Should you limit your activities?
If you have hip arthritis, the more you walk the more the hip will hurt. In time, running, tennis, golf and eventually even walking may become impossible. You can minimize the pain by simply cutting back on activities which seem to aggravate the hip. Whenever possible, use an elevator (or an escalator) instead of stairs, and avoid long walks that leave you in pain. However, “saving the joint” by becoming totally sedentary will not slow down the arthritis. Therefore it is recommended that you remain as active as your pain will comfortably allow. A reported study in the Annals of Internal Medicine, in 1992 suggests that people with hip arthritis who force themselves to remain active may do better in the long run than those who “baby” themselves. Also, being totally sedentary leads to a loss of muscle and bone strength. If you feel that you really need it, you may ask Dr. Hirshorn and his staff to arrange for a handicapped parking sign for your car, but you are better off parking further away and forcing yourself to walk! The best all-around exercise for you is swimming. The water relieves the stress on your hip as you “walk” about in the shallow end of the pool. Dr. Hirshorn can prescribe a program of “pool therapy” for you. Bicycling (stationary or mobile) is also well tolerated. If you do not have access to an exercise bike or pool, then walk as much as you can tolerate without causing yourself excessive pain.
Two important facts about canes:
- Hold the cane in the opposite hand (yes, the opposite hand) from the side with the hip problem and
- The cane should be the correct height. Any medical supply company that sells you a cane will adjust it to the correct length.
Weight loss will probably decrease your pain if you are greatly overweight. One pound of weight loss equals 3 pounds in stress reduction on the hip during normal gait! But weight reduction alone is unlikely to completely relieve the pain. Obesity also makes the hip operation more difficult, and complications occur more frequently in overweight people. It can be very difficult to lose weight when you are not very active because of your hip pain. Do the best you can!
Injections and methotrexate may be useful for rheumatoid arthritis. The treatment is complex and usually only given under the supervision of a rheumatologist.
Cortisone injections into the hip joint can be very effective if the cortisone is injected accurately into the joint. It quite frequently gives good relief for six months or so. It is a deep joint, and a long needle must be used with x-ray guidance for the needle. It is therefore not often done as an office procedure. Dr. Hirshorn is skilled at injecting the hip in the office without x-rays because of his intimate knowledge of the anatomy of the hip. For obese patients, he recommends the use of x-rays to be sure the needle is in the joint. Cortisone occasionally gives remarkable results, with even up to a year of relief in quite severe arthritis. You never know how well it will work until you actually try it. Bursitis of the hip (another common cause of “hip pain”) is easily (and effectively) treated with cortisone injections given in the office.