The hip is a ball and socket joint. The surfaces of the bones are covered in a smooth cartilage to allow them to slide over each other. This cartilage can become damaged for many reasons including impingement, inflammatory arthritis, trauma or tumours, but the most common is simple wear and tear, otherwise known as arthritis.
As the cartilage wears out, the joint becomes inflamed which leads to further damage and pain. Hip arthritis pain is commonly felt in the groin, but it can be felt in the knee, or even in the other hip joint.
Eventually the cartilage will wear away to such an extent that the head of the femur (thigh bone) will rub directly on the bone of the acetabulum (socket). This will erode the bones, making the hip feel stiff and often painful, although patients whose hip joints look very eroded on their x-rays, can feel little or no pain.
Initially, non-surgical measures are taken. These may include pain killers or glucosamine. Glucosamine Sulfate is available from health food shops, supermarkets and over the internet. It provides nutrition for the remaining cartilage, and has a little anti-inflammatory action. 1000mg – 1500mg should be taken regularly for 2 weeks to see if it has an effect.
Some patients find cushioned footwear can be of great benefit. Losing weight can reduce stress on the hip joint, can help with the pain, and may reduce the rate of damage to the joint.
Some patients find that physiotherapy can help strengthen core muscles and improve co-ordination to control the hip socket and reduce pain.
If these fail to reduce the pain then the patient might then consider a hip replacement.
The main form of physiotherapy exercises will involve quadriceps, gluteal and hamstring strengthening. Most patients recover well and occasionally the use of hydrotherapy to help move the stiffer joints is helpful.