Osteoarthritis (OA) of the hip

Osteoarthritisis the most common form of arthritis, and the hip is the second most commonly affected joint.

每个人的关节在一生中都经历了正常的磨损周期。当您的关节修复自己时，它们的形状和结构可能会改变。如果这种关节发生在一个或多个关节中，则称为骨关节炎。

关节是两个或多个骨头相遇的身体的一部分。您的髋关节由大腿骨顶部的球组成，该球适合您的骨盆中的插座。

The ends of both bones in a joint are covered by a smooth slippery surface, known as cartilage. This is the soft but tough tissue that allows the bones to move against each other without friction.

骨关节炎会导致您的髋关节软骨变得更薄，并且关节的表面变得更粗糙。这会导致肿胀，疼痛和僵硬，但并不是每个人都有这些症状。

The exact cause of osteoarthritis is often not known, as there can be quite a few reasons why a person develops the condition. These include the genes inherited from your parents.

骨关节炎通常从45岁以上的人开始，在女性中比男性更为普遍。

Research has shown that injuries, and jobs that involve heavy lifting or long periods of standing up, are associated with an increased risk of developing hip osteoarthritis.

Being overweight can also be a factor, as it increases the load on your joints.

尽管许多人没有症状，但那些这样做的人会有广泛的经历。被诊断出患有骨关节炎并不意味着您的病情会恶化，因为您可以采取一些措施来改善症状。

In hip osteoarthritis, the pain comes on gradually over a period of months or years. However, it could also be triggered by a recent injury. You might find symptoms come and go and that the pain is worse at the end of the day.

疼痛的区域通常是下背部，臀部和腹股沟。有些人也从大腿顶部到膝盖感到不适。有时甚至可以一直感觉到脚踝。这可以称为引用或辐射疼痛。

如果您的臀部受到严重影响，走路，站起来或弯曲会突然变得更加困难。您的臀部也可能会“锁定”片刻。

If you have advanced hip osteoarthritis, the muscles around the hip can become smaller and weaker due to not using them. This then puts even more strain on the joint.

The best thing you can do at home for hip osteoarthritis is exercise, as it will strengthen the muscles that support your hip joint.

有时，骨关节炎的作用会使人们感到沮丧或焦虑。它也会影响您的睡眠方式，甚至可能影响您的人际关系。值得与您的医生谈论这些问题。

There’s no cure for osteoarthritis, but there are things you can do for yourself that can make a difference to how the condition affects you. There are also some treatments available that could significantly reduce your pain and improve your mobility. It’s likely that you’ll need to use a combination of different things to get the best results.

Exercise

Joints need to be exercised regularly to keep them healthy. It’s very important to keep moving if you have hip osteoarthritis. Whatever your fitness level, exercise should form a core part of your treatment.

Exercise can strengthen the muscles around your hip, improve your posture and help you to lose weight, all of which can help your pain and other symptoms.

It’s important to carry on with your exercises, even if you start to feel better. Stopping or reducing the amount of exercise you do could cause your symptoms to come back again. Try to start off slowly and gradually increase how much you do. Exercising little and often is a good place to start.

See if you can talk to aphysiotherapistor speak to your doctor about being referred to one. A physiotherapist can give you specific advice and exercise tips that are tailored to your needs. They might even be able to start you on a personalised exercise plan, but you’ll need to build this into your daily routine to get the most benefit from it.

Your physiotherapist may recommend exercise in a hydrotherapy pool. It can help get muscles and joints working better and, because the water is warmer than in a normal swimming pool, it can be very soothing and relaxing.Hydrotherapyis sometimes called aquatic therapy.

练习减少负载你的关节,往下h as swimming and cycling, are recommended for treating hip osteoarthritis. Water-based exercises are particularly good for treating hip osteoarthritis, as the water takes the weight of your body and reduces the strain on your hips.

