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Physical Therapists Offer Help for Hip Osteoarthritis

Exercise has been shown to reduce pain and improve function for patients with hip osteoarthritis (OA). But the effects don't last if the patient stops exercising. Many patients end up with a total hip replacement (THR).

In this study, physical therapists look at the effect of mobilization and manipulation of the hip combined with exercise. Manual physical therapy (MPT) plus exercise has been studied with OA in general. This study is different because it focuses on just the hip.

Seven patients ages 52 to 80 years with hip pain or a diagnosis of hip OA were included. Range of motion (ROM), strength, and function were measured before and after treatment.

All patients had limited hip flexion and internal rotation. Weakness of the muscles that externally rotate and abduct (move the leg away from the body) was reported. Younger patients had problems with bike riding, golfing, driving, and skiing. Older patients were unable to garden and had trouble with stairs and daily activities.

Treatment included thrust or nonthrust MPT based on the therapist's exam of each patient. Description of these techniques is given in this study. A program of home exercises was given to improve strength and flexibility.

All seven patients showed changes in hip ROM, pain, and function. Results were maintained six months later. Patients were able to return to their favorite activities.

The authors conclude physical therapy may be able to help patients with hip OA avoid having a THR. The cost savings is upwards of $30,000. More studies are needed to find out which MPT methods work best for patients with hip pain.

References: Cameron W. MacDonald, PT, DPT, GCS, OCS, FAAOMPT, et al. Clinical Outcomes Following Manual Physical Therapy and Exercise for Hip Osteoarthritis: A Case Series. In Journal of Orthopaedic & Sports Physical Therapy. August 2006. Vol. 36. No. 8. Pp. 588-599.

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