What you need to know about Osteoarthritis and your hips

What is Osteoarthritis (OA)?

Osteoarthritis (OA) is a degenerative disease that affects the cartilage of joints. Cartilage is a firm, flexible connective tissue that lines the surface of many joints and provides shock absorption and cushioning for the bony surfaces of those joints as they move. During the process of OA, cartilage gradually begins to break down and is worn away. This means that the bony surfaces below the cartilage start to rub together, creating increased stress and friction. The body reacts to this increased stress by creating small bony deposits around the joint, as more of these are created the joint becomes increasingly painful and difficult to move.

The hip is one the joints most commonly affected by osteoarthritis. While OA is generally considered to be a disease associated with aging, younger people can be affected, particularly following trauma to the hip. As a general rule, however, the cartilage in our bodies loses elasticity as we age, making it more susceptible to damage. Other risk factors for the development of OA are a family history of OA, previous traumatic injury of the hip, obesity, improper formation of the hip at birth (developmental dysplasia), genetic defects of the cartilage, impingement of the hip (femoroacetabular impingement) and a history of intense weight bearing activities.

What are the signs and symptoms?

The most common symptoms of hip OA are pain and stiffness with reduced movement of the hip, particularly in the direction of internal rotation. These symptoms in a person over the age of 50, in the absence of a trauma that may have caused a fracture, indicate possible OA. Pain originating from the hip joint can be felt as a deep ache that can be noticed in the groin, buttocks, thigh or even knee. It is also typical for sufferers of OA to experience stiffness in the morning upon waking that lasts less than 30-60 minutes. Grating or cracking sensations with hip movements are also common complaints, along with mild to moderate joint swelling.

In the early stages, mild pain may be felt with activities such as walking or running. As the disease progresses these activities will become more painful with the muscles that provide additional support to the joint becoming weaker, exacerbating the disease process. For many people, a total hip replacement may be necessary to reduce pain and restore function.

How can physiotherapy help?

For mild to moderate cases of OA, physiotherapy can help to reduce pain and maintain function for as long as possible. Keep the musculature around the hip as Strong and healthy as possible can have a significant impact on your quality of life and your physiotherapist work with you to help you to set and reach your goals for treatment

Treatment will also include stretching, trigger point therapy, joint mobilization to increase the joint’s mobility, and a personalised exercise program, including hydrotherapy and isometric exercises that work to increase muscle strength while putting less pressure on the joint.

For those whose best course of treatment is surgical joint replacement, physiotherapy can help to achieve great outcomes by helping with effective preparation and rehabilitation, getting you on your way to recovery as quickly as possible.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

Surprising reasons why your sleeping position could be making your pain worse

For most of us, the hours we spend sleeping are simply a time for rest and recovery. However, you might be surprised to learn that your sleeping position can have a significant impact on your body, particularly if you already have an injury. When you consider that we spend approximately 40% of our lives in bed, it becomes less surprising.

Ideally, your body should be held in a position of minimal stress while sleeping. This means that all your joints and muscles are resting in a neutral position. Over time, joints that are held in more extreme positions may put pressure on the surrounding structures and this may lead to a feeling of stiffness in the morning.

Back Pain

For sufferers of back pain, finding a comfortable position at night can be difficult. Ideally, the natural curves of the spine should be maintained and supported throughout the night. The correct mattress will support your lower back without making you feel as though you have been sleeping on concrete all night. A mattress that is too soft might feel comfortable to begin with, but over time will let you sink too much, meaning the curve of the lower spine will be lost. Waking up with a stiff spine could be a sign that you are using the wrong mattress.

For many people, sleeping on their side keeps their spine in a more natural alignment than on their back. If you sleep on your back, placing a pillow under your knees can help to maintain your lumbar spinal curve throughout the night.

Neck Pain

While you may be attached to your pillow, it could be the cause of unnecessary neck pain for you. The neck is often the most vulnerable part of our body when our sleeping setup is not ideal. Side sleepers may let their neck fall excessively to the side with a pillow that is too low or have their neck elevated too much by having their pillows too high.

The importance of having a supportive pillow that supports your neck while sleeping cannot be overstated. If you find yourself putting your arm under your pillow while you sleep, it is likely that your pillow is too low. Having your shoulder in this position overnight can put unnecessary stress on the structures in the shoulder joint and should be avoided if possible.

Sleeping on your stomach with your head turned to the side can be the cause of many issues and if this is your preferred sleeping position, it could be worth chatting to your physiotherapist about strategies improve your sleeping posture.

Hip Pain

Side sleepers often spend their nights with one leg crossed over their body. This can place extra pressure on the structures on the side of the hip, such as tendons and bursa and can impact the health of these tissues as compression can reduce the blood flow to the area. If the mattress is too firm then the hip on the underside of the body may also be compressed under your bodyweight.

Placing a pillow under your knee while sleeping on your side can help to maintain a neutral alignment of your hip. This can also help to keep your lower back in a more neutral position during the night.

Speak to your physiotherapist for more advice on how to improve your sleeping posture and find out if your sleeping setup is right for you.