Rheumatoid arthritis can affect the hip joints in a similar way to other joints, causing stiffness, swelling, and pain.
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 joints in the:
RA can also affect the joints in the hips, causing severe discomfort and stiffness. This condition is characterized by inflammation, and hip pain is a classic symptom when the condition develops in the hip joint.
In this article, we’ll go over how RA affects the hips, its causes, symptoms, and more.
RA may initially occur in your smaller joints in a symmetrical pattern. 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, like 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.
Hip pain doesn’t always indicate rheumatoid arthritis. It may be from another kind of arthritis, like psoriatic arthritis, or from a pinched nerve, tight muscles around the hips and buttocks, or simple overuse.
When your hip pain is due to inflammation caused by RA, you may experience other symptoms as well.
Here are some of the signs of hip pain from RA:
- dull ache around the groin, buttocks, or thighs
- heat or warmth to the touch around the hips, buttocks, thighs, and groin
- pain or stiffness in the morning, which may reduce with movement or activity
- difficulty standing or walking due to pain in the hip joint
- limping, often after RA progression leads to further joint damage
As RA can affect your whole body, you may also experience generalized symptoms like:
RA can affect both hips, as the condition often creates symptoms in the same joint on both sides of the body.
RA is an autoimmune disease. Hip pain from RA results from an inflammation of the synovium, the tissue lining of a joint.
The synovium makes fluid to aid in joint mobility. Synovial cells also replicate in the joint space. This is known as synovial proliferation.
But with RA, this tissue swells and becomes painful. The bone and cartilage of the joint may eventually break down.
It’s the inflammatory action of RA that causes the main symptoms of hip pain. Less often, the wear and tear of the joints contribute to hip pain. When RA is in remission, degenerative joint damage can still cause hip pain.
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Other factors also increase the risk of developing RA, like
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 stages. There isn’t one single test to diagnose this condition. Even so, blood tests can check for autoantibodies and markers of inflammation.
Imaging studies are also used to detect inflammation and joint damage. Your doctor may order an X-ray, MRI, or ultrasound of the affected joints.
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, a period when symptoms disappear, and prevent joint damage. RA that is not in remission can lead to osteoarthritis (OA) or degenerative joint disease (DJD).
Your treatment will depend on the nature and severity of your symptoms.
A number of medications can be used to treat RA. These include:
- Anti-inflammatory medications: If symptoms are mild, over-the-counter (OTC) nonsteroidal anti-inflammatory medications (NSAIDs) can help manage inflammation and pain. These include ibuprofen (Advil) 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 another 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 targets 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, but 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 cycling, 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 doctors reporting satisfactory results in more than 80% of people 12 to 15 years after the procedure.
See a doctor for any unexplained hip pain or if you suspect arthritis in your hip.
Because RA is a progressive and chronic disease that can destroy the hip joint, early diagnosis and intervention are important. Unchecked RA can lead to joint destruction and cause joints to shift out of place.
If you receive an RA diagnosis, consider seeing your doctor frequently. Working closely with them can improve your quality of life.
A medical professional can help you understand your options to slow the progression of this disease and enjoy periods of remission. Those options might include lifestyle changes, medication, or surgery.
A treatment plan can help you maintain mobility and support your overall health. Your doctor can work with you to change treatments if your RA symptoms don’t improve. They’re your partner in managing the condition and finding solutions that reduce pain and inflammation and increase well-being.