Ostoarthritis (OA), typically referred to as “wear and tear” arthritis, is the most common form of arthritis.1 It is prevalent in the hip, and structural changes related to osteoarthritis typically occur as we age.2 These structural changes are not always accompanied by symptoms.1
Risk Factors for Hip OA May Include 3,4
- Developmental hip disorders
- Heavy physical work
- Prior injury to the hip
Signs and Symptoms May Include5
- Hip pain
- Loss of hip motion
- Hip stiffness in the morning lasting < 60 minutes
The most common cause of hip pain in older adults is symptomatic hip OA.4 The prevalence of osteoarthrits tends to increase as we age.6 In one large U.S. population study symptomatic hip OA was found in 9.7% of adults older than 45 years.7 Overall, 28% of the study’s 3,068 participants had radiographic hip OA. This suggests only one-third of those with radiographic evidence of hip OA will have symptoms.
Physical Therapy Treatment
A patient may be treated conservatively with physical therapy, medication and injections. 4,6,8
Physical therapy may consist of:
- Patient education 9
- Gait, function, and balance training 4
- Manual Therapy 10
- Flexibility/aerobic and strengthening exercise 4,11
Surgery including hip joint replacement, may also be considered.8 If surgical management has been elected, physical therapy after the procedure tends to be utilized, depending on the type of procedure performed and the surgeon’s philosophy. In general, post-operative physical therapy treatment applies the same therapy principles as those applied prior to surgery.
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1.Lawrence, Reva C., et al. “Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II.” Arthritis & Rheumatism 58.1 (2008): 26-35.
2.Garbedian, Shawn, and Eugene K. Wai. “Systematic review of the prevalence of radiographic primary hip osteoarthritis.” Clinical orthopaedics and related research 467.3 (2009): 623-637.3.Juhakoski, R., et al. “Risk factors for the development of hip osteoarthritis: a population-based prospective study.” Rheumatology 48.1 (2009): 83-87.
4.Cibulka, Michael T., et al. “Hip pain and mobility deficits–hip osteoarthritis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American Physical Therapy Association.” The Journal of orthopaedic and sports physical therapy 39.4 (2009): A1.
5. Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 1991;34(5):505-14.
6.Vogels, E. M. H. M., et al. “Clinical practice guidelines for physical therapy in patients with osteoarthritis of the hip or knee.” Amersfoort: KNGF (2001).
7.Jordan, Joanne M., et al. “Prevalence of hip symptoms and radiographic and symptomatic hip osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project.” The Journal of rheumatology 36.4 (2009): 809-815.
8.Zhang, Weiya, et al. “EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT).”Annals of the Rheumatic Diseases 64.5 (2005): 669-681.
9.Superio‐Cabuslay, Edith, Michael M. Ward, and Kate R. Lorig. “Patient education interventions in osteoarthritis and rheumatoid arthritis: A meta‐analytic comparison with nonsteroidal antiinflammatory drug treatment.”Arthritis & Rheumatism 9.4 (1996): 292-301.
10.Hoeksma, Hugo L., et al. “Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial.” Arthritis Care & Research 51.5 (2004): 722-729.
11.Roddy, Edward, et al. “Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee—the MOVE consensus.” Rheumatology 44.1 (2005): 67-73.