Hip Osteoarthritis

Hip osteoarthritis typically affects those >50 years old as it is associated with the cartilage wearing down. X-rays will show bony spurs, osteophytes and a loss of joint space. Pain typically comes with weight bearing activities and bending motions such as squatting to a toilet seat/low chair and putting socks and shoes on. Pain is typically described in a C-shape at the front of the hip/groin and the patient will have decreased ROM, pain with palpation and oftentimes an antalgic gait or a compensatory Trendelenburg gait due to weakness or to offload the hip. Conservative care may delay the need for a hip replacement, but don't wait until you have a decline in quality of life as the surgery and rehab is very successful.

Weight loss, the use of a cane, NSAIDs and cortisone injections are simple ways to reduce inflammation and decrease pain with activities. Physical therapy should focus on manual therapy with stretching and especially joint mobilizations to improve the mobility of the joint capsule itself. This should be followed by self-stretching and self-mobilizations with bands or belts. Strengthening of the hip muscles and quadriceps are very important to provide stability to the lower extremities and improve function with daily activities. Balance is typically addressed as OA typically comes along with older age and falls risk reduction is beneficial in those who need it.