Hip Arthritis

Like any joint, the hip joint can deteriorate and wear out. The degree of deterioration can vary of course and it goes in stages. First the cartilage thins out and the joint space decreases. At that stage treatment can have a significant impact and decrease pain levels. If you then continue to stretch and exercise appropriately it may halt the course of the degeneration. The next stage is when the cartilage wears out and bone beings to rub on bone. At this stage it gets significantly harder to make an impact, but we can still have a reasonable degree of improvement so long as you are willing to get involved in the treatment process and do regular stretching and exercising.

The final stage is when the bone integrity is compromised and cysts form under the surface of it. At this stage the best we can do it control the symptoms to an extent with a view towards getting a hip replacement organised for you if the condition is limiting your daily activities sufficiently. At that final stage we have to ask the hard question: is the lack of mobility which a badly arthritic hip causes going to begin to affect your other areas such as your knees and lower back. We will discuss such factors with you in detail and help you find the solution you are most happy with.

Labral Problems

The hip joint carries a lot of weight so the body aims to try and create as much stability as possible. A labrum is a lip made of cartilage which runs along the edge of the joint and in a way 'grips' the head of your thigh bone as it inserts into the joint. With extreme movements the labrum can get pinched, torn and partially avulsed. This usually produces a deep seated pain around the hip area all around - from the outer side, in a circle around into the groin and back. There is always a particular range of movement which aggravates the condition greatly, whereas other ranges of movement can be quite free.

Small labral tears, irritations and avulsions are treated conservatively and by avoidance of aggravating activities. In general we prefer to get this diagnosed accurately via imaging if your response to treatment is not what we would expect. Once it is accurately diagnosed and we know that osteopathic treatment is appropriate, we can confidently persevere with the correct steps to get you the best possible result. If the damage to the labrum is significant enough, there may be a need for a small arthroscopic surgery. Generally you would be recovered back to normal walking / moving within about 3-4 weeks and then you can gradually get back into your usual activities as you had done before. Whilst we always look for all options to help you avoid surgery, if the other option is that the labral tear leads to gradual hip arthritis and then you end up needing a total hip replacement which takes much longer to recover from.

Referred Pain

Pain referral into the hip and pelvis can be very varied. The knee joint can refer up to the hip, the lower back muscles and joints can send pain into the hip and pelvis and the sacroiliac joints can send pain into the hip area too. Structural osteopathy can help address all of these easily. Organs which are in the lower abdomen and pelvis can also send pain into the wider area and appear to be pain coming from the mechanical structures. The difference is that organ related pain is not affected by mechanical stimulii. For example if your pain gets worse after a big, long walk then it is far more likely mechanical pain. If the pain is worst after having a large meal it is more likely related to your lower digestive system.

The most common organs which will affect the area are the gynaecological organs, bladder, ureters and the lower digestive system. In all of these cases it may be a simple restriction or organ movement which we can ease through visceral osteopathy. It may, however, be a more serious visceral condition in which case we would need to either organise further investigations or further treatment. We would of course discuss all options together with you in order to choose the approach you are most comfortable with.

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