Navigating the management of hip osteoarthritis presents a significant hurdle in today’s healthcare landscape. With the public hospital system’s waiting list extending to over five years, the urgency of this issue becomes all the more apparent. Our patients are grappling with this arduous wait, and, as healthcare professionals, we should explore every avenue to optimise their pain relief management and improve their functionality.
Currently, a multitude of non-operative pain management strategies are marketed directly to patients. However, when working with chronic pain patients, it is crucial to ensure they are well-informed and protected from ineffective treatments, which could unnecessarily drain their resources.
To assist in this endeavour, this page summarises the currently available treatment options. This is collated through current evidence analysis from the American Academy of Orthopaedic Surgeons.
Strong Recommendations
Educating the Patient
The cornerstone of effective arthritis management is patient education. By providing information about the nature of their condition, patients can gain realistic expectations, aiding in their treatment journey. This educational process is optimally undertaken by a multidisciplinary team comprising general practitioners, physiotherapists, and specialist consultants.
Oral Analgesics and Anti-Inflammatories
Oral medications, such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), are highly effective in managing both arthritis and associated pain. These medications, considered the first-line treatment, act by reducing inflammation and providing symptomatic relief.
Topical NSAIDs: The Role of Voltaren Emulgel
Topical NSAIDs, such as Voltaren Emulgel, provide an under-utilised yet efficient treatment strategy. They enable targeted treatment application directly onto inflamed joints, offering localised relief with minimal systemic side effects.
The Importance of Supervised Exercise Programs
Engaging in a supervised exercise program under the guidance of a physiotherapist plays a pivotal role in managing arthritis. It enhances joint mobility, muscle strength, and improves proprioception, thereby reducing joint force and associated pain. For instance, the GLA:D (Good life arthritis: Denmark) program has demonstrated exemplary success in treating arthritis, providing a robust model for similar initiatives.
Moderate Recommendation
Assistive Walking Devices
Utilising uncomplicated walking aids, such as canes, walking sticks, and off-loading braces, can be beneficial and effective. We recommend referrals to professional services, such as physiotherapy or orthotics, for the provision of such aids. Nonetheless, it’s important to note that off-loading braces may be onerous to use, resulting in inconsistent compliance.
Weight Reduction and Dietary Changes
Previously, the American Academy highly recommended weight loss in this field; however, this advice has recently been updated to a moderate recommendation. While the benefits of weight reduction and its maintenance are well-acknowledged, we must consider the challenge it presents for many patients. Understanding this difficulty is paramount when exploring this option.
Administration of an Intra-Articular Corticosteroid Injection
This tactic serves as a readily available and successful method for temporary alleviation of discomfort. However, it’s essential to consider that the relief it offers is ephemeral and carries with it the associated risk of introducing bacteria into the existing joint.
Limited Evidence
- Oral and Dietary Supplements
- Massage
- Acupuncture
- Transcutaneous Nerve Stimulation/Ablation
- Genicular Artery Embolisation
- Platelet Rich Plasma Injection
Advise Against
Opioid Medication Use
Studies have now shown that opioid medications are less effective and create dependence. Thus, the use of opioids is not recommended for the treatment of osteoarthritis.
Hyaluronic Acid Injection
Currently, there is insufficient evidence to advocate for the routine utilisation of hyaluronic acid injections in treating hip osteoarthritis. Studies indicate injectables may offer minor temporary pain relief in the early stages of osteoarthritis. However, this space needs ongoing review as injectable solutions and combinations are an active area of research aimed at addressing hip osteoarthritis symptoms.
Dr Yas Edirisinghe
Dr Yas Edirisinghe is open to offering his expertise in managing hip arthritis and can guide you through surgical and non-surgical options suitable to your patient’s unique situation. For questions concerning arthritis care, please contact the practice to submit your inquiries. Dr Edirisinghe remains dedicated to supporting health providers as they care for patients experiencing any stage of hip and knee arthritis, steering their course of treatment.
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