NHS Lanarkshire logo

Hip Osteoarthritis

Information about Hip Osteoarthritis

What Is Hip Osteoarthritis 

Hip osteoarthritis is a common cause of joint pain of the lower extremity and can cause varying degrees of limitations.

Osteoarthritis is a long term condition that can affect one or more joints in the body and over time cause pain, stiffness, decreased range of movement in the joint and weakness of the muscles around the joint. It happens when there is breakdown of the cartilage in the joint which causes joint space narrowing. Some people report mild symptoms whereas other people may find their symptoms are severe. Osteoarthritis can affect people of all ages but is more common with people aged 40 and over.

 

What Are The Symptoms Of Hip Osteoarthritis

Pain in or around the hip joint and groin area is the most common symptom of hip osteoarthritis. Additionally, pain in the groin or thigh that moves into the buttocks or knee is another symptom. Pain may develop over a gradual period initially and can worsen over time.

Morning pain and stiffness can happen with this condition. Also after a period of rest, pain and stiffness may follow.

A reduction in the “smoothness” of a joint during movement may also be an indicator of hip osteoarthritis. These symptoms may include “locking”, “sticking” or “grinding” (crepitus) in the joint and may cause a reduction in the hips range of movement.

People often experience some difficulty with tasks such as walking, getting up from a chair and getting in and out of a car.

How Common Is Hip Osteoarthritis?

In the UK approximately 8.5 million people have painful joints secondary to osteoarthritis. Osteoarthritis is more common in woman and people in the older age groups. X-ray studies show that at least 50% of people aged over 65 have evidence of osteoarthritis. It is estimated that around 10% of people over the age of 45 years in Scotland have osteoarthritis of the hip.

What Causes Hip Osteoarthritis?

Osteoarthritis causes the cartilage which covers the end of bones to break down resulting in it becoming thin and roughened. The bone underneath the cartilage can then react and grows larger causing swelling and reduced range of movement in the joint. The body’s natural inflammation process is the main cause for these changes within the joint as it attempts to repair the injured area.

The exact cause of osteoarthritis is unknown, however, it is likely that a combination of factors may contribute such as:

  • Previous joint injury – overusing the joint when it’s not had enough times to heal. Repetitive activities and physical jobs can also increase the risk.
  • Age-related changes – the risk of getting osteoarthritis increases as you get older.
  • Family history – osteoarthritis may run in families due to people inheriting certain genetics from their parents.
  • Being overweight – this increases the load which goes through the joint and puts extra strain on them.
  • Female gender – osteoarthritis is more common in woman than men.

What Can Help With Hip Osteoarthritis?

There is no cure for hip osteoarthritis however there are many strategies that can be tried to manage and help your symptoms. The good news is that these can be really effective.

Helpful Tips

  • Footwear: The use of appropriate footwear may help with shock absorbency of the hip joint which can help reduce pain. High heels or wedge typed footwear are discouraged due to not allowing for an even weight distribution.
  • Positioning: Avoid sitting in low chairs as this can be more difficult to stand up from. Crossing legs is not advised due to causing a strain in the hip joint. Placing a pillow or cushion in-between your legs in side sleeping can help elevate pain by maintaining a neutral position. Similarly placing a pillow under your knees when lying on your back may also increase comfort.
  • Assistive devices (walking aids): There are many different walking aids available which can aid a person struggling with their mobility. A physiotherapy assessment will help to provide the correct walking aid for you, for example, a walking stick or crutch can help ease the pressure of hip pain when walking.

Timescales / Prognosis

Osteoarthritis is a long term condition that many people are able to self-manage. Osteoarthritis can be variable and it is normal to have good and bad periods.

Exercise

Exercise is a key treatment for the management of hip osteoarthritis. Research suggests the earlier you start to increase your physical activity the better it will be for your hip long term. Regular balanced exercise is important to help you maintain range of movement, strength and overall fitness levels. Range of movement exercises will help ease stiffness and promote flexibility in the hip. Muscle-strengthening exercises aim to support and protect the joint resulting in reduced pain levels. Participating in regular exercise will help your overall fitness levels which releases the body’s natural pain killers (endorphins). It’s important to start gently and gradually increasing the length of time you are exercising. Different types of exercise could include walking, swimming or cycling. Guidance may be beneficial from your Physiotherapist or GP to identify what level of exercise is right for you.

The early exercises are easiest and should be tried first followed by the middle and later exercises.

people streching

Pain Activity Ladder

By following the pain activity ladder you can identify activities that you would consider severely painful, moderately painful and mildly irritating and act to change your habits.

The pain scale, most often used in healthcare, measures pain from 0-10 (zero being no pain and 10 representing the worst pain you could imagine).

If you can identify the level of pain you are experiencing, you will find out if you are in the green, amber or red zone. The best way to move down to the green zone is by pacing and spacing your activity.

