As we age, it’s common for our joints to show signs of wear and tear. This is especially true of the hip joint, which bears the brunt of our body weight when we walk, run, and engage in other activities. For many adults, the first sign that their hip joints are wearing out is pain. If you’re experiencing chronic hip pain, stiffness, or limited mobility, it could indicate that the cartilage and other tissues surrounding your hip joint have broken down over time. In this article, we’ll go over the common signs and symptoms that your hips may be worn out and explain when it’s time to see a doctor. Read on to learn more about managing hip joint degeneration and finding relief from hip discomfort.
What causes hip joint wear and tear?
There are several factors that contribute to the gradual wearing down of the hip joint over time:
Normal aging
As we get older, the cartilage that cushions the hip joint becomes thinner and less effective at absorbing shock. This normal breakdown due to aging is known as osteoarthritis. The loss of protective cartilage causes the hip bones to rub together, leading to pain and stiffness.
Injuries
Previous injuries to the hip joint or muscle strains can accelerate joint degeneration. Even minor injuries that occurred years ago can increase wear and tear on the hip over time.
Obesity
Carrying excess body weight puts additional strain on the hip joints during everyday activities like walking, standing up from a chair, or climbing stairs. This constant overload can cause the cartilage to deteriorate more rapidly.
Genetics
Some people are simply predisposed to developing hip osteoarthritis due to genetic factors. This congenital susceptibility combined with other lifestyle factors often leads to premature hip joint breakdown.
Inactive lifestyle
Lack of physical activity allows the hip muscles to become weak and tight. This can affect the stability and biomechanics of the hip joint, resulting in uneven wear and tear over time.
Signs that your hips are worn out
Here are some of the most common indications that the cartilage and other connective tissues surrounding your hip joint have started to degrade:
Hip pain
One of the first symptoms that your hip is worn out is pain in the hip joint. You may feel aching, soreness, or stiffness in the hip area that worsens with activity and eases with rest. The pain is usually felt in the groin area. As the joint damage progresses, pain may be present even at rest.
Reduced range of motion
Healthy hips allow a wide range of fluid movement. But arthritis and impingement can restrict mobility of the hip joint. You may notice difficulties with everyday movements like putting on shoes and socks, getting in and out of a bath or car, or reaching down to pick something up.
Clicking, crunching, or popping sounds
As the hip bones lose their protective cartilage coating, you may hear grinding or crunching noises when moving the hip joint. This crepitus indicates that the bones are rubbing directly against each other.
Muscle weakness
The muscles surrounding the hip joints can become weak from disuse and arthritis pain. You may notice difficulties standing up from a seated position, climbing stairs, or difficulty standing on one leg to put on pants or socks.
Unstable hip feeling
Advanced hip joint wear and tear can make the hip feel loose or unstable, as if it might give out when bearing weight. This sensation is usually a sign of severe damage to the cartilage and supporting ligaments.
Limping or altered gait
You may start walking with a limp as a way to avoid pain from arthritic hip joints. Or you may notice a change in posture to compensate for weak hip muscles or instability in the joint. These adaptations affect the biomechanics of walking and can lead to pain in other joints.
Difficulty sleeping
At the end of the day when you’re exhausted, arthritic hip pain can make it very difficult to find a comfortable sleep position. You may constantly need to shift positions throughout the night which leads to poor sleep quality.
When to see a doctor
You should make an appointment with your doctor if:
– Hip pain is persistent and not improving with rest or over-the-counter medications.
– Mobility is becoming limited and affecting your daily activities.
– You notice sensations of buckling, grinding, or instability in the hip joint.
– You have to significantly modify your gait or posture due to hip discomfort.
– Hip symptoms are disrupting your sleep.
– You experience swelling, redness, or warmth in the hip area suggesting an infection.
– You develop sudden inability to bear weight on the leg due to severe hip pain.
– Hip pain results from a fall or injury.
– Non-hip related symptoms occur like unexplained weight loss or fever.
Seeking prompt medical care is important for proper diagnosis and treatment before significant hip joint damage occurs. Make sure to tell your doctor about all symptoms you’ve been experiencing, even if they seem unimportant.
Physical exam
During the appointment, your doctor will perform a physical examination of the painful hip. They will palpate the joint looking for tenderness and feel for any fluid buildup or swelling. Your doctor may also measure the range of motion in the hip by having you move the joint through different positions. This can pinpoint where mobility is restricted.
You’ll likely be asked to walk back and forth so your doctor can assess your gait pattern. They will note if you have a limp or other compensatory movements. Neurological tests may also be conducted to rule out nerve involvement. Your doctor will compare findings between the painful hip and the unaffected side.