Ultimately, the best form of exercise for osteoarthritis is something you enjoy and will keep doing. Try different things and see what works best for you. This could be a class, or something you do on your own.

您应该尝试结合加强，有氧运动和运动范围。You can find examples on our exercises for the hips page.

Strengthening exercises

This type of exercise is important, as it strengthens the muscles that control your hip, and helps to stabilise and protect the joint.

Try to do strengthening exercises at least two days a week.

增强腿部肌肉的一种好方法是对抵抗力进行抵抗。您可以通过在浅游泳池中行走圈来做到这一点。

运动范围

这些非常适合姿势，并有助于保持关节的灵活性。这些练习可以像伸展一样简单。确保您的关节穿过一系列位置，每次都可以舒适地稍微延伸。

Aerobic exercise

This is any exercise that increases your pulse rate and makes you a bit short of breath. Regular aerobic exercise should help you sleep better, is good for your general health and wellbeing, and can reduce pain by stimulating the release of endorphins, which are hormones that help with pain relief.

Different types of aerobic exercise include cycling, swimming and walking. Try to work hard enough to get out of breath, but still be able to have a conversation.

您应该每周尝试进行2小时30分钟的有氧运动，但是您可以在一周内将其散布，而不是一口气。

Weight management

Being overweight increases the strain on your joints, especially your hips and knees. This makes it more likely that you’ll develop osteoarthritis and that your condition will get worse over time.

Losing weight if you’re overweight could reduce your pain and other symptoms.

There’s no special diet that will help with specific diet that’s recommended for people with osteoarthritis. However, if you need to lose some weight, you should try to follow a balanced, reduced-calorie diet, combined with regular exercise.

The NHS has a greatweight loss plan您可以遵循的可以帮助您以健康的方式减肥。

Your doctor should be able to give you advice on diets and exercise that will help. You can also speak to your doctor for advice. The Association of UK Dieticians also have aninformative leaflet on diet and OA。

减少臀部的压力

Apart from keeping an eye on your weight, there are a number of other ways you can reduce the strain on your hips.

• 加快您的活动，不要一次解决所有的身体工作。将更艰苦的活动分为大块，并在两者之间做一些更轻柔的事情。即使臀部有些不舒服，也要继续使用臀部，并在它变得太痛苦之前将其休息。
• Wear shoes with thick soles and enough room for your toes. Good shoes should reduce the shock through your hips by absorbing some of the impact when walking. Try to avoid wearing high heels.
• 如果您走路时需要额外的支撑或膝盖，请与您的脚说话physiotherapist,occupational therapist或医生要为鞋子制作鞋垫。
• Use a walking stick if needed to reduce the weight and stress on a painful hip. Hold it in the hand on the opposite side of the body to your affected joint. Try to avoid carrying items on the same side as the affected hip.
• Use the handrail for support when going up or down stairs. Go up stairs one at a time with your good leg first, but go downstairs with your bad leg first.
• Think about making changes to your home, car or workplace to reduce unnecessary strain. An occupational therapist can advise you on special equipment, such as sock aids to help when bending, that will make things you do every day easier.
• When sitting, chairs should be firm and high enough so that your hip is slightly higher than the knee. Wedge-shaped cushions or a folded towel could be useful to correct the slope of a car seat. Try to avoid crossing your legs.

Coping with low mood and sleep problems

You might find that osteoarthritis makes you feel depressed or anxious. Speak to your doctor if you’re feeling low. They may be able to recommend psychological therapies to help you, such as cognitive behavioural therapy (CBT) and a few stress-relieving techniques. If your sleep is disturbed because of hip osteoarthritis, this could make your pain feel worse. However, there are things you can do for yourself that might help, such as:

• 如果您的睡眠问题有任何模式，请保留睡眠日记以锻炼身体。
• 常规时间睡觉，使您的身体进入常规。
• Try to wind down before bed by having a warm bath or reading a book.
• 如果要有更舒适的睡眠姿势，请在侧面躺着的情况下在双腿之间使用枕头，或者如果躺在背上，则在膝盖下使用枕头。

如果您仍然有问题，请与您的医生或occupational therapist。They can give you some tips and techniques. They may also refer you to a pain management clinic, where you can be shown how to live a more active life.

