribute to earlier onset of cartilage degradation.
Recognizing Common Symptoms
The primary symptom of hip arthritis is pain, which most commonly localizes in the groin area. This discomfort can radiate to the outer thigh, the buttock, or down to the knee, known as referred pain. The pain is often described as a deep ache that worsens with activity and weight-bearing tasks like walking or standing for long periods.
Joint stiffness is another symptom, particularly noticeable after periods of rest or upon waking. This morning stiffness typically lasts for less than an hour, easing as the person moves and warms up the joint. As the condition progresses, a grinding, catching, or clicking sensation, known as crepitus, may be felt during movement.
Functional limitations become apparent, making certain daily movements difficult. These limitations include:
- Trouble bending forward to put on socks or shoes.
- Difficulty getting in and out of a car.
- Problems climbing stairs.
The pain and restricted range of motion may also lead to a noticeable limp or gait change as the body attempts to protect the joint. Symptoms typically develop gradually over years, though they can sometimes worsen rapidly following an acute injury or flare-up.
How Hip Arthritis is Diagnosed
Diagnosis begins with a physical examination. The physician will assess the hip’s range of motion, often finding limitations in internal rotation and difficulty moving the leg across the body. The examination also includes observation of the patient’s gait to check for signs of a limp, which suggests pain with weight-bearing.
The primary imaging tool used to confirm hip arthritis is a plain X-ray. The images reveal the effects of cartilage loss, including a narrowing of the joint space between the femoral head and the acetabulum. The X-ray may also show the presence of osteophytes, which are abnormal bone spurs that form around the edges of the joint.
For a more detailed look at soft tissues or to identify early-stage damage, Magnetic Resonance Imaging (MRI) may be used. If an inflammatory type of arthritis, such as Rheumatoid Arthritis, is suspected, blood tests may be ordered. These tests help rule out other conditions by checking for specific inflammatory markers or autoantibodies.
Foundations of Non-Surgical Treatment
The initial approach to managing hip arthritis focuses on reducing pain and maintaining function. A cornerstone of this management is physical therapy, designed to strengthen the muscles surrounding the hip, including the gluteals, quadriceps, and core. Strengthening these muscle groups helps stabilize the joint and offload pressure on the damaged cartilage.
Physical therapy also incorporates stretching and flexibility exercises to combat joint stiffness and preserve range of motion. Patients are advised to engage in low-impact aerobic activities, such as swimming or cycling, which maintain fitness without subjecting the hip to jarring forces.
Lifestyle adjustments are important for managing symptoms. Losing excess body weight is beneficial, as even a modest reduction significantly decreases the load on the hip joint, leading to less pain and improved mobility. Activity modification involves avoiding or minimizing movements known to aggravate the condition, such as excessive stair climbing or prolonged standing.
Medication options often begin with over-the-counter Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen or naproxen, which reduce both pain and inflammation. For short-term pain relief during a severe flare-up, a physician may administer a corticosteroid injection directly into the hip joint. These injections provide temporary relief by reducing inflammation in the joint capsule. Supportive devices like a cane can also be effective, transferring a portion of the body weight away from the painful hip and reducing strain during walking.