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Osteoarthritis of the hip joint is a problem affecting mainly older people and is the most common disease affecting the hip joint, with 25% of women and 15% of men experiencing symptoms over the age of 60 years.
Previous trauma, such as fracture, dislocation or diseases of a joint often predisposes it to osteoarthritic change. You are also more likely to get it if you have a family history of the disease and you are more at risk if you are obese, as that puts more stress on your hips.
But, you can get osteoarthritis even if you do not have any risk factors.
Symptoms of osteoarthritis of the hip can vary. Your first sign may be a bit of discomfort and stiffness in your groin, buttock or thigh when you wake up in the morning. Commonly, there is a gradual increase of pain over the side of the hip into the groin, with pain down the front of the thigh and into the knee joint. Pain over the knee can be the main presenting symptom and the hip problem can therefore easily be overlooked. The pain is usually worse with activity, especially weight bearing activity such as walking, it can also feel worse with cold weather.
Loss of muscle strength and mobility is often seen, resulting in difficulty running or even walking. It is common to see a, so called, flexion fixture of the hip, resulting in a very characteristic limp with the person unable to extend the thigh back. The foot tend to turn outwards due to restricted hip movement, so when cycling, the thigh and knee wants to turn out. It also gets more difficult to squat down and put on socks and shoes.
Rest is often found to relieve pain, but not always. It depends on the level of inflammation and damage to the joint. Using a walking stick (cane) for support will usually help you to walk easier.
There is little evidence that structural changes of osteoarthritis can be changed or reversed, but some cases have been reported. But we know that chiropractic treatment will help you avoid unnecessary pain and disability and slow the progression of the disease. Hence, delay possible surgery or maybe even avoid the need for it.
The chiropractor performs a detailed examination using chiropractic, orthopaedic, neurological and muscle testing procedures in order to accurately diagnose the problem.
Apart from examining the hip joint, it is important to include an examination of the back, knee, ankle and foot. As all these areas can influence the hip problem.
Although the physical examination usually, easily picks up the problem, an x-ray examination is necessary to confirm the diagnosis. The x-ray findings will also give a clearer picture of how severe the problem is. This will help the chiropractor to give an accurate prognosis, rule out other causes and help to select the most appropriate treatment.
The aims of the treatment are:
The treatment will involve stretching and massage techniques to tight and tender muscles, gentle mobilization techniques and manipulation of the effected joints and the use of low-level laser therapy (LLLT), ultrasound or interferential modalities.
You will also be given exercises based on your personal need and fitness level. Supervised stretching and strengthening exercise-programs have been shown to be far more effective than unsupervised programs and we would therefore suggest that it should be your first choice.
Good nutritional support and a healthy lifestyle are of course always important to keep you healthy and feeling well. It becomes particularly important if your body needs to heal from an injury.
Glucosamine and chondroitin supplements have been proven to help symptoms of osteoarthritis in some studies, but a recent review stated that it was not effective.
Some cases of severe osteoarthritis may need to be referred for an orthopaedic opinion and may need surgery, but this should not necessarily be your first option.
Chiropractic treatment may help you delay any need for surgery and the earlier you receive treatment the more likely you are to benefit.
However, should you need surgery, rehabilitation after surgery is important to strengthen your muscles and restore or maintain the flexibility of your hip and other related joints.
Any physical preparations you make before the surgery can affect both the outcome and your recovery time. It is also worth remembering that doing exercises to strengthen your upper body will help you cope better with crutches or a walker after surgery. If you familiarize yourself with postoperative exercises and practice them before the surgery, they will be easier to perform after the surgery.
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I have been a patient of Dr. Pisarek for a few years now. Every morning I have to say "thank you Dr. P.!". Your care and your treatment renew my energy... no more pains in my lower back, knee and foot. With your help I lost 20 pounds and I am keeping it off. I am really grateful to you and your wife Hilda for taking care of me. My retirement got a new meaning, thanks to you.