Imaging tests
If your doctor suspects hip arthritis based on symptoms and exam, they will probably order imaging scans to assess the extent of cartilage and joint damage.
X-rays
Plain x-rays can reveal bone spurs, loss of joint space, and other signs of osteoarthritis. The hip joint is clearly visualized and your doctor can grade the severity. However, x-rays do not show soft tissue damage to muscles, cartilage, and ligaments.
MRI
This study uses magnetic waves rather than radiation to create 3D images of the hip structures. MRI scans give the most accurate view of cartilage breakdown, inflammation, and other hip problems. Your doctor can determine if you have osteoarthritis, impingement, or other issues.
CT scan
A CT scan combines multiple x-ray views to construct cross-sectional images of the hip joint. It is sometimes used instead of MRI in cases of contraindications like metal implants or severe claustrophobia. CT reveals bone spurs, fracture, loose bodies, and other bony abnormalities.
Ultrasound
Musculoskeletal ultrasound uses sound waves to create real-time images of the hip tendons, bursae, and muscles. It can identify areas of swelling, fluid buildup, and tissue damage. Ultrasound is often used to guide joint injections or aspirations.
Bone scan
Also called a nuclear medicine scan, this test uses a radioactive tracer to detect areas of increased metabolic activity suggesting arthritis inflammation. It is not routinely performed but may help find causes of unexplained hip pain.
Common causes of worn out hips
Based on your symptoms, physical examination findings, and imaging study results, your doctor can diagnose the problem causing your hip pain and joint degeneration. Here are some of the most common hip conditions:
Osteoarthritis
This is the gradual wearing away of the hip cartilage from aging, obesity, or overuse injuries. It leads to pain, stiffness, and loss of mobility. X-rays show narrowed joint space, bone spurs, and sclerosis.
Rheumatoid arthritis
An inflammatory autoimmune disease that attacks multiple joints including the hips. It causes painful swelling that can rapidly damage hip cartilage and ligaments. Blood tests confirm this diagnosis.
Hip impingement
A structural problem where the ball of the femur does not move smoothly in the socket due to irregular bone shapes. Activities cause the bones to rub abnormally leading to early cartilage damage.
Hip labral tear
The labrum cartilage ring that lines the hip socket tears or separates. This causes pain, clicking, instability, and premature arthritis. MRI best detects labral tears.
Hip fracture
Breaking the upper thigh bone near the hip joint. It usually results from a major fall and causes acute pain with inability to bear weight. X-rays reveal the fracture.
Avascular necrosis
Loss of blood flow to the ball of the femur leads to death of the bone tissue. The damaged femoral head then collapses causing arthritis. Early MRI can diagnose avascular necrosis before X-ray changes appear.
Hip dysplasia
A shallow, misshapen hip socket present since birth leads to abnormal wear and early arthritis. This congenital hip problem is visible on X-rays of the pelvis.
Nonsurgical treatment options
In the early stages of hip arthritis, your doctor will probably recommend trying conservative therapies before considering surgery:
Activity modification
Avoid high-impact activities that worsen hip pain like running and jumping. Switch to low-impact exercises like swimming, cycling, or elliptical training. Use proper technique and avoid overdoing activities. Take regular breaks.
Medications
Over-the-counter pain relievers like acetaminophen, NSAIDs, or topical creams help ease hip discomfort and swelling. Your doctor may also prescribe stronger anti-inflammatory drugs. Joint injections can provide temporary pain relief.
Physical therapy
Specific hip-strengthening and flexibility exercises can improve mobility and gait. A physical therapist can advise lifestyle and posture changes to protect the hip joint. Assistive devices like canes or walkers can also take pressure off the hips.
Weight loss
shedding excess pounds reduces mechanical stress on the hip joints with daily activities. Even modest weight loss can provide significant symptom relief if you are overweight. Improving muscle mass also helps support the joints.
Alternative therapies
Options like massage, acupuncture, yoga, tai chi, heat/ice therapy, and dietary supplements may offer additional hip pain relief in some individuals. Consult your healthcare provider before starting alternative treatments.
When is surgery needed?
If nonsurgical methods do not adequately control your pain and improve hip function, your doctor may recommend surgery, especially if imaging shows advanced joint damage. Hip surgery aims to repair damaged tissues, increase mobility, and delay the need for hip replacement. Surgical options include:
Arthroscopic surgery
Small incisions are made to insert a tiny camera and instruments. The surgeon trims torn cartilage, removes loose fragments of bone or cartilage, and smooths damaged joint surfaces. This can reduce pain and delay arthritis progression.
