Psoriatic arthritis (PsA) may cause pain, swelling, and stiffness in your hips. Early diagnosis and treatment can help decrease disease progression and improve your mobility and quality of life.

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Psoriatic arthritis (PsA) is an inflammatory disease that causes pain, swelling, and stiffness in your joints. People with PsA most commonly develop psoriasis first, which is an autoimmune skin condition.

PsA commonly affects the small joints in your hands, feet, elbows, and wrists.

However, the condition may also affect the bigger joints, such as your hips. This could affect your mobility, making daily activities more challenging.

Early diagnosis and treatment are key to reducing inflammation, slowing disease progression, and preventing complications like permanent joint damage.

Keep reading to learn more about the symptoms, causes, and treatment options for PsA in the hips.

PsA may affect one or both of your hips and could cause the following symptoms:

  • stiffness that’s often worse in the morning
  • pain in the outer thigh, groin, or buttocks
  • difficulty walking
  • reduced mobility

You may also experience other symptoms that do not specifically target your hips, including:

  • scaly patches of skin
  • fatigue
  • eye redness, pain, or blurriness
  • vision changes
  • nail pitting, crumbling, or breakage
  • swollen toes or fingers (dactylitis)
  • pain in your heels (enthesitis)

PsA is an autoimmune condition that develops when your body mistakenly attacks healthy tissue, joints, and ligaments. This triggers inflammation, which can cause stiffness, pain, and tenderness.

Approximately up to 30% of people with psoriasis may develop PsA within 10 years after psoriasis begins.

It’s estimated that up to 15% of people living with PsA will develop hip pain. This may simply result from a high degree of inflammation in your joints. However, PsA is a type of spondyloarthritis. These arthritis conditions may cause inflammation and stiffness in the joints that connect your spine and pelvis, resulting in hip pain.

Diagnosing PsA-related hip pain may be challenging at first. This is because joint pain and swelling are caused by other types of arthritis and inflammatory conditions, including:

  • rheumatoid arthritis
  • osteoarthritis (OA)
  • ankylosing spondylitis
  • avascular necrosis, a complication of steroid use when treating lupus

That said, some key signs may differentiate PsA from other conditions. For example, hip PsA may cause pain around the buttocks, groin, and outer thigh, while hip OA primarily affects the groin and the front of the thigh.

Other causes of hip pain may include muscle strains, stress fractures, and hip dislocation.

Talk with a healthcare professional if you’re experiencing hip pain that affects your daily activities. They can help identify the underlying cause based on the following criteria:

  • your personal health history, including any infections or injuries
  • symptoms of psoriasis and PsA
  • a family history of psoriasis, PsA, or any other autoimmune conditions
  • imaging tests, such as ultrasounds or MRIs
  • blood tests to assess inflammation (like ESR and CRP)
  • blood tests to rule out other conditions

They may also refer you to a rheumatologist, a specialist trained in diagnosing and treating autoimmune diseases of the joints, bones, and muscles.

There’s currently no cure for PsA. However, treatments may relieve symptoms, decrease inflammation, and slow disease progression to help prevent further hip damage.

Medications

A healthcare professional may recommend over-the-counter (OTC) or prescription medications to help you manage your symptoms. These may include the following types of medications:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) help lower inflammation.
  • Disease-modifying antirheumatic drugs (DMARDs) help lower inflammation, slow disease progression, and prevent joint damage.
  • Biologics are a type of DMARD that helps reduce inflammation by targeting certain parts of your immune system. They’re typically self-injected, but they can also be administered intravenously.
  • Janus kinase (JAK) inhibitors are oral medications that interfere with inflammatory signaling pathways.
  • Oral PDE4 inhibitors like apremilast (Otezla) inhibit intracellular pathways in inflammation cells.
  • Immunosuppressants help slow down your immune system to reduce inflammation.
  • Steroids can be injected near the affected hip to help reduce inflammation.

Natural remedies

Some natural remedies and lifestyle habits may help relieve pain, decrease inflammation, and complement your medications. These may include:

  • stretching routines, including tai chi and light yoga
  • moderate intensity exercises, such as walking, biking, and swimming
  • eating an anti-inflammatory diet
  • heat or ice therapies
  • stopping smoking, if you smoke
  • trying acupuncture
  • maintaining a healthy weight
  • stress-relieving activities, such as breathing exercises
  • getting at least 7 hours of sleep every night

Physical therapy

The goal of physical therapy is to help you move better. With PsA in the hip, the focus is to help increase your range of motion so you can move more comfortably.

Each physical therapy program is tailored to the individual but can include the following:

  • guided exercises
  • stretches
  • orthotics, which are shoe inserts designed for you
  • assistive devices
  • heat and/or cold therapies

Surgery

Surgery may be an option for severe PsA in the hip that is not responding to other treatments.

A doctor may first recommend surgery to help preserve your joint, cartilage, and ligament health. This could help restore joint mobility.

In severe cases of joint damage, they may recommend hip arthroplasty, known as a hip replacement. Although this is considered a major surgery, it may help:

  • restore joint mobility
  • reduce pain
  • improve your quality of life

It’s important to discuss all options with a healthcare professional, as there may be side effects associated with surgery.

What does psoriatic arthritis in the hip feel like?

The Arthritis Foundation suggests that hip pain caused by PsA is typically felt in your buttocks, groin, and outer thigh. It could affect one or both sides.

What are the six signs of psoriatic arthritis?

Although there aren’t six specific early signs of PsA, some early signs of PsA may include:

  • stiffness in the morning
  • swollen fingers, toes, or joints
  • scaly patches of skin
  • vision troubles
  • nail changes, such as pitting or crumbling

What are the symptoms of a psoriatic arthritis flare-up?

A PsA flare-up is when your PsA symptoms worsen. This may include more swelling, stiffness, or pain in your joints, as well as feeling more tired.

PsA is an inflammatory condition that can cause swelling, stiffness, and pain. Sometimes, it can affect the joints and ligaments in your hips, resulting in pain.

Speak with a doctor if you’re experiencing hip pain, especially if it’s affecting your day-to-day activities. They can diagnose the underlying cause and help you develop a treatment plan. This is key for reducing any further joint damage and maintaining or improving mobility.