The Perils of Leaving Hip Problems Unaddressed

No pain, no gain. Push through the pain. For many of us, the ability to withstand discomfort is a point of pride. But pain that’s left unaddressed can worsen and keep you from participating in the activities you love.

One common cause of hip pain is osteoarthritis, which is defined as loss of or damage to cartilage, the tissue that covers the ends of bones where they come together to form joints.

“Any time that cartilage gets some wear and tear on it, some damage, some thinning, that’s what arthritis is. Osteoarthritis is associated with age-related wear and tear,” says Dr. David Hirschi, a sports medicine physician with ThedaCare Orthopedic Care.

Osteoarthritis is common, and almost everyone who lives a long life will develop the condition to some degree, Dr. Hirschi says.

Symptoms of osteoarthritis of the hip include:

Function-limiting hip pain — often dull and achy

Discomfort that arises from walking long distances and standing for long periods

Pain at night or rest

Activity-induced swelling

Stiffness

Feeling of the hip “giving way” or “buckling”

These symptoms typically stem from a lack of cartilage, which results in irritation as the bones bump against one another.

“As we do our activities of the day, it can get inflamed,” Dr. Hirschi says. “Then that joint gets irritated. That swelling inside the joint is typically what’s causing most of the symptoms.”

Diagnosis and Treatment

To diagnose hip osteoarthritis, the provider will go over your history, conduct a physical exam and order an X-ray. The X-ray can show a narrowing of the joint space, thickening of underlying bone and development of osteophytes — often called burn spurs. An MRI is rarely needed for diagnosis.

Once you have a diagnosis, it’s about treating the symptoms, not about curing osteoarthritis, which isn’t possible, Dr. Hirschi says. “What we’re doing is helping you manage the symptoms so that your quality of your life is great or good.”

A wide range of treatments is available and can include:

Home exercise program

Physical therapy

Over-the-counter and prescription medications

Injections

Interventional pain management procedures

Surgery

Dr. Christina Brooks, a pain management physician with ThedaCare Orthopedic Care, says she and her colleagues offer interventional pain management procedures for people who aren’t surgery candidates, such as those who are on blood thinners, have had a heart attack or have an elevated A1C. They can also work with those who don’t want surgery or who wish to delay it as long as possible.

Interventional pain management procedures include:

Bursa or intra-articular steroid injections

Sacroiliac joint steroid injections

Articular branch radiofrequency ablation

Peripheral nerve stimulation

Spinal cord stimulator

Dorsal root ganglion stimulator

The goal of these treatments and procedures is to improve functionality, Dr. Brooks says. They can allow you to better tolerate physical therapy, walk for greater distances, and get back to doing everyday tasks like standing at the sink and doing dishes.

“These are the things that people without chronic hip pain wouldn’t even pay attention to, but anyone with chronic pain knows it can be severely debilitating. It might not only affect the person but also their family and their caregivers,” Dr. Brooks says.

If you’ve exhausted all your other options, have daily functional limitations and are seeing your quality of life decline, you may want to consider hip replacement surgery, says Dr. Michael Ziegele, an orthopedic surgeon with ThedaCare Orthopedic Care.

“For those folks who have tried a lot of the non-operative measures, hip replacement is a great option,” Dr. Ziegele says. “Across all medicine, not just orthopedics, hip replacements are one of the most successful surgeries in terms of patient satisfaction and complication rate.”

Osteoarthritis is the most common condition that leads to hip replacement surgery. The procedure is designed to give you back the ability to move your hip without pain.

Most patients who have the surgery go home the same night. People often use a cane or walker for stability and support at the beginning of their recovery process and then can stop using it altogether. They’ll also do an exercise program either at home or through physical therapy at the surgery center or hospital.

A typical progression for people is to turn the corner at two weeks, to feel good after six weeks and to feel great at the 12-week mark, Dr. Ziegele says.

People often come to Dr. Ziegele when their pain is stopping them. His goal is to get them back to doing what they love.

“Obviously, this is a major surgery and it takes some time to recover, but my ultimate goal is to get you feeling better than you were before surgery and back to doing the things you want to do,” he says. “This really can be a life-changing surgery for the right patient.”

If hip pain is stopping you, call to make an appointment.

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