Rheumatoid arthritis in the hip: Symptoms and management

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Rheumatoid arthritis (RA) is a chronic, progressive autoimmune disease that can affect the hip joint. It can cause pain, stiffness, and restricted movement in one or both hips. A person may experience hip pain on both sides of the body. In this article, we look at how RA affects the […]

Rheumatoid arthritis (RA) is a chronic, progressive autoimmune disease that can affect the hip joint. It can cause pain, stiffness, and restricted movement in one or both hips.

A person may experience hip pain on both sides of the body.

In this article, we look at how RA affects the hip. We also discuss its causes and symptoms and outline treatment options for managing the condition.

RA is a type of inflammatory arthritis, which occurs when an overactive immune system attacks healthy tissue in the body.

The hip joint consists of a ball and socket. The acetabulum, which is part of the pelvis bone, forms the socket. The femoral head, which is the top part of the thighbone, forms the ball.

A tissue called articular cartilage covers the surfaces of the ball and socket. This cartilage provides a smooth, slippery surface to allow the bones to move easily.

The hip joint also has a thin, protective covering called synovium. The synovium releases a lubricating fluid that allows better movement.

In people with RA, the synovium does not function properly. It becomes thicker and swollen and produces substances that attack the articular cartilage surrounding the hip joint.

RA usually affects smaller joints in the body to start with, such as in the hands and feet. As the condition progresses, it can spread to one or both hips.

According to the American Academy of Orthopaedic Surgeons (AAOS), people may experience RA symptoms in both hips. This is because RA typically affects the same joint on both sides of the body.

Symptoms of RA in the hip include:

  • pain, stiffness, or swelling in one or both hips
  • pain that may feel worse in the morning or after periods of resting or sitting
  • pain that may lessen with movement and increase with vigorous physical activity
  • severe joint pain that causes limping or makes walking difficult

Symptoms of RA may come and go. The Arthritis Foundation (AF) notes that joint pain or stiffness that lasts for 6 weeks or more and joint stiffness in the morning that lasts for 30 minutes or more may be a sign of RA.

Can RA in the hip affect other areas?

RA can also affect other areas of the body. People may experience dull, aching pain in the:

  • groin
  • buttocks
  • outer thigh
  • knee

People can also experience more general symptoms, including:

Vs. osteoarthritis in the hip

Osteoarthritis (OA) is another type of arthritis that can develop in the hip.

OA is the most common type of arthritis and occurs when the cartilage around the hip wears down. This causes the bones to rub together, creating uncomfortable symptoms and restricted movement.

OA leads to pain and stiffness in the hip and can cause difficulty walking. Other symptoms of OA that differ from those of RA include:

  • pain that may only occur in one hip rather than both
  • pain that usually occurs in the groin area and front of the thighs
  • grinding noise and locking, or sticking sensation when moving the hip

Experts are currently still unsure why the body attacks healthy tissue and causes RA.

Researchers believe genetic factors could play a role in the development of RA. People with the condition may have genes that respond to environmental triggers, such as viruses, bacteria, or stress.

The AF notes that a person is more likely to develop RA if they have a family member with the condition. It also seems to affect females more often. However, there is no known reason for this.

People can discuss a treatment plan with a healthcare professional. A combination of treatments may be the most effective at managing RA symptoms.

Medication

Medication may help manage pain and reduce inflammation in the body.

A doctor may recommend:

  • nonsteroidal anti-inflammatory drugs to relieve pain and reduce inflammation
  • topical, oral, or injection corticosteroids, such as prednisone, to reduce inflammation
  • synthetic disease-modifying antirheumatic drugs (DMARDs), such as methotrexate and sulfasalazine, which target the immune system to slow RA progression
  • biologic DMARDs, which are also available in a self-injectable form

Surgery

If RA does not respond to other treatments, people may require surgery. There are two main types of surgery for treating RA of the hip:

Total hip replacement

During total hip replacement, a surgeon will remove the damaged cartilage and bone of the hip joint. They will then use a metal or plastic joint to replace the ball-and-socket joint.

Total hip replacement surgery can help alleviate pain and increase the range of motion of the hip joint.

Synovectomy

Synovectomy involves removing all or part of the synovium. The procedure may be suitable for people with RA that has only damaged the joint lining, rather than progressed to the cartilage and bone.

