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Osteoarthritis of the joints What makes OA so special? We can help
 
ARTHRITIS INFO
NO. 13
 
 
 
 
 
 
 
 






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Practical Tips for Osteoarthritis of the Hip

The following tips for patients with osteoarthritis of the hip joint supplement the 12 suggestions in ARTHRITIS INFO No. 3, which described important basic principles, and which we would like to recommend once again.
On the following pages, we describe the most common types of osteoarthritis of the hip, explain the most prevalent symptoms, and also give some useful tips for effective treatment.


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1. Type 1: Congenital Deformation of the Hip Joint
 

If the hip joint socket is improperly formed at birth and not deep enough, it cannot contain the femoral head and give it the stability it requires. Often, the femoral neck may also be angled too steeply, further contributing to the malformation of the hip
joint. Thus, all of the weight that the hips bear when walking will be concentrated in a small area at the edge of the socket. This constant
pressure soon overburdens the cartilage in that region, resulting in osteoarthritis at an early age. (Regarding corrective operations: please refer to Tip No. 6.)
 

 




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2. Type 2: Prior Disease of the Hip Joint
 

The second type of osteoarthritis is the result of a prior, sometimes long-forgotten disease of the hip. Such diseases of the hip, which may lead to substantial permanent deformities within the joint, occur most frequently in children between the ages of 5 and 15.
In adults, they may be caused by prolonged treatment with high doses of cortisone, excessive alcohol consumption, or severe fractures. The resulting deformation of the femoral head leads to increased strain and a deterioration of the joint cartilage, and finally to osteoarthritis.
 

 




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3. Type 3: “Primary” Osteoarthritis of the Hip
 

Types 1 and 2 used to be the most common forms of hip osteoarthritis, but that has changed. More and more often, osteoarthritis is diagnosed in joints that have not suffered any major damage or deformity. Doctors call this third form “primary” osteoarthritis of the hip. It used to occur mostly among people who have physically demanding jobs such as farming, but it is now seen more frequently in many other professions as well. Slight deformities leading to increased pressure in the hip joint (impingement) are also assumed to be a contributing factor.

 




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4. Typical Patterns of Pain
 

Osteoarthritis of the hip joint can cause very different patterns of pain.The following patterns are the most common:

(1) Pain radiating into the groin area,
(2) Pain in the thigh or knee joint (even though the knee is healthy),
(3) Pain in the buttocks (which often feels similar to some types of sciatic pain).

These different kinds of pain explain why patients with the same diagnosis, “osteoarthritis of the hip,” may have very different symptoms.

 




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5. External Changes Accompanying OA of the Hip
 

In advanced cases of hip osteoarthritis (OA), the following changes may become evident:

(1) The affected hip cannot be bent backwards as far as usual (your doctor calls this “limited hip extension”).
(2) It is more difficult to spread the leg sideways (“reduced hip abduction”).

The further these changes progress, the more they limit normal walking and other daily activities. In addition, other joints, such as the knee and the spine, are then put under additional strain and may start to hurt as well.

 




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6. Osteotomy?
 

A surgical procedure aimed at correcting the position of the hip joint at an early stage is usually referred to as an “osteotomy.” This operation adjusts and corrects the position of the joint socket, and sometimes that of the femoral head as well. This is a very invasive procedure, and it is primarily performed by highly specialized surgeons. Overall, this corrective surgery is performed far less frequently today than in the past, and is more often performed on younger patients.

 




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7. Stretching, Strengthening and Careful Mobilization
 

Good and regular physical therapy is of great value in the treatment of early hip osteoarthritis. The physical exercises have three goals:

(1) To stretch the muscles around the hip,
(2) To strengthen certain muscles, and
(3) To increase the reduced range of motion.

These goals can only be reached with focused and careful training.
Please note: The increased muscle strength should only provide a reserve, and not tempt you to overburden the arthritic hip joint.

 




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8. Electrotherapy, Massages, and Hydrotherapy
 

In addition to physical exercises, there are a variety of other treatments that can reduce pain. Microwaves, interference currents, diadynamic currents, and other forms of electrotherapy may bring relief in many cases, if your doctor recommends them. Massages may assist in loosening tense muscles. Hydrotherapy at temperatures between 82°F and 90°F can also be helpful as long as there is no acute inflammation in the joint.
A bath in your tub at home with a handful of table salt added to the water may relieve pain as well.

 




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9. “Buffer” Heels and Heel Inserts
 

“Buffer” heels may provide useful cushioning for the affected hip joint, if your doctor approves them.
In Europe, some orthopaedic shoe specialists substitute a soft layer of rubber, approximately one-third of an inch thick, for part of the heel, without changing the overall height of the shoe. This may help reduce the pain you experience when walking.
As an alternative, you may use soft, thick-soled athletic shoes or try flexible, removable heel inserts or cushions in your shoes, which have a similar effect and are available at pharmacies and medical supply stores.

 




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10. Correct Sitting Posture
 

Choosing the right position when sitting can also relieve your hip joint. Here are a few useful tips:

1. When sitting on a chair, shift your weight to your healthy side. It may also help to put a small cushion under your healthy (!) side.
2. Don’t bend the knee on the affected side. Instead, stretch your leg out in a relaxed manner.

In severe cases, it may be worthwhile to look for a chair with a seat that is split in the front, so that the inclination of the seat on the arthritic side can easily be adjusted (not yet available in the U.S.).

 




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11. When Pain is Acute
 

When you feel acute pain in your hip, always see your doctor without delay. Your doctor’s medical treatment can often be assisted by:

(1) keeping the weight off your hip by using crutches or a walking stick for a few days,
(2) applying cold, and
(3) keeping the leg elevated.

These measures are always best discussed in detail with your doctor. Also, for a quicker recovery, your doctor may give you shots or advise you to take medication for a few days, as long as you respond well to it. Some doctors are also trying acupuncture to treat acute hip pain.

 




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12. Sports
 

In addition to our sports tips in ARTHRITIS INFO No. 3, the following suggestions may be helpful:

1) For shopping, taking walks or hiking, wearing jogging shoes may be beneficial. Their broad, padded, springy heels have a similar effect to the “buffer” heels mentioned above.
2) A stationary bike can be a useful part of a safe and effective exercise routine. It allows you to exercise without worrying about traffic, bad weather, or the time of day. Always choose a lower resistance setting when exercising.
 

 




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