Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes severe pain, stiffness, and swelling in the lining of the joints. This condition occurs when the immune system mistakenly attacks healthy joints in your body.
RA can affect different parts of the body, including the joints in the hands, feet, knees, and shoulders. It can also affect the joints in the hips, causing severe discomfort and stiffness.
Because rheumatoid arthritis is characterized by inflammation, hip pain is a classic symptom when the condition develops in the hip joint.
RA may initially occur in your smaller joints. Since there’s no cure, the disease can advance to other parts of your body. When diagnosed with RA, hip involvement typically happens later in life.
Hip pain may start off as mild and intermittent. You may only feel discomfort with certain activities, such as weight-bearing exercises. This includes:
- weight training
- climbing stairs
- playing tennis
Pain while completing these activities may come and go at first. But as the disease progresses and damages your hip joint, pain can become more regular or constant. Discomfort may continue while at rest or sleeping.
These parts of the body may also be tender to the touch or feel warm.
The hip is a larger joint, so developing RA in this part of the body can affect mobility.
You may have pain or stiffness in the morning, which can make it difficult to move around. In some people, however, morning stiffness improves with movement or activity.
Pain in the hip joint can also make it difficult to stand or walk. As inflammation continues to damage the joints in your hip, you may also develop a limp.
If you suspect RA in the hip, medical tests can help confirm or rule out this condition. The doctor will conduct a physical examination and ask questions about your symptoms, medical history, and family history.
A physical examination helps your doctor assess your pain level and joint mobility. Knowing your family history is also helpful because genetics may play a role in this disease. Your risk for RA increases if a family member has the condition.
RA can be difficult to diagnose because it can mimic other diseases like lupus and fibromyalgia, in the early stage. There isn’t one single test to diagnose this condition. Even so, blood tests can check for autoantibodies and for markers of inflammation.
Imaging tests are also used to detect inflammation and joint damage. Your doctor may order an X-ray, MRI, or ultrasound.
There’s no cure for rheumatoid arthritis, but treatment is available to reduce inflammation and stop the progression of the disease.
The goal of treatment is to help you achieve remission, which is a period when symptoms disappear. Your treatment will depend on the severity of your symptoms.
A number of medications can be used to treat RA. Those include:
- OTC pain relievers. If symptoms are mild, over-the-counter nonsteroidal anti-inflammatory medications can help manage inflammation and pain. These include ibuprofen (Motrin) and naproxen sodium (Aleve).
- Corticosteroids. These are very effective at reducing pain and inflammation. Steroids are available orally, or your doctor can administer a steroid injection in your hip. Your doctor may prescribe a corticosteroid for a brief period for severe flares, or as a bridge until other medication is effective. They’re not recommended as a long-term treatment due to side effects.
- DMARDs. Disease-modifying anti-rheumatic drugs (DMARDs) decrease inflammation and stop the progression of rheumatoid arthritis. Options include, methotrexate (Trexall), leflunomide (Arava), tofacitinib (Xeljanz), or hydroxychloroquine (Plaquenil).
- Biologics. If the above therapies aren’t effective, your doctor may recommend a biologic, or targeted therapy. This newer class of anti-rheumatic drugs works by targeting specific parts of the immune system that trigger an inflammatory response. Biologics can be used alone or combined with other DMARDs.
Therapy and home remedies may also provide some relief from joint pain, although these remedies don’t stop the progression of the disease.
Exercise and home remedies
If RA in the hip limits mobility, working with a physical therapist or an occupational therapist can help improve joint flexibility and walking. You’ll learn specific exercises to strengthen your hip joint. A few strategies include:
- Low-impact exercises. This may help to reduce inflammation and ease hip pain. Try gentle workouts, including walking, swimming, or water aerobics.
- Heat and cold therapy. Use heat to reduce stiffness in the joints and cold to alleviate pain.
- Meditation, deep breathing exercises, and relaxation. These can all help lessen stress. Chronic stress stimulates your body to produce more mediators of inflammation throughout your body.
In the case of severe joint pain and damage, your doctor may recommend a surgical procedure to reduce pain and improve your quality of life. Surgery can replace the hip joint.
Depending on the severity of pain or joint destruction, you might be a candidate for a hip joint replacement. This procedure can also relieve pain and restore range of motion. Your doctor may perform this surgery if it could improve mobility and quality of life.
This surgery removes parts of your damaged hip joint and replaces it with a metal or plastic prosthesis.
Hip replacement surgery has a high success rate, with more than 80 percent of people reporting satisfactory results up to 15 years after their procedure.
Because RA is a progressive and chronic disease that can destroy the hip joint, see a doctor for any unexplained hip pain, or if you suspect arthritis in your hip.
You should also see your doctor for RA in the hip that doesn’t improve with treatment, or worsens. This may indicate that your current therapy isn’t working. It’s important to control inflammation because unchecked RA can lead to join destruction, and cause joints to shift out of place.
There’s no cure for RA in the hip, but working closely with your doctor can improve your quality of life. Between medication, lifestyle changes, and in severe cases, surgery, it’s possible to slow the progression of this disease and enjoy periods of remission.