They say prevention is better than cure and that is certainly true in hips! Having said that you can’t change your genetics. Some people have a certain shape to their hip which seems to predispose to the development of arthritis. These ‘CAM’ and ‘Pincer’ shaped hips predispose to pinching (impingement) of the hip against its socket, leading to damaged cartilage and eventually arthritis. Hip Arthroscopy surgery can be used to reshape the hip and may prevent early arthritis progressing to advanced stages.
The most important modifiable risk factors for arthritis is your weight and activity level. Being even slightly overweight leads to increased load on the hip joint. Over time the hip can be squashed down and change shape permanently. The increased angle leads to more pinching and the hip wears down more quickly. Losing weight can slow the whole process down. Other people have illnesses in childhood such as Hip Dysplasia (the hip and socket are too shallow, having not formed properly), Perthes disease (the blood supply to the hip gets cut off in childhood), or Slipped capital femoral epiphysis (the growth plate of the bone slips out of place). All of these conditions need to be spotted in childhood so something can be done about it and potentially prevent adult hip osteoarthritis.
Early hip OA is much easier to fix than advanced OA. Sometimes X-rays can miss the early features, MRI or CT scans are more reliable. If you are sure that you have hip or groin pain, but the X-ray is normal, you will need to speak to your doctor about a specialist opinion or scan.
Sometimes a steroid injection done under X-ray guidance can give temporary relief, and provide clarification around whether pain in the groin or buttock area is truly coming from the hip joint, however, they generally wear off after 2-3 months, so it is not a long-term option. Other substances such as hyaluronic acid (an artificial version of your natural joint fluid) and PRP are also being used but need to be further evaluated to see if they have long-term benefit.
It is important to do regular strengthening exercise (such as core stability and pilates) and maintain a healthy weight, if hip pain is becoming intrusive, ask to see one of our specialists.
Dr Leon Creaney