Have hip pain? Review your options

The hip is the largest joint in the body and, when working properly, it’s a thing of wonder — able to support forces equal to three times a person’s body weight and to allow the leg to swing backward and forward, to flex and twist, to bend and to pivot. As a ball and socket joint, the hip provides flexibility, power and the ability to propel us from a sitting position, to stand, walk, run and climb stairs.

When there’s a problem with the hip, however, the everyday movements of life become difficult and painful.

“The hip relies on a smooth layer of cartilage to cushion the joint, allowing the ball to glide smoothly within the socket,” said Adam Goodyear, an orthopedic surgeon with OrthoKansas. “Aging, activity, and trauma as well as genetic components can cause the layer of cartilage to break down. As this happens the bones that make up the hip joint come in contact with one another leading to pain and loss of function.”

While cartilage deterioration is not the only cause of hip pain, it is the most common. Other issues related to muscle, soft tissue or nerve problems can also cause discomfort in the hip.

Hip problems typically show up first as stiffness and soreness, and not just in the hip itself. Often pain is felt in the back, groin, buttocks, or even the knee. Catching, popping or locking of the joint are also frequent symptoms of a problem.

There are a number of conservative, nonsurgical treatments to relieve pain, improve mobility and prolong the time before replacement surgery may be required.

• Heat applied to a stiff, painful joint can improve circulation and ease soreness. A warm bath, heating pad (with a cloth buffer to protect skin), or even a moist, warm towel are simple, but effective. Ice is also a great way to decrease inflammation around the joint.

Lawrence Memorial Hospital is a major sponsor of WellCommons.

• Gentle stretching and moderate exercise are important to improve circulation in the joint and to maintain strength in the muscles that support the hips and legs. Yoga, tai chi, walking, bike riding, and swimming are all good low-impact exercise options.

• Physical therapy options also can help to alleviate pain and improve strength and flexibility.

• Weight loss can reduce the stress on the affected hip, relieve pain and improve mobility. Studies have shown that even a loss of 10-15 pounds can have a positive effect.

• Anti-inflammatory medications, both over-the-counter or by prescription, can control pain and reduce inflammation. However, side effects like stomach pain, constipation, liver damage, increased risk of stroke or heart attack, or even suppression of the immune system, require careful review of benefits and risks by patient and physician.

When conservative options fail and your quality of life is compromised, you and your doctor might discuss surgical options such as total hip replacement.

“In total hip replacement surgery, we remove the entire top of the femur, any cartilage, and replace everything with prosthetic components,” said Goodyear. “Surgical options have their advantages and disadvantages; a surgeon will sit down with you and carefully review all the options and discuss which option is best for you, your health, and your lifestyle.”

Goodyear explained that successful recovery also includes extensive physical therapy, which can begin almost immediately after surgery, and will continue even after you have returned home.

Lawrence Memorial Hospital offers a Total Joint Program to provide comprehensive care for patients undergoing total hip replacement. To learn more or to view a list of orthopedic surgeons who choose LMH, visit www.lmh.org/orthopedics.

— Amy Northrop is physician liaison manager at Lawrence Memorial Hospital, a major sponsor of WellCommons. Email at amy.northrop@lmh.org.