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Hip
Pain
Common
sources of hip pain that rarely require surgery:
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Trochanteric Bursitis - Throughout the body,
small sacs, sometimes filled with a little fluid, called bursae
act as cushions between bones, tendons and muscles. Several bursae
are located around the outer area of the hip near the portion of
the thighbone (femur) called the greater trochanter. The greater
trochanter is a broad, flat area of bone that anchors several
large muscles. An inflammation of one of the trochanteric bursa is
a common cause of hip pain.
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Labral Tear -The labrum is the cartilage that
lines the socket (acetabulum) in which the ball of the hipbone
(femur) sits. This cartilage provides cushioning for the joint. It
also helps keep the ball in the socket. A tear in the labral
cartilage can result from injury or degeneration, such as from
osteoarthritis.
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Iliopsoas Bursitis - The iliopsoas bursa is a
saclike cavity between the iliopsoas tendon and the lesser
trochanter of the femur. This bursa is the largest and most
important bursa about the hip. Iliopsoas bursitis, or an
irritation and inflammation of the iliopsoas bursa, occurs
primarily in gymnasts, dancers and track athletes and is caused by
repetitive hip flexion.
If
conservative treatment, such as lifestyle and activity modification,
physical therapy and/or medications, such as non-steroidal
anti-inflammatory drugs (NSAIDs) or nutritional supplements, (Chondroitin/Glucosamine)
to reduce pain and inflammation does not provide relieve from these
common sources of hip pain, your physician may recommend an injection
of a corticosteroid preparation, which is usually successful in
relieving symptoms. Surgery is rarely required.
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The most common cause of chronic hip pain and disability
is arthritis.
Arthritis of the hip is a disease which wears away the cartilage
between the femoral head and the acetabulum, the two bones will
scrape against each other, raw bone on raw bone. When this
happens, the joint becomes pitted, eroded and uneven.
The result is pain, stiffness and instability. In some cases,
motion of the leg may be greatly restricted. |
Osteoarthritis
Osteoarthritis, which is the most
common form of arthritis in the US; is degenerative and, although it
most often occurs in patients over the age of 50, it can occur at any
age, especially if the joint is in some way damaged.
Osteoarthritis is usually confined to the large weight-bearing joints
of the lower extremities, including the hips and knees, but may affect
the spine and upper extremity joints, too. Patients with
osteoarthritis often develop large bone spurts, or osteophytes, around
the joint, further limiting motion.
Osteoarthritis of the hip is a condition commonly referred to as "wear
and tear" arthritis. Although the degenerative process may accelerate
in persons with a previous hip injury, many cases of osteoarthritis
occur when the hip simply wears out. Some experts believe there may be
a genetic predisposition in people who develop osteoarthritis of the
hip. Abnormalities of the hip due to previous fractures or childhood
disorders may also lead to a degenerative hip. Osteoarthritis of the
hip is the most common cause for total hip replacement surgery.
Symptoms
The first and most common symptom
of osteoarthritis is pain in the hip or groin area during weight
bearing activities such as walking. People with hip pain usually
compensate by limping, or reducing the force on the arthritic hip. As
a result of the cartilage degeneration, the hip loses its flexibility
and strength, and may result in the formation of bone spurs. As the
condition worsens, the pain may be present all the time, even during
non weight-bearing activities.
Treatment
Before considering total hip replacement surgery, your doctor
and you may try various non-surgical therapies. An appropriate weight
reduction program may be beneficial in decreasing force across the hip
joint. However, weight reduction can be difficult for people with hip
arthritis since the arthritis pain precludes them from increasing
their activity and burning calories.
An exercise program may be instituted to
improve the strength and flexibility of the hip and the other lower
extremity joints. Lifestyle and activity modification may be
undertaken in an attempt to minimize the activities that are
associated with hip pain.
Finally, various medications such as
non-steroidal anti-inflammatory drugs (NSAIDs) and/or nutritional
supplements (Chondroitin/Glucosamine) to reduce pain and inflammation
associated with the disease may be considered.
Assistive devices like a cane or a crutch
can help to reduce the force transmitted through the hip joint during
walking and thereby may help to decrease hip arthritis pain. If
non-surgical treatment is unsuccessful, you and your surgeon may
decide that a total hip replacement is the best available treatment
option.
Rheumatoid
Arthritis
Unlike
osteoarthritis which is a "wear and tear" phenomenon, rheumatoid
arthritis is a chronic inflammatory disease that results in joint
pain, stiffness and swelling. The disease process leads to severe, and
at times rapid, deterioration of multiple joints, resulting in severe
pain and loss of function.
Causes
Although the exact cause of rheumatoid arthritis is unknown, some
experts believe that a virus or bacteria may trigger the disease in
people having a genetic predisposition to rheumatoid arthritis. Many
doctors think rheumatoid arthritis is an autoimmune disease in which
the synovial tissue of the joint is attacked by one’s own immune
system. The onset of rheumatoid arthritis occurs most frequently in
middle age and is more common among women.
Symptoms
The primary symptoms of rheumatoid arthritis are similar to
osteoarthritis and include pain, swelling and the loss of motion. In
addition, other symptoms may include loss of appetite, fever, energy
loss, anemia, and rheumatoid nodules (lumps of tissue under the skin).
People suffering with rheumatoid arthritis commonly have periods of
exacerbation or "flare ups" where multiple joints may be painful and
stiff.
Treatment
Treatment of rheumatoid arthritis may involve medications such as
NSAIDs, aspirin and analgesics. Corticosteroids, such as prednisone
may be prescribed, and are effective in decreasing the inflammation
associated with rheumatoid arthritis. Side effects can occur with the
use of corticosteroids, and close monitoring by a physician is
essential.
Researchers have made
progress in the treatment of rheumatoid arthritis and newer
prescription drugs are now available. If non-surgical measures fail,
you and your surgeon may decide that total hip replacement is the best
treatment option to relieve your pain and help you return to an
improved functional level.
Click here for information
on treatment options for hip arthritis
Link to the
American Academy of Orthopaedic Surgeons |
