Osteoarthritis - wear and tear of the hip
Osteoarthritis of the hip is a common condition which presents with pain in the groin and/or buttock. It can spread down the leg towards the knee. It usually begins with pain after long walks but tends to progress. Early treatment options include analgesia (painkillers) and therapy if stiffness is a major issue. As the joint damage worsens, it tends to reduce the ability to walk all but short distances and the analgesia becomes ineffective. This can lead to the patient being kept awake at night with often a dramatic effect on quality of life. It is at this point that joint replacement is likely to be the only option available to provide long term pain relief. If there are contraindications to surgery or reasons to delay it, Mr. Miles can refer you for an injection of the hip. He uses very long acting steroid and the injection is performed under X-ray to ensure it reaches exactly the right place.
Secondary arthritis - wear and tear brought on by another problem
Secondary arthritis is a very similar process to osteoarthritis, in that it is a result of wearing out of the cartilage in the hip. The difference is that it has been caused by, or at least contributed to, by other factors. These are often problems that lead to a change in the shape of the hip or the bones nearby. This can be problems from a very early stage (see childhood abnormalities), following trauma to the hip or because of a loss of blood supply to the head of the femur (see avascular necrosis).
Rheumatoid arthritis - inflammatory hip disease
Rheumatoid arthritis is a condition that can affect many joints of the body as well as other tissues. It is an inflammatory process - the tissues of the joints become inflammed and may fill with liquid. It is often accompanied by a change in shape of the joints and can change the shape of entire areas, typically the hands for example. Its effect on the hip are pain, stiffness and instability. It is possible to try to change the way the disease is affecting your joints by medications. These are usually prescribed by rheumatology doctors and Mr. Miles works closely with several rheumatologists who may be able to help you. Surgical options are also available and can be considered. They are often more challenging cases than osteoarthritis and may best be done by a hip and knee specialist.