By Emsie Martin
Being mobile is actually a great privilege, although most of us take it for granted. But when movement becomes strained and difficult, one sees the problem from another angle. Many people immediately think of a hip replacement, but this is not your first option and the discomfort could have many reasons. Here are a few:
Arthritis of the hip
Arthritis of the hip is a disease where the cartilage between the femur head and the acetabulum degenerates and causes the two bones to rub against each other – bone on bone. When this happens the joint becomes rough, degenerated and uneven. The result is pain, stiffness and instability. In some cases leg movement becomes severely restricted.
Osteoarthritis, which is the most common form of arthritis, is a degenerative condition.
Although it occurs mostly in patients over the age of 50, it can appear at any age, especially if the hip has been damaged in some way or other. Osteoarthritis is usually limited to the big weight-bearing joints in the lower part of the body, including the hips and knees, but it could also affect the spine and joints of the torso. Patients who have osteoarthritis sometimes develop large bone splinters, or osteophytes, that restrict movement even more.
Osteoarthritis is generally referred to as “wear-and-tear” arthritis. Although degeneration can accelerate in people with previous hip injuries, many cases of osteoarthritis occur where the hip simply becomes worn or degenerates. Osteoarthritis of the hip is the most common reason for a hip replacement.
The first and most common symptom of osteoarthritis is pain in the hip or groin area during activities such as walking. People with pain in the hip usually compensate by walking with a limp or decreasing the weight on the arthritic hip. Eventually, as the condition becomes worse, the pain is always present, even during non-weight-bearing activities.
Before you look at a hip replacement, you and your doctor can try out several non-surgical options. A suitable weight-loss programme could help to reduce the tension on the hip joints. However, weight loss could be difficult for patients with arthritis of the hip as the arthritic pain prevents them from increasing their levels of activity to burn away calories. An exercise plan aimed at improving the strength and mobility of the hip can be followed.
In contrast to the “wear-and-tear” phenomenon in osteoarthritis, chronic rheumatoid arthritis is an inflammatory disease that causes joint pain, stiffness and swelling. The disease leads to severe and sometimes fast degeneration of multiple joints, which causes severe pain and loss of function.
Although the precise cause of rheumatoid arthritis is unknown, some experts believe that a virus or bacterium can stimulate the disease in people with a genetic inclination towards rheumatoid arthritis. Rheumatoid arthritis usually occurs in middle-aged people and is more common among women.
The primary symptoms of rheumatoid arthritis are similar to those of osteoarthritis and include pain, swelling and loss of mobility. Other symptoms may include loss of appetite, fever, listlessness, anaemia and rheumatoid nodules (tissue nodules under the skin). People who suffer from rheumatoid arthritis usually experience periods of exacerbation when multiple joints can be painful and stiff.
The treatment of rheumatoid arthritis may include medication that is effective in relieving inflammation. Use of these drugs may have side-effects. Continuous monitoring by the doctor is essential.
The first alternative to a hip replacement comprises lifestyle adjustments such as weight loss, the avoidance of activities that require long periods of standing or walking, as well as the use of a walking stick to lessen pressure on the painful hip.
Exercise and physiotherapy
Exercise and physiotherapy may be prescribed to improve the strength and mobility of your hip and the muscles in the lower part of your body.
Arthritic pain is mainly caused by inflammation of the hip joint. Lessening the inflammation of the hip tissue may give temporary relief and postpone the operation.
Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to lessen the inflammation associated with arthritis. However, because of the large number of side-effects of these drugs, a doctor must closely monitor their use.
Two dietary supplements, glucosamine and chondroitin (generally available in a combined tablet) could relieve the symptoms of hip arthritis. Glucosamine and chondroitin sulphates are naturally occurring molecules, and issues associated with both are currently being actively researched. It would appear, however, that people who regularly use these supplements do experience relief of their arthritis symptoms.
If all the above-mentioned options have been exhausted and your orthopaedic surgeon recommends an operation, a hip replacement could be very successful in relieving your pain and improving your mobility.