Hip Osteoarthritis (Coxarthrosis)

Synonym for hip osteoarthritis

• Coxarthrosis

What is hip osteoarthritis?

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

It is often said that osteoarthritis is wear and tear on the cartilage between our bones. This is true, but it is more than that. Cartilage acts as a cushion between bone surfaces. It allows your joints to slide smoothly and move fluidly.

With the development of osteoarthritis, the cartilage becomes thinner. However, all the structures that form the hip joint can be affected. Changes can be observed in the cartilage, bone, ligaments, capsule, synovial membrane, and muscles.

What are the symptoms of hip osteoarthritis?

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

It is important to understand that osteoarthritis does not always cause symptoms. This may seem surprising, but it is true.

When osteoarthritis becomes symptomatic, here is what you may 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
• Crackling or popping sounds when moving
• The pain can sometimes radiate to the buttock, thigh, or knee.

What are the risk factors for hip osteoarthritis?

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

From the age of 45-50 onwards, most people have osteoarthritis of the hip. However, osteoarthritis does not develop overnight. It is a process that takes place over several years.

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

• A previous hip injury (fracture, sprain, surgery)
• Being a woman (women are at greater risk than men)
• Obesity
• Physical inactivity
• Practicing a high-impact sport for several years
• Certain inflammatory diseases such as rheumatoid arthritis

How is hip osteoarthritis diagnosed?

The diagnosis of hip osteoarthritis is mainly based on your symptoms and a physical examination. An X-ray can confirm the signs of osteoarthritis, but is not always necessary.

Your physical therapist or doctor can diagnose hip osteoarthritis by asking you questions about your symptoms and examining your hip. Tests of movement, strength, and flexibility provide valuable information.

An X-ray of the hip can reveal signs of osteoarthritis such as narrowing of the joint space or osteophytes (small bony growths). However, it is important to note that what is seen on an X-ray does not always correspond to your symptoms. Some people have a lot of visible osteoarthritis but little pain, and vice versa.

When should you seek physical therapy for hip osteoarthritis?

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

You do not need to see a doctor before consulting a physical therapist. If your condition requires medical attention, your physical therapist will be able to advise you and refer you to a doctor.

Consult quickly if:

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

What are the physical therapy treatments for hip osteoarthritis?

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

Your physical therapist will first conduct a comprehensive 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

• Mobilize your hip to reduce pain and improve movement
• Provide you with specific exercises to improve control of your hip movements
• Prescribe exercises to restore mobility, reduce pain, and regain muscle strength.
• Teaching you how to balance your daily activities and leisure time
• Giving you advice on your posture and everyday movements

What can you do at home for hip osteoarthritis?

The best thing to do is to stay active. Movement is the best remedy for osteoarthritis symptoms. Start slowly and gradually increase according to your tolerance.

If you are sedentary, start by taking regular walks and doing mobility exercises for your hips and legs. Respect your pain 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 afterwards.
• Limit the amount of time you spend in the same position. Get up at least once an hour to move around for a few minutes.
• Get some exercise every day based on your tolerance level.
• Apply heat to your hip before activity to reduce stiffness.
• Use ice after activity if you have inflammation.

How can hip osteoarthritis be prevented?

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 up as often as possible (light activity counts too)
• Do strength training with exercises that include the 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 physical therapists, 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.