Health – Is your hip joint wearing out?

It is time that this myth gets debunked – I all too often see people who think that they have a worn out hip joint when they still have thousands of kilometres left in them, and sometimes no joint problems at all. Pain in the perceived area of the hip is commonly mistaken for a dodgy joint when it may actually be completely unrelated, even when the best advice from your neighbour says otherwise!

The most common assumption is that a worn hip joint is most painful on the outside aspect of the hip (i.e., at the outside of the top of the leg). This area is seldom, in fact, where you will feel pain if the hip joint is worn out. The most common area to have pain when a hip joint is worn out is from the groin to the knee.

For successful diagnosis, there is no substitute for sound investigation. This includes:
• X-ray/MRI or similar imaging.
• Relevant and concise history of the problem. This is the least ‘impressive’ of the investigations but is frequently the most critical when the right questions are answered accurately.
• Full joint examination to ascertain how well the joint moves, ideally compared to the other hip. Assuming the other is OK, this gives a good comparison.
• Full muscle examination to see how much the muscle is affecting movement and pain. Many muscles ‘mimic’ deep joint pain and can readily confuse the sufferer.
• Assessment of neighbouring areas (especially the lower back, but even the leg) that may be referring pain into the hip region.
• Appropriate treatment. Often successful treatment will eliminate the symptoms that were unfairly labelled as from a worn out joint. Obviously, if the symptoms disappear indefinitely it eliminates the worn joint diagnosis as the main cause of the pain.

All of these features need to be correlated so that we get a clear picture about what is going on. On their own they may well lead to a misdiagnosis. While X-ray is critical it can be misleading if not considered with all other factors. Even if a joint has wear and tear that is evident on X-ray, it may not be the source of the pain.

Many cases that I have seen where the pain is centred around the outside of the hip have been referred from the lower back. This is not an uncommon finding among health professionals. Richard Moon (local Osteopath at Warkworth Natural Therapies) and I have frequently shared cases that display the pain ‘in the hip’ actually coming from the lower back.

I have seen too many hips destined for the chopping block that were made pain-free by addressing some rather simple factors. But when a joint is well worn out and clearly the cause of the problems, then a new joint can give the sufferer a whole new lease of life.