When you are completing your rehabilitation exercises it is often best to work within the green (and sometimes amber zones depending on what you deem is an acceptable level of pain) both during the exercises and within 48 hours of completing your exercises. If you find yourself in the red zone you are likely pushing yourself too hard and may flare up the pain.

Pacing and Spacing

Pacing and spacing methods can help you manage your pain better.

Pacing is the term used for breaking down an activity or task. This can be done by taking regular breaks. Prioritising daily activities can also help. This can prevent “over stimulating” your pain system.

When completing challenging tasks or activities, it may be useful to set a “baseline”. This is the amount you can manage on a good or bad day without increasing your symptoms. Therefore, you can plan rests and set achievable goals.

Lifestyle Adaptations

With any ongoing conditions, you may need to make some changes to your regular activities to make life easier. Here are some suggestions:

Washing and Dressing

Non-slip bat mats, rails, bath boards or seats may make getting washed easier. If you struggle to get on and off the toilet a raised toilet seat or grab rail may be of use. Consider the layout of your toiletries and avoid having to stretch to reach items.

When drying hair you could try supporting your arm on a table if you are bothered with overhead activity and struggle to hold the weight of the hairdryer.

Getting dressed is easier in a seated position. There are various tools on the market that may help with dressing for example a long-handled shoehorn.

Sleep and Posture

If you have one side that is painful try to avoid sleeping on the affected side especially with neck, shoulder or hip pain. You might find it helpful to use extra pillows to support your arms or legs.

If sitting try not to spend too long in one position. We recommend moving every 20 minutes. Consider the height of your chair and sit in a higher chair if you struggle to get up from sitting. Armchairs may be better than a sofa as you will have arm support.

Housework and Garden

Try not to attempt too many tasks in one day.  Avoid spending too long doing repetitive activities such as cleaning windows and hoovering. You could try sitting down to iron.  

In the garden try to vary the jobs so you don’t spend too long in one position.    

Shopping and Driving

If appropriate to you take a trolley rather than a basket even if you are only needing a few items as this will give you more support and avoid you having to carry heavy objects.

Try to break up longer journeys, get out and stretch your legs regularly.  

Please see the below links for further information.

When To Speak To A Health Professional  

If your symptoms continue to persist or get worse after considering this advice, it may be appropriate to speak to your GP or Physiotherapist for further advice and management on your condition.

 

 

Help And Support

If after following the above advice, your symptoms have not improved within 6 to 12 weeks, a referral to a physiotherapist may be beneficial.

You can access physiotherapy by any of the following:

Additional information

Acute Injury Management

POLICE is an acronym (Protection, Optimal Loading, Ice, Compression and Elevation) that is used as a management strategy for many injuries and conditions for the first 24 to 72 hours.

  • Protection and relative rest are advised immediately after injury for the first 24 to 72 hours.
  • Optimal Loading refers to having a balanced rehabilitation program which encourages early and gradual activity to improve recovery. How you progress will vary from person to person depending on the injury. It is about finding the injured areas happy place and increasing slowly and gradually.
  • Ice may be used for reducing pain and swelling. There are safety points to follow when you use ice:
    • Don't ice over a numb area or open wound. If the skin is numb you won't notice if you're developing an ice burn and ice on an open wound can increase the risk of infection.
    • Be wary of ice burns – don't apply ice directly to the skin, wrap an ice pack in a clean, damp tea towel before applying. Avoid prolonged exposure to ice, 10-20 minutes is usually adequate.
    • Apply crushed ice/frozen peas wrapped in a damp towel for 10-20 minutes, 2-3 times per day for the first 5-7 days post injury/ flare up of pain.
    • Stop applying ice if there are any negative effects such as increase in pain or swelling or skin soreness.
  • Compression and Elevation are helpful for reducing inflammation. This can be done by keeping your joint raised on a pillow and compressed by wrapping a bandage around it.
    Do not make the bandage too tight and do not wear tubi-grip or any compression bandage in bed at night.
  • Heat: After 2-3 days, you may find that heat is more relaxing.

You could use a heat pad or a hot water bottle with an insulated cover on it. Make sure this is not too hot and is not directly touching your skin.

You should do this for 10 to 15 minutes, 3 to 4 times a day.

What do I do if my symptoms flare up?

Flare ups of pain are common. Some people have recurrent flare ups of pain so it is important to know how best to manage these flare ups. In most cases a pain flare-up will settle within 6 weeks.

Top Tips

  • You will likely find it helpful to rest a bit more but it is still important to keep active. This will help to avoid becoming stiff and your muscles becoming weak.
  • If you aim to get a balance between rest and activity it should help your pain to settle down. You may be sore at first, however, start slowly and gradually increase the amount you do.
  • Reduce movements or tasks that aggravate your symptoms. This can help especially in the early days.
  • Adopting positions or movements that reduce your pain can be useful.

