OA Hip Osteoarthritis (OA) is a common problem for many people after middle age. It is sometimes referred to as degenerative, or ‘wear-and-tear’ arthritis. OA commonly affects the hip joint. There have been huge improvements in the way this condition is treated – from the early stages through to the more advanced condition so patients can have less pain, better movement, and improved quality of life.
OA affects the articular cartilage which is the smooth lining that covers the surfaces of the ball-and-socket joint of the hip which gives the joint freedom of movement by decreasing friction. When the cartilage degenerates, or wears away, the underlying (subchondral) bone is uncovered and this increases friction and generates inflammation and pain.
What causes OA?
OA of the hip can be caused by a hip injury earlier in life. Changes in the movement and alignment of the hip eventually lead to wear and tear on the joint surfaces too (just like the out-of-balance tyre that wears out too soon on your car). Not all cases of OA are related to alignment problems or a prior injury - scientists believe that genetic make-up predisposes some people to developing OA in the hip.
What does OA of the hip joint feel like?
The symptoms of hip OA usually begin as pain while putting weight on the affected hip. You may limp, which is the body's way of reducing the amount of force that the hip has to deal with. The changes that happen with OA cause the affected hip to feel stiff and tight due to a loss in its range of motion. Finally, if the condition becomes worse, pain may be present all the time and may even wake you at night.
What is the treatment?
OA can't be cured, but physiotherapy can really help to ease symptoms and improve function of the joint. Many peoples condition can be maintained with careful self management so, just because the condition has been diagnosed, it doesn’t necessarily mean that the condition always deteriorates. Treatment includes joint mobilization and stretching exercise to maintain/improve range as well as strengthening exercise to steady the joint and protect it from shock and stress. Physios will also suggest tips for getting tasks done with less strain on the joint.
Medical studies have shown that glucosamine and chondroitin sulphate can also help people with OA. These supplements seem to have nearly the same benefits as anti-inflammatory medicine with fewer side effects.
If the symptoms are more severe, a corticosteroid injection can be used – this has a powerful anti-inflammatory effect – but does seem to increase the chance of infection after surgery and for this reason it is only used in exceptional circumstances. If the more severe symptoms persist consideration should be given to joint replacement (arthroplasty). Physiotherapy has an important role in helping people rehabilitate immediately after surgery and once discharged from hospital a few additional appointments may be needed for patients who still have problems walking or who need to get back to more physically demanding work or activities. The therapist's goal is to help maximize hip strength and restore a normal walking pattern without risking further injury to your hip. When you are well under way, you will be in charge of doing your exercises as part of an ongoing home exercise program.
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