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HEALTH MATTERS 5/20: Managing Hip and Knee Osteoarthritis

By Brian Culp, MD

More than 32.5 million adults in the United States have osteoarthritis, according to the Centers for Disease Control and Prevention.

And while osteoarthritis can affect any joint in your body, it is especially common in your knees and hips, which can make it hard to enjoy normal daily activities.

Proper management, however, can help ease the pain and discomfort.

If osteoarthritis is keeping you from doing the things you love, talk with your doctor. Treatment options range from lifestyle changes, physical therapy, and medication to minimally invasive joint replacement surgery.

Understanding Osteoarthritis

Osteoarthritis is a degenerative joint disease that is the result of wear and tear on your joints as you age.

With osteoarthritis, the cartilage that cushions and protects the ends of your bones and enables them to glide easily without any pain, begins to break down.

In addition, changes in the bone and connective tissues that hold the joint together and attach the muscles to the bone may also start to occur.

As the disease progresses, it can lead to debilitating pain and inflammation.

Osteoarthritis typically affects people who are middle-aged or older, and the risk increases with age. Other risk factors include previous injury to the joint, obesity, family history of osteoarthritis, and gender (women are more at risk than men).

Recognizing the Symptoms

In general, symptoms of osteoarthritis include pain, stiffness, decreased range of motion, and swelling.

More specifically, osteoarthritis in the hip or knee may cause:

• Pain in your groin or thigh that radiates to your buttocks or your knee (with hip osteoarthritis).
• Weakness or buckling of the knee (with knee osteoarthritis).
• Locking or sticking of the joint during movement or creaking, clicking, snapping, or grinding noises.
• Pain that flares up with vigorous activity.
• Stiffness that makes it difficult to walk or bend.
• Decreased range of motion that affects the ability to walk and may cause a limp.
• Pain that is worse in the morning or after sitting or resting for a while.

Symptoms of osteoarthritis can range from mild to severe. Typically, symptoms develop gradually over time, but sudden onset is possible.

If you are experiencing signs of osteoarthritis, make an appointment to see your doctor. Osteoarthritis is typically diagnosed through a review of symptoms, physical exam, imaging tests, and bloodwork.

Treating and Managing

There is no cure for osteoarthritis, but there are a variety of approaches to treat and manage its symptoms depending on their severity.

For mild to moderate pain and discomfort, treatment may include:

• Exercise. Though it may seem counterintuitive, moving and exercising your joints can help relieve osteoarthritis pain. Low-impact exercise, such as swimming and cycling, is often recommended for people with osteoarthritis. Additionally, exercises that strengthen the muscles that support the joints can help ease the stress on them and stretching can improve movement and range of motion.

• Weight loss. Excess weight puts additional force on your hips and knees. As the Arthritis Foundation notes, a key study published in Arthritis & Rheumatism found that losing one pound of weight resulted in four pounds of pressure being removed from the knees. That means losing just 10 pounds if you are overweight would relieve 40 pounds of pressure from your knees.

• Physical therapy and assistive devices. Physical therapists can help develop an exercise plan specific to your individual needs and can also provide education and instruction to make movement easier. They can also recommend assistive devices such as braces and shoe inserts to help ease symptoms.

• Medication. There are several medications, including over-the-counter pain-relievers, that can help treat pain associated with osteoarthritis. Corticosteroids, taken by mouth or injected into the affected joint can help reduce inflammation and discomfort.

For pain that does not respond to lifestyle changes and conservative treatment, surgery to repair or replace the joint may be recommended to restore mobility and relieve pain.

The Jim Craigie Center for Joint Replacement at Penn Medicine Princeton Medical Center offers a comprehensive approach to joint replacement surgery for hips and knees, including minimally invasive outpatient procedures for patients who meet certain criteria.


In addition to seeking treatment for osteoarthritis pain, there are other steps you can take to slow down the progression of the disease and prevent pain. The Arthritis Foundation offers these self-care tips:

• Maintain a healthy weight. Excess weight worsens osteoarthritis. Combine healthy eating with regular exercise to maintain a healthy weight.

• Control blood sugar. Many people with osteoarthritis also have diabetes. Having high glucose levels can make cartilage stiffer and more likely to break down. Having diabetes causes inflammation, which also weakens cartilage.

• Protect your joints. Make sure to warm up and cool down when exercising. If you play sports, protect joints with the correct gear. Use your largest, strongest joints for lifting, pushing, pulling, and carrying. Watch your step to prevent falls. Balance rest and activity throughout the day.

• Maintain range of motion. Make a habit of putting your joints through a full range of motion, but don’t overdo it and stop if it causes more pain. Gentle stretching, raising and lowering legs from a standing or seated position, daily walks, and hobbies such as gardening can help.

Hip and knee arthritis can be a real pain, but it doesn’t have to stop you from doing the things you love. With the appropriate medical treatment and self-care, you can manage your symptoms and reclaim your life.

For more information about or find an orthopaedic surgeon affiliated with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.

Brian Culp, MD, is board certified orthopaedic surgery and orthopaedic sports medicine. He is the director of the Jim Craigie Center for Joint Replacement at Penn Medicine Princeton Medical Center. 

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