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Rheumatoid Arthritis and Your Hips

Cheryl Lathrop

Last updated: October 20, 2016 7:33 pm

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Did you experience complications after a hip replacement?

OA? Osteoarthritis. RA? Rheumatoid arthritis. JA? Juvenile arthritis. They’re all arthritis— the umbrella term we use to describe our painful joints. They hurt. And they limit your movement and mobility. And no, it isn’t just Grandma and Grandpa that suffer. Two-thirds of people with arthritis are under the age of 65, including 300,000 children. 1

The Arthritis Foundation defines the 3 types of arthritis as:1

  • Osteoarthritis (OA) is the most common form of arthritis. It’s a progressive degenerative joint disease characterized by the breakdown of joint cartilage associated with risk factors, such as overweight/obesity, history of joint injury, and age. The mechanical wearing down of cartilage causes your bones to rub against each other, which causes pain and inflammation. OA does not involve the immune system.
  • Rheumatoid Arthritis (RA) is an autoimmune disease. This means the body’s own immune system attacks its joints. This causes inflammation of the membranes lining the joint, which in turn causes pain, stiffness, warmth, swelling, and sometimes severe joint damage. RA tends to run in families.
  • Juvenile Arthritis (JA) is an umbrella term that describes the many autoimmune and inflammatory conditions that can develop in children ages 16 and younger.

Many of the basic symptoms of RA and OA are the same:

  • painful, stiff joints
  • limited range of motion (movement)
  • warmth or tenderness in the affected area
  • more symptoms first thing in the morning

Distinguishing Between Osteoarthritis and Rheumatoid Arthritis

But OA and RA are different. OA sufferers don’t have whole-body symptoms; it is limited to just the joints. RA affects the entire body, not just the joints. Early signs of RA can include low-grade fever, muscle aches, and fatigue. Later stages of RA may include hard lumps beneath the skin near the joints called rheumatoid nodules. These can be painful and affect normal movement. RA is a symmetrical disease—meaning you’ll have symptoms on both sides of your body at the same time.

RA begins in the smaller joints of the body—likely pain, stiffness, and tenderness in the finger joints. As it progresses, symptoms can develop in the larger joints such as the hips, shoulders, and ankles. The primary treatment goal for RA is to reduce pain and inflammation, and to minimize damage to the joints. Anti-inflammatory and corticosteroid medications are generally effective. Disease-modifying drugs (DMARDs, SMARDs, biologics) are also prescribed to stop the immune system from attacking the joints.

Treatment may help relieve symptoms and control the disease, but there is no cure. If a joint is severely damaged or deformed and causing extreme pain, and not responding to medicine or physical therapy, joint replacement surgery may be considered. For severe hip RA, a hip replacement (hip arthroplasty) may be the best treatment. This surgery can relieve disabling pain and restore enough motion to allow you to do your daily activities. Many people have good results lasting 20 or more years; and for most patients, joint replacement surgery will be a lifelong solution for arthritis of the hip. 2

However, others have experienced complications. Before you have surgery, be sure to talk with your doctor, your rheumatologist, and with an orthopedic surgeon who is experienced in joint surgery for RA. Also be sure to research this well. The American College of Rheumatology (ACR) says that while this is an extremely effective surgical treatment, it should be considered as a last (rather than first) treatment option.

Treatment Options and Side Effects

Drug therapy is the