Massage therapy · Kitchener–WaterlooInflammatory Arthritis of the Hip

Blood tests such as ESR and CRP can show inflammation in the body, but they do not diagnose inflammatory arthritis on their own. Doctors also use other blood tests (such as antibody tests), X-rays and an examination, and people with suspected inflammatory hip arthritis should be seen by a rheumatologist (a specialist in these conditions) (AAOS, n.d.).

People with inflammatory arthritis of the hip typically notice a dull, aching pain in the groin, outer thigh, knee or buttock, which is often worse in the morning or after sitting or resting and eases with activity (AAOS, n.d.). They may also notice pain when getting out of bed and when trying to put shoes and socks on, and the pain may cause a limp.

• Hip flexion and extension: moving the leg forwards and backwards
• Hip abduction and adduction: moving the leg out to the side and back in
• Rotation: turning the leg so the toes point outwards or inwards

1. Anti-Inflammatory Medication

The American Academy of Orthopaedic Surgeons says that non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, may relieve pain and help reduce inflammation in inflammatory arthritis of the hip (AAOS, n.d.). (This medicine information comes from the American Academy of Orthopaedic Surgeons, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Exercise

Swimming is a good exercise for people with ankylosing spondylitis (AAOS, n.d.). For people with PMR, walking is usually the most suitable exercise, because weight-bearing exercise helps to protect the bones while taking steroid tablets (Arthritis UK, n.d.).

3. Assistive Devices

A walking stick, walker, long-handled shoehorn or reacher may make everyday activities easier (AAOS, n.d.). I can help you set up a walking stick or walker and practise walking with it, and point you to an occupational therapist if you need more help with everyday tasks.

Options outside my scope

• Steroids: powerful anti-inflammatory medicines that can be taken as tablets or by injection (AAOS, n.d.). A steroid called prednisolone is the main treatment for PMR (NHS, 2023).
• Disease-modifying antirheumatic drugs (DMARDs): prescription medicines, such as methotrexate, that act on the immune system to help slow the disease (AAOS, n.d.). In PMR, a DMARD may sometimes be added to steroid treatment (Arthritis UK, n.d.).
• Biologics: newer prescription medicines that target specific parts of the immune system and can be very effective for some types of inflammatory arthritis (AAOS, n.d.).
• Surgery: if other treatments do not relieve your pain, options include total hip replacement, which is often recommended for people with rheumatoid arthritis or ankylosing spondylitis whose hip is badly damaged, and synovectomy (removal of the inflamed joint lining) in early disease (AAOS, n.d.).

How I can help (see the My Approach tab)

Ask for an urgent appointment with your family doctor or nurse practitioner if (NHS, 2026):

• You have severe pain and swelling in just one joint that started suddenly
• The skin around a joint is red or hot
• You have sore joints with a high temperature, or you feel hot, cold or shivery

Work on the buttock and hip muscles is only with your informed consent and a written consent form. After a hip replacement or synovectomy, I need your surgeon's okay before hands-on treatment; then gentle drainage for swelling, scar work once the wound has healed, and a gradual return to strength. With rheumatoid arthritis, I avoid moving the top of your neck. If pain lasts more than about an hour after a session or exercise, we scale back. I don't treat when you have a fever; see Ask for an urgent appointment and the giant cell arteritis warning.