Hip osteoarthritis (coxarthrosis)

Synonym for hip osteoarthritis

• Coxarthrosis

What is hip osteoarthritis?

Hip osteoarthritis is a gradual wearing down of the joint. This condition affects the cartilage, but also the bone, ligaments, joint capsule, and muscles around the hip. It is a normal process that develops over time.

Osteoarthritis is often described as the wearing down of cartilage between our bones. While this is true, it's more complex than that. Cartilage acts like a cushion between bone surfaces, allowing your joints to glide smoothly and move freely.

As osteoarthritis develops, the cartilage becomes thinner. However, all the structures that make up the hip joint can be affected. Changes can be observed in the cartilage, bone, ligaments, joint capsule, synovial membrane, and muscles.

What are the symptoms of hip osteoarthritis?

Symptoms of hip osteoarthritis include progressive groin pain, morning stiffness, and reduced mobility. Many people live with osteoarthritis without experiencing any pain.

It's important to understand that osteoarthritis doesn't always cause symptoms. This might seem surprising, but it's true.

When osteoarthritis does cause symptoms, here's what you might experience:

• Pain in the groin area that develops gradually
• Hip stiffness, often worse in the morning or after a period of inactivity
• Morning stiffness usually improves within 30 minutes with movement
• Decreased hip flexibility
• Creaking or cracking sounds with movement
• Pain can sometimes spread to the buttock, thigh, or knee

What are the risk factors for hip osteoarthritis?

Aging is the main factor causing osteoarthritis, regardless of the joint in the body. Other factors can increase your chances of developing this condition more quickly.

From ages 45-50, most people have hip osteoarthritis. However, osteoarthritis doesn't develop overnight; it's a process that occurs over several years.

Here are the risk factors that increase the chances of developing hip osteoarthritis more quickly or severely:

• A previous hip injury (fracture, sprain, surgery)
• Being female (women are at higher risk than men)
• Obesity
• Physical inactivity
• Participating in high-impact sports for several years
• Certain inflammatory diseases like rheumatoid arthritis

How is hip osteoarthritis diagnosed?

Hip osteoarthritis is mainly diagnosed through your symptom history and a physical examination. An X-ray can confirm signs of osteoarthritis but isn't always necessary.

Your physiotherapist or doctor can diagnose hip osteoarthritis by asking about your symptoms and examining your hip. Movement, strength, and flexibility tests provide valuable information.

A hip X-ray can show signs of osteoarthritis, such as narrowing of the joint space or osteophytes (small bone growths). However, it's important to know that what's visible on an X-ray doesn't always match your symptoms. Some people have significant visible osteoarthritis but little pain, and vice versa.

When should you consult a physiotherapist for hip osteoarthritis?

You should consult a physiotherapist if you experience the symptoms described above or if your doctor has already ruled out other possible causes for your pain.

You do not need to see a doctor before consulting a physiotherapist. If your condition requires seeing a doctor, your physiotherapist will be able to inform you and provide a referral.

Consult quickly if:

• Pain limits your daily activities
• Stiffness lasts more than 30 minutes in the morning
• You have difficulty walking or climbing stairs
• Pain wakes you up at night

What are the physiotherapy treatments for hip osteoarthritis?

The best treatment for osteoarthritis symptoms is movement and tailored exercise. Your physiotherapist will create a personalized program based on your needs and goals.

Your physiotherapist will first conduct a complete assessment to determine why your osteoarthritis is causing you pain. This assessment includes:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your muscle strength and stability

• Mobilizing your hip to reduce pain and improve movement
• Providing you with specific exercises to improve control over your hip movements
• Prescribing exercises to regain mobility, reduce pain, and restore your muscle strength
• Teaching you how to properly manage your daily activities and hobbies
• Giving you advice on your posture and daily movements

What to do at home for hip osteoarthritis?

The best thing to do is stay active. Movement is the best remedy for osteoarthritis symptoms. Start gently and gradually increase as tolerated.

If you are sedentary, start by taking regular walks and doing mobility exercises for your hips and legs. Listen to your body and increase gradually. If you are already active, continue with activities that do not cause too much pain.

• Temporarily stop movements that cause too much pain and gradually resume them later
• Limit the time spent in the same position. Get up at least every hour to move around for a few minutes
• Engage in physical activity every day according to your tolerance level
• Apply heat to your hip before activity to reduce stiffness
• Use ice after activity if you have inflammation

How to prevent hip osteoarthritis?

You can reduce your risk of developing osteoarthritis or experiencing symptoms by adopting an active lifestyle. Regular exercise is the most important factor for joint health.

Here are the Canadian recommendations for physical activity:

• 150 minutes per week of moderate to vigorous cardiovascular activity
• Stand as often as possible (light activity also counts)
• Do strength training exercises that include major muscle groups twice a week
• Limit sitting time to 8 hours per day

• Maintain a healthy weight (this varies from person to person)
• Avoid accumulating multiple joint injuries
• Adopt healthy eating habits

To learn more

You can listen to the podcast created by one of our physiotherapists, Alexis Gougeon. Episode #15 specifically discusses osteoarthritis.

Find the episode on YouTube.

Sources

• Lespasio MJ, Sultan AA, Piuzzi NS, Khlopas A, Husni ME, Muschler GF, Mont MA. Hip osteoarthritis: a primer. The Permanente Journal. 2018;22.

• Canadian Society for Exercise Physiology. Canadian 24-Hour Movement Guidelines for Adults ages 18-64 years. 2021.