Hip osteoarthritis

Osteoarthritis is the most common type of arthritis. In the hip, the smooth cartilage that cushions the joint breaks down, and the bone and other tissues around it change too. The hip becomes painful and stiff, and may lose some movement.

The hip is one of the joints most often affected. It is not simply wear and tear, and it does not always get worse. There is no cure, but treatment can ease pain and keep you moving.

Symptoms usually develop slowly. They can include:

• Pain in the groin, which may also be felt in the inner thigh, buttocks or knee
• Pain that is worse with activity and eases with rest, and in later stages may be worse at night
• Stiffness after rest or first thing in the morning, usually lasting less than 30 minutes
• Loss of movement in the hip, and a grating or crackling feeling
• A feeling that the joint is loose or unstable
• Tiredness, poor sleep or low mood

See a doctor if hip, groin or thigh pain lasts more than a few weeks, keeps coming back, or limits walking, stairs, work or sleep. Morning stiffness that lasts longer than half an hour can point to another kind of arthritis and also needs checking.

The exact cause is not known. The joint tissues break down and the body's repair does not keep up. It can follow an earlier hip injury, a hip that formed differently, or another joint disease such as rheumatoid arthritis or gout.

• Older age
• Being overweight or obese, which puts extra load on the hips
• A past injury to the hip, or a hip that did not form correctly
• Heavy or repeated strain on the joint, as in some jobs and sports
• A family history of osteoarthritis
• Being female, especially after the age of 50

Hip osteoarthritis is long term and often gets worse slowly. In some people it can:

• Make walking, climbing stairs and daily tasks difficult when it is severe
• Reduce the movement of the hip over time
• Cause tiredness, poor sleep and low mood

It cannot be fully prevented, but these steps may lower the risk:

• Keep to a healthy weight, which eases the load on the hips
• Stay active with regular moderate exercise and strength exercises
• Avoid joint injuries, and jobs that repeatedly put heavy strain on the joints
• Keep good posture and take breaks from sitting

A doctor asks about your symptoms and examines the hip, checking movement, tenderness and how you walk. Osteoarthritis can often be diagnosed from this alone. An X-ray is not always needed, but can show how much the joint has changed and help rule out other problems such as a fracture.

Blood tests may be done to rule out other kinds of arthritis, such as rheumatoid arthritis.

Exercise and weight control come first. Exercise that strengthens the muscles around the hip, such as walking, cycling or swimming, eases pain and stiffness. If you are overweight, losing weight helps. A physiotherapist can plan exercises that suit you.

Walking sticks, suitable footwear and insoles can reduce strain. Paracetamol is often tried first for pain, and anti-inflammatory creams or tablets may be used, but the tablets can irritate the stomach and affect the heart, so they do not suit everyone. A steroid injection into the joint can bring short-term relief.

Hip replacement is considered when the damage is severe and other treatments have not helped enough. The damaged cartilage and bone are replaced with artificial parts, which can relieve pain and improve movement. Risks include dislocation of the new joint, blood clots and infection.