Hip and knee osteoarthritis

You’ve probably heard of osteoarthritis. It’s a condition that can make our joints painful, especially as we grow older. It usually starts affecting us from our late 40s onwards, but so far we don’t know why age is a factor.

Our knees and hips are some of the joints most often affected by OA. (However you can develop OA in your hands, neck, lower spine, big toes and hands too.)

Osteoarthritis mainly affects the cartilage that makes up a vital part of our joints. However, it also affects the area of bone that the cartilage covers.

What is osteoarthritis?

What causes osteoarthritis?

OA tends to particularly affect joints that have been injured in the past  –through an accident, for instance - or through quite physical work, or playing sport.

You may be more likely to develop OA if you are overweight. Your hip and knee joints are likely to be particularly affected if this is the case. This is because being overweight means that these joints are put under considerable strain.

Lifestyle changes for osteoarthritis

You may also be more prone to OA if someone else in your family has had this condition.

OA usually happens in joints that have become worn and damaged. Your body reacts to that damage in a number of ways.

The cartilage that usually provides a good protective covering to the ends of your bones can become thinner. The bone underneath the cartilage can grow thicker, which can mean that the joint as whole may seem bigger.

Other parts of the joint react to the damage as well. Bony spurs may develop on the bones that are at the edges of your joints, and make the joint swollen. These spurs are known as osteophytes.

What are the symptoms of osteoarthritis?

According to Arthritis Research UK, the effect osteoarthritis has on most people is relatively mild. However, in people over 65, around one in 10 people can be quite seriously affected, to the point where OA can cause a serious disability. In these cases the main areas affected are usually the knees and hips.

Hip and knee joints that have been damaged by OA may feel stiff if you’ve been still for a while. You may also feel that you can’t move as much as you used to, because your joints don’t seem as flexible. The joints affected by OA can also swell up. This is because they produce extra fluid, which can’t easily drain away.

Hip osteoarthritis

Symptoms of hip OA

You may not feel all of the symptoms mentioned here, and you may not feel the same symptoms all the time, as they can appear sporadically.

Some of the symptoms you are likely to have can include feeling tender around the affected joint, and pain, especially when moving.

The pain may also become worse towards the end of the day. The amount of pain you feel can vary with the temperature. Colder and damper weather tends to make the pain worse, while your hips may feel less painful in warmer weather.

If you have OA in your hips, it’s fairly common to have pain that spreads over a fairly large area. This can include your groin, the front and side of the affected thigh, and in the area of your buttocks. The pain can also spread down to your knee. This is known as radiated pain.

Find out more about hip pain

Treatment for hip OA

If one or both your hips are so affected by OA that you are in considerable pain, your doctor may suggest that you have a hip replacement. This will involve an operation to remove your damaged hip joint, and replace it with an artificial joint.

Hip replacement operations have become increasingly common, and most people recover well. According to Arthritis Research UK, most people are able to leave hospital within four to eight days of their operation.

Physiotherapy and occupational therapy will be part of your recovery process, following the operation, and when you are at home. You’ll also have at least one follow-up appointment, to check that everything is going well.

Get more information on hip replacement operations

Read a diary of a hip replacement

Knee osteoarthritis

We put our knees though a lot. Walking up and down stairs, bending, twisting, and putting extra pressure on them when we stop suddenly, can take its toll. So it’s not surprising that they sometimes show the strain.

Symptoms of knee OA

Osteoarthritis in the knees can cause you pain at the sides and front of your knees. These are the areas where your knee is likely to have the most damage, with the possibility of osteophytes (bony growths) developing at either side of the joint, and very little cartilage remaining between the upper and lower bones in your knee joints.

Other symptoms can include your knee joints swelling and appearing bigger than they used to. This can happen when the joint capsule (the outer part of the tissue surrounding the knee joint) becomes thicker, and produces more fluid than usual.

Find out more about knee pain

Knee replacement surgery

If your knee is so affected by OA that it is constantly painful, and is affecting your ability to have a normal life, your doctor may suggest knee replacement surgery. This operation is usually carried out on older people, from their 60s to 80s. This is because the replacement joint tends to last longer than it does in younger people. 

There are two levels of knee replacement. Total knee replacement (TKR) involves replacing both sides of the knee joint. If only one side of a damaged knee joint is affected, your doctor may suggest a partial (half) knee replacement (PKR). As this suggests, in this operation only one side of your knee joint is replaced. An advantage with this type of operation is that you may spend less time in hospital, and recover more quickly.

What you need to know about knee replacement surgery

Knee replacement recovery tips

Painkillers

If you have mild pain as a result of OA in your hips or knees, rather than an operation, your doctor may suggest painkillers. These are likely to include  paracetamol or ibuprofen, an anti-inflammatory painkiller.

You can take both of these as tablets, and you can have ibuprofen and some other anti-inflammatory drugs in gel form. This means that you can rub the gel onto the skin covering the painful part of your hip. Check with your doctor to be sure that this is suitable for you.

If these painkillers aren’t effective talk to your GP about the pros and cons of taking stronger painkillers. Bear in mind that stronger drugs may also have stronger side-effects.

Know your painkillers

Physiotherapy for hip and knee osteoarthritis

Physiotherapists are part of the group of health experts that you’re likely to see if you have osteoarthritis. They will offer advice and guidance to help you manage painful joints. This can help if you are recovering from a hip or knee replacement operation, or learning to cope with osteoarthritis in your hips or knees.

Physiotherapists will give you advice on the right type of exercises for you, and how to gently increase the amount of activity you carry out each day.

They will guide you through exercises that will help improve the strength of your muscles around the affected joint(s). Making the muscles around your hip and knees stronger will help to reduce the amount of pain you’re feeling. It will also help you to be more mobile.

How a physiotherapist can help

Occupational therapy

Occupational therapists also have a very hands-on approach to helping you cope with OA. They can give you advice on aids to help you both at home, and when you are out and about.

These can include an extra rail at hand-height in your stairway, so that you can hold on at both sides, and gadgets in the kitchen to help you lift a kettle or a saucepan full of boiled water.

Occupational therapists can also help you with exercises to build up your strength. And they can give advice on planning your day so that you have time to rest between tasks or trips out.

Read more about expert help for osteoarthritis

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