Hip Arthritis

Arthritis (joint inflammation) comes in three broad categories: osteoarthritis, inflammatory arthritis, and septic arthritis.

1. Osteoarthritis is caused by “wear and tear” or by repetitive motion and traumatic injuries.
2. Inflammatory arthritis is caused by a systemic disease, which is usually of the autoimmune type. Rheumatoid arthritis is the most commonly known disease in this category. Other examples are lupus (systemic lupus erythematosis, or SLE), and ankylosing spondylitis (AS).
3. Septic arthritis refers to inflammation of a joint caused by an infectious agent, such as a bacteria. It can often be treated successfully with antibiotics.

Osteoarthritis of the hip occurs when the smooth, slippery surface of the head of the femur, which allows it to rotate easily in the hip joint, is worn away. As the disease progresses, the body tries replace this surface. The result is fingerlike projections that sometimes further interfere with joint motion. Osteoarthritis is often less painful in the morning and gets worse as the day goes on and the involved joint is used.

Inflammatory arthritis of the hip is characterized by a dull aching pain of the buttocks, outer thigh, or groin. The pain is generally worse in the morning, gets better with movement and during the day, but can be aggravated by strenuous exercise.

Osteoarthritis sometimes affects only one joint, while inflammatory arthritis often afflicts both sides. The involvement of many joints—hands, wrists, knees, and hips, also suggests inflammatory arthritis rather than osteoarthritis.

Osteoarthritis is treated by stopping activities and motions that cause repetitive stress or trauma to the hip, physical therapy and non-traumatic exercise (like swimming, walking in the shallow end of a swimming pool, or bicycling), non-steroidal anti-inflammatory drugs (like ibuprofen) for pain, and weight loss.

If osteoarthritis progresses, joint replacement surgery can often relieve pain and return people to a more active lifestyle.

The good news for people with inflammatory arthritis is that recent gain in understanding of the body’s immune system has provided more effective treatments for this disease. Treatment once consisted only of drugs that ease the symptoms of inflammatory arthritis, but did not alter the course of the disease. Aspirin and steroids are in this category.

New treatments for inflammatory arthritis include anti-cancer drugs (like methotrexate) and drugs that inhibit TNF, which is a mediator in inflammation. These and other drugs form a category known a DMARDS (disease modifying anti-rheumatic drugs) and can slow or stop the progression of the disease as well as relieve symptoms.