Hip pain OA or IA

Elmbow

Hello. Hope everyone is well. I have a query about hip pain.

I have inflammatory arthritis (psoriatic), for which I take hydrxychloroquine and Humira. They have been working well for me and I am more or less unbothered by severe flare-ups now. However...

I have been getting progressively worse right hip pain for a few years. The pain is deep in the hip joint, groin and occasionally felt in the buttock. I had an x-ray and MRI in 2019 that showed nothing in my hip or SI joints. Then it really seemed to get suddenly much worse last August.

It is particularly bad first thing in the morning, often waking me up. It's worse when I sit for long periods. It's stiff and eases up when I move up. It seems to ease off somewhat with high doses of naproxen. In other words, it behaves a lot like inflammatory joint pain.

But, it also gets worse when I walk more than a couple of miles. It seems to seize up so if I stop to sit down, bending at the waist to sit can be agonising. This isn't like any inflammatory joint pain I've had before.

So I'm wondering if it's osteoarthritis and, if so, how can I tell and what I can do about it. The MRI was clear, so when do changes start to appear on scans?

Has anyone else with hip or SI problems experienced this stiffness after walking? I'm 42 and generally pretty fit and healthy all things considered, so I don't think this is a normal ageing thing.

Any advice?

Lilymary

I have severe OA in one of my hips (not so bad in the other), and it must have been building up for years, mostly benignly. Like you, I'd find my hip very sore after a long walk, then later also building up over the last few years to general referred pains elsewhere in my leg. After a relatively minor fall last Feb it suddenly got much worse to the point that it was agony to move at all, and they finally sent me for an xray where they decided there and then it needed replacing. (Still waiting, thanks to Covid). My surgeon and my GP both said it can come on suddenly, so it's possible this has happened to you also. Your symptoms sound very similar to mine.

The problem is your age I'm afraid, as they don't usually do hip replacement on people so young, as they can only do it a limited number of times and the replacement joints don't last indefinitely. My GP was reluctant to send me for an xray initially as if it's unlikely to result in a surgical outcome, there's not much point. It may be that you will need to keep managing it with pain relief and appropriate exercise to support the joint better. There are some good exercises on this site specific to hip pain that you may find helpful.

Elmbow

Thank you @Lilymary . This is kind of what I suspected; I think my dad was in his mid-50s when he had his hip replaced but he'd got to the point where he couldn't put any weight on it at all and needed a walking stick. I am thankfully not that far along, but I'd like to be able to manage the pain better and move more freely. I can't take naproxen for too long as it exacerbates my asthma, which has been worse lately since having Covid earlier this year. I will look for the exercises.

It must be very hard waiting for an op and not knowing when things will start moving again. I hope you're not waiting too much longer.

Lilymary

Look up the “Let’s move with Leon” programme of exercises on the site. They’re very gentle and actually quite fun to do, and may help both with general mobility and building up muscle tone. I’m afraid my hip is so far gone that the exercises make it worse. Until it all kicked off last year, I was going to Pilates and yoga twice a week with no problem, so I recognise many of the moves and sometimes added a few of my own during the “explanation bits”.

I’d also suggest investing in some sessions with a good private physio (NHS ones are really limited in no of sessions, and very long waiting lists, and many aren’t even seeing patients yet.)

re the wait for surgery, the world is upside down, it is what it is. I’m lucky in that my condition can be fixed by surgery, for so many that’s not an option, so I have no right to complain. It does get me down sometimes, but I try to keep my eye on the bigger picture.

Ellen

Link to let's move with Leon as mentioned by Lilymary:

https://www.versusarthritis.org/about-arthritis/exercising-with-arthritis/lets-move-with-leon/

In case you were interested @Elmbow

Best wishes

Ellen