Drugs

药物可用于帮助缓解骨关节炎引起的疼痛和僵硬。如果保持活跃，减轻臀部的压力，并在需要的情况下服用毒品，您将获得最佳效果。

您可以尝试的一些药物和治疗方法包括：

• Painkillers: simple over-the-counter painkillers such as paracetamol may help, but your doctor may prescribe you stronger painkillers if needed.
• Non-steroidal anti-inflammatory drugs (NSAIDs): a short course of NSAIDs, such asibuprofen，可以帮助减轻疼痛，炎症和肿胀。但是，NSAID并不适合所有人，因此请确保您在服用药剂师之前与药剂师交谈。
• 辣椒素霜: a pain-relieving cream made from the pepper plant, which is available on prescription.
• Steroid injections:an injection into the soft tissue on the side of the hip, which can help reduce some of the pain. Usually you’ll only be able to have three of these a year.

如果您要服用上面提到的任何柜台药物，请确保您按照医生或患者信息传单的指示服用。不要忘记让医生知道您服用的所有药物。

Other pain relief

If the methods of pain relief above don’t help you, you might want to try some of the following:

• 手动疗法：Consists of several techniques and stretches performed byphysiotherapists。手动疗法可以是提高臀部运动质量和范围的有效治疗方法。
• Transcutaneous electrical nerve stimulation (TENS):a small machine that sends tiny electric shocks, through pads placed on your skin, to relieve pain. TENS machines aren’t suitable for everyone, so talk to your doctor before using one.
• 热疗法：Ice packs and heat packs, such as a hot water bottle or a bag of frozen peas, can relieve some of the pain and stiffness in your hip. But be careful not to put ice or heat packs directly on your skin as they could cause burns. Make sure to wrap them in a damp tea towel or cloth.
• Hyaluronic acid injections:透明质酸在体内自然发生和helps to lubricate joints. These injections aren’t available on the NHS as they’ve not been proven to be an effective treatment for osteoarthritis.
• Supplements:There’s a wide range available, including鱼油,turmeric,葡萄糖胺和chondroitin。几乎没有证据表明他们的工作能力，但是有些人确实感到从他们身上受益。
• Acupuncture:是一种在皮肤中特定点插入非常细的针头的技术。虽然没有证据表明acupunctureis an effective treatment for hip osteoarthritis, some people find that it helps them.

You need to be wary of some of these treatments, but what works for you can be completely different to what works for someone else. If you think some of these treatments could be right for you just have a quick chat with your doctor first.

Surgery

Exercise, treatments and keeping to a healthy weight usually improve the symptoms of hip osteoarthritis. But if these treatments haven’t worked for you, you may benefit from having hip surgery.

Surgery might be suggested if you have symptoms that have a substantial impact on your quality of life, such as severe pain or reduced mobility.

Total hip replacement surgeryis one of the most commonly conducted and successful operations in the world. The operation can give a lot of pain relief and improve movement in your hip.

Surgical techniques are improving all the time and most hip replacements now last for at least 15 years.

Hip resurfacing is an alternative type of surgery where, rather than replacing the entire hip, only the damaged surfaces are replaced. However, resurfacing is less popular than hip replacements, as there are worries over how the new metal surfaces could cause damage to the soft tissues that surround the hip. Your surgeon will be able to tell you which option is best for you.

在进行手术之前，您将参与共同的决策过程。这涉及讨论治疗臀部的最佳选择，并涵盖手术的风险和好处。

该过程通常由外科医生或高级物理治疗师进行。他们可以为您提供最佳建议和信息，因此您可以做出适合您的决定。