tay.generalcomments@nhs.scot

Hip Joint Pain/ Osteoarthritis

General information 

  • No single specific cause, but there are certain factors increase likelihood of developing OA
    • Increasing age
    • Family history of osteoarthritis
    • Previous injury to the hip joint
    • Obesity
    • Developmental dysplasia of the hip joint
  • Hip OA affects 7%–25% of people older than 55 years.

Symptoms and signs

  • Pain localized to the groin area and the front or side of the thigh.
  • Pain overnight and/or Morning stiffness
  • Limited range of movement of the hip (Medial (internal) rotation, flexion, abduction, extension)
  • Pain during movement or flares up with vigorous activity
  • Pain on weight-bearing/limp
  • Difficulty putting on shoes/socks
  • Locking, grinding and/ or joint instability
  • Beware of knee pain as referred pain can be associated with OA hip

Initial management

  • Analgesics/NSAIDs, Analgesia taken regularly can aid comfort with pain/ reduced ROM
  • Walking aid, Lifestyle modifications as necessary
  • Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling)
  • Ensure pain not referred from lumbar spine pathologies
  • MSK Physiotherapy assessment/treatment
  • Weight management For those who are overweight (body mass index [BMI] ≥25 kg/m2 ) or obese (BMI ≥30 kg/m2 ), a minimum weight loss target of 5–7.5% of body weight is recommended. Weight loss should be combined with exercise for greater benefits. For people of healthy body weight, education about the importance of maintaining healthy body weight is essential. Refer Tayside weight Management Service

Primary Care diagnostics

  • AP pelvis X-Ray beneficial to aid diagnosis

Useful resources

Who to refer

  • Disabling symptoms
  • Gross OA changes on XR
  • Surgical candidates (BMI over 35: consider weight loss strategies). 

How to refer

Information to include:
  • Duration of symptoms and any cause of onset
  • Pain spread and severity (constant/ intermittent/ night pain)
  • Conservative treatment to date
  • Use of walking aid
  • Functional limitation
  • XR findings
  • Restriction of internal rotation
  • BMI