Pain Relief

Analgesia

  • Analgesia also known as pain relief can be an important part in helping you manage your symptoms and allow you to stay active.
  • Taking suitable pain relief regularly allows you to move more normally and continue your usual activities without causing any damage. It is unlikely that medication alone will resolve your pain totally. For this reason we are using the term pain relief (A 30-50% reduction in pain would be deemed to be a good success).

Paracetamol

  • Paracetamol is a good general pain management medication. It is used to help manage lots of different types of pain.
  • Sometimes people believe they need something ‘stronger’ than paracetamol when in fact, taking a regular dose rather than a one-off dose is more effective.
  • Spreading the doses of the paracetamol evenly out over a day will help you control your pain. Visit NHS Inform for more detailed information on paracetamol.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

  • NSAIDs are medications that can reduce swelling around joints and nerve endings to give pain relief. They are particularly useful
    in treating inflammatory type pain. Two commonly prescribed NSAIDs are ibuprofen and naproxen.
  • Although NSAIDs can be very useful they are not suitable for everyone. Visit NHS inform for further information related to NSAIDs.

There are other forms of pain relievers available. If you feel your current pain relievers are not helping your pain or you are
experiencing any side effects from your medication, please seek advice from your GP or pharmacist.

For general information on medication visit NHS Inform.

Staying in work and returning to work

We know that staying in work or returning to work as soon as possible is good for your mental and physical health.

If you have problems with activities at work, it may be helpful to ask for a workstation/workplace assessment or talk with your manager or Occupational Health Department. This can help with alterations or provision of equipment or altering your working day or tasks.

There are organisations which can support you at work or help you return to work. You can visit Knowledge Scotland for further information.

Weight Management

Weight Reduction – People who are overweight tend to have more prolonged pain and poorer tissue healing due to increased levels of inflammation in the body. Reducing your weight can generally help improve the healing process.

A good indicator of whether you need to lose weight is your body mass index (BMI), which you can calculate with the NHS BMI calculator.

If your BMI states you are overweight or obese it is likely that losing weight will reduce your symptoms. Carrying extra fat also increases your risk of heart disease, stroke, type 2 diabetes, and some cancers. Reducing your portion sizes and eating a balanced diet can be helpful in reducing weight. NHS informs provides a free online 12-week weight management programme to get you started right away.

If you need a little more help and feel that you would benefit from working with others in group sessions NHS Lanarkshire’s Weigh to Go programme, groups in North and South Lanarkshire, will help you become more active, eat well and lead a healthier lifestyle.

Smoking

Smoking can affect how your body recovers from musculoskeletal problems. If you smoke then the good news is that by stopping smoking it can improve your health in many different ways. Giving up smoking is not something you have to do on your own. You’re twice as likely to stop smoking successfully if you get the right support from the NHS. There is a free NHS stop smoking service available in Lanarkshire to help you succeed.

Chronic Pain

Some people will have pain which persists beyond the expected time frame for their condition. For further information on this and how best to manage it please visit our Chronic Pain webpage.

Pain Association Scotland is a national charity that delivers professionally led self-management pain education in the community.

Active Health Programme

South Lanarkshire

Active Health is a programme for residents of South Lanarkshire living with long term conditions. Residents are referred via Acute, Physio & specialist nurses to a 10-week programme and then signposted onto a wide variety of mainstream physical activity, sport & outdoor opportunities.

South Lanarkshire Leisure and Culture have many active community opportunities as well as specialised referral programmes. Full details of the 20 leisure centres can be found on the SLL website. Contact details across South Lanarkshire or call 01698 476262 to find out the number of your local leisure centre.

Please contact your health professional to discuss this referral or contact SLLC on 01698 476262.

Contact details

North Lanarkshire

North Lanarkshire Leisure’s Active Health Programme in partnership with NHS Lanarkshire provides a range of supported programmes to help individuals realise the benefits of becoming more physically active whilst also assisting those who are recovering from minor or even more serious illness.

The Active Health Programme has both a General Programme where individuals can access the mainstream health and fitness programmes running within NL Leisure Venues including swimming, jogging, golf and more!

A Specialised Health Class Programme which requires a referral from a health professional, this option is available to individuals who require additional specialised support in taking part in physical activity and classes include Strength and Balance, Cardio I, Cardio II, Back Care and Macmillan Move More classes.

A health and social care professional can make a referral by using the Active Health referral form found at the bottom of the page in the link below.

Contact Details - Health & Wellbeing Information

Mental Wellbeing

It is very important to look after your own mental wellbeing. This can have an influence on your recovery or management of your Musculoskeletal problem. Visit our mental wellbeing page for more information.

Your Feedback – comments, concerns and complaints

NHS Lanarkshire is committed to improving the service it provides to patients and their families. We therefore want to hear from you about your experience. If you would like to tell us about this please visit our feedback page.

Near Me Lanarkshire