Physical therapy may help increase freedom of movement and the range of motion in the hips.

Specific exercises may also help strengthen the muscles surrounding the hip, which in turn supports the hip joint.

Learn more about exercises for RA pain here.

Alternative treatment options include:

Acupuncture

People may want to try acupuncture or acupressure to address their RA symptoms.

Acupuncture involves inserting small needles into specific points of the body to relieve pain.

Acupressure is a similar technique, but it uses firm pressure rather than needles to target specific points in the body.

Massage and relaxation techniques

People may find that massage helps relax muscles and reduce pain, stress, and anxiety.

Relaxation techniques, such as deep breathing and meditation, may help relax the body and lower stress.

People can also take time to do activities they enjoy to relieve stress and support emotional well-being.

Supplements

Certain supplements — such as omega-3 and curcumin, which is a compound present in turmeric — may help relieve pain and morning stiffness.

People should consult a healthcare professional to check whether it is safe for them to take a supplement.

Herbal medicine

Some traditional Chinese medicine (TCM) herbal remedies may help slow the progression of RA:

  • Guizhi-Shaoyao-Zhimu decoction (GSZD): A 2016 article notes that GSZD consists of nine herbs and may have antirheumatic effects. It can help stop inflammatory responses that result from RA. However, the researchers state that more studies are necessary to determine the efficacy of GSZD on RA, as there were limitations to their research.
  • Wu-Tou decoction: According to a 2017 in vivo evaluation, Wu-Tou decoctions helped reduce inflammatory responses in rats.
  • Tripterygium wilfordil Hook F (TwHF): Authors of a 2018 study found that TwHF was as effective as the DMARD methotrexate. However, the study was small, consisting of only 109 participants in the 2-year follow-up.

It is important to note that research into herbal medicine is limited. Moreover, the National Center for Complementary and Integrative Health states that high quality studies on TCM herbal products are lacking.

It also states that a person should consult a healthcare professional before using any TCM remedy, especially if they:

  • have a health condition
  • are pregnant
  • are nursing

The following home remedies may help people manage RA symptoms and relieve pain:

  • A balanced diet: Eating a balanced, nutritious diet can aid in maintaining overall health, well-being, and a moderate weight.
  • Regular movement: Daily movement may help reduce stiffness from periods of rest. People may want to choose walking places instead of using public transport wherever possible or taking the stairs instead of an elevator.
  • Moderate exercise: Low-impact exercise, such as swimming, may help increase endurance and reduce stiffness.
  • Rest: It is important to balance activity with rest, especially during RA flare-ups. People should aim for regular breaks throughout the day, which can help with inflammation, protect the joints, and increase energy.
  • Hot and cold treatments: Heated compresses or warm baths can help ease stiff, aching, or tired joints and muscles. Cold compresses can help numb the affected area and decrease inflammation to reduce more severe pain and swelling.
  • Assistive devices: People may find using a cane or walker or tools such as a long-handled shoehorn helps them carry out their usual day-to-day activities.
  • Support network: Having family, friends, or co-workers as a support network can help with emotional well-being.

Doctors may use the following to diagnose RA:

Symptoms of RA may affect areas of the body other than the hips and legs.

Other symptoms in the body can include:

  • inflammation, redness, pain, or dryness in the eyes
  • sensitivity to light
  • vision problems
  • dry mouth
  • irritation, infection, or inflammation of the gums
  • small bumps under the skin in bony parts of the body
  • shortness of breath, which can be due to inflammation and scarring of the lungs

RA can also cause inflammation of the heart and blood vessels, which can damage the heart muscle, nerves, and organs. People with RA may also have a low red blood cell count.

People can speak with a doctor if they have unexplained hip pain or any other symptoms of RA. An early and accurate diagnosis can help in providing effective treatment for the condition.

A doctor may refer people to a rheumatologist, who is a doctor specializing in inflammatory conditions developing in the joints, tendons, ligaments, bones, and muscles.

RA causes inflammation of the hip joint. It can result in pain, stiffness, and difficulty with movement.

A combination of treatment options, including medication, home remedies, and alternative treatments, may help manage symptoms and relieve pain.

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