There are two major components to treating hip osteoarthritis. The first is taking away the inflammation from the joint to alleviate the pain. And the other is to make sure that we address the biomechanics to take the pressure off the hip so that the inflammation doesn’t return.
Another important consideration with treating hip osteoarthritis is the role that weight has to play with hip osteoarthritis. The more weight that we put on, the more force that goes through the hip, the more stress on the hip.
We all, I think, know this intuitively, that if we can drop some weight, it’s going to help our joints in general. One of the issues that I take with this sometimes is the idea that, well, it’s the patients that I treat who come in and say, “I know, I know, I know I’ve just got to lose the weight, I know you can’t do anything until I lose the weight.” And it can be a very frustrating experience for someone who is overweight who feels guilty about that and feels like they just have to lose the weight and it really is their fault and there is nothing they can do until they lose the weight.
When people have a lot of pain from hip or other osteoarthritis, often it’s hard to get up and do that exercise, and that leads to more weight gain, and more weight gain can contribute to more pain, and you can see the vicious cycle that that sets up. Sometimes simply stepping in and breaking that cycle, taking away the pain, which allows the person to then get up and move around. Simply even doing mundane tasks, like not having to think about getting up and walking over and picking up a cup of coffee or glass of milk, not having to make those decisions because it doesn’t hurt that much to get up and walk across the room, that alone can start to help people to lose some weight.
And then of course, getting in with physical therapy, and doing more of an overall exercise regimen, you can really help you start to shed the pounds. As you lose the weight, that helps in terms of taking the pain away, and you start to cycle in the right direction, where the pain is less, you exercise more, you exercise more, the weight goes down, the weight goes down so the pain is less and so on and so forth.
Of course, we shouldn’t de-emphasize the role of nutrition, that’s always important. And that’s always a consideration that we should always be stressing, but we shouldn’t look at that like just the role of nutrition is the whole picture, either.
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