Osteotomy
For hip impingement or dysplasia, the surgeon cuts and repositions the femoral bone to improve its fit in the hip socket. This helps evenly distribute forces across the joint.
Hip resurfacing
Only the damaged bone and cartilage surfaces of the femoral head are removed and replaced with a smooth metal covering. This conserves healthy bone compared to full hip replacement.
Total hip replacement
For severe hip arthritis, this surgery removes the damaged femoral head and acetabulum. These are replaced with artificial components made of metal alloys, ceramics, and plastics to restore hip function.
Recovering after hip surgery
Recovery time after hip procedures depends on the type of surgery:
Arthroscopic hip surgery
This is an outpatient procedure and you can go home the same day. Use crutches for 1 to 3 weeks to avoid bearing weight until the hip heals. Full recovery takes about 6 weeks.
Open hip preservation surgery
Hospital stay is 1-3 days. You’ll use crutches or a walker for 4-8 weeks after surgery. Total recovery can take 3-6 months for osteotomies and resurfacing procedures.
Total hip replacement
Hospitalization is 3-5 days on average. You’ll need a walker or cane for 3-6 weeks post-surgery. Restrict activities for at least 3 months to allow the new hip parts to fully integrate. Most people can drive and return to normal daily activities after 6 weeks.
Physical therapy is a crucial part of recovery after any hip surgery. Your surgeon will provide restrictions and milestones for your rehabilitation. Proper healing and therapy helps ensure you regain optimal hip function.
Preventing repeat hip joint damage
Certain lifestyle measures can help preserve your new hip joint after surgery and prevent the need for additional procedures down the road:
Exercise
Low-impact activities like walking, swimming, and cycling promote strength and flexibility without overtaxing hip joints. Stick to non-jarring exercises recommended by your surgeon and physical therapist.
Watch your weight
Keep your weight in a healthy range to prevent excessive wear and tear on hip cartilage. Losing even a small amount of weight can make a big difference in joint stresses.
Posture and body mechanics
Use proper posture and movement patterns during daily activities to distribute your weight evenly across the hip joints. Avoid positions that overload the hips like crossing your legs.
Be aware of joint overuse
Listen to warning signs like hip pain and fatigue to avoid overworking the joint during exercise or sports. Take frequent breaks and days off from impact activities to rest the hips.
Assistive devices
Braces, shoe orthotics, raised toilet seats, and other devices prescribed by your doctor or physical therapist can protect the hips from further damage.
Warning signs of hip replacement failure
While most total hip replacements last 15-20 years, complications can occasionally cause the artificial joint to fail prematurely. Contact your surgeon right away if you have:
– Sudden onset of severe hip pain with inability to bear weight
– Clicking, popping, or grinding noises from the hip
– Joint swelling and inflammation
– Abscesses or drainage from the surgical wound
– Fever or chills suggesting possible infection
– X-ray findings showing component fracture, loosening, or malposition
Depending on the cause of failure, revision surgery may be needed to remove and replace the damaged artificial hip components. Rehabilitation is longer after revision procedures. Your surgeon will discuss options to get you back on your feet again.
Outlook for worn out hips
The prognosis for severe hip arthritis depends on the underlying cause and your adherence to treatment:
– For gradual “wear and tear” osteoarthritis, nonsurgical management may help for years before joint replacement is needed.
– Inflammatory arthritis like rheumatoid arthritis has a worse prognosis leading to rapid destruction of the hip joints.
– Prognosis is good if hip impingement and dysplasia are treated early with joint preservation surgery before arthritis develops.
– Total hip replacement provides excellent relief of arthritis pain and restoration of hip function in over 90% of patients.
– With proper activity modification and weight control, hip replacements typically last 15-25 years.
– Close follow-up and therapy after surgery are vital to ensure full recovery and prevent complications.
In general, staying active while avoiding hip overuse, maintaining a healthy weight, and seeking prompt care for new hip pain offers the best odds of avoiding or delaying significant arthritis-related hip joint damage. Work closely with your medical providers to find the optimal treatment plan for your individual hip condition.
Conclusion
Worn out hip joints can greatly limit mobility and quality of life. Luckily, many effective treatment options are available to ease hip arthritis discomfort and improve function. Pay attention to changes in hip pain, stiffness, range of motion, gait, and everyday activities that may indicate joint degeneration. See your doctor promptly for an evaluation if you notice new hip symptoms arise. With appropriate lifestyle modifications, medication use, physical therapy, assistive devices, injections, or surgery if necessary, most people can successfully manage hip joint wear and tear as they age. Staying proactive with treatment helps ensure you can keep your hips healthy and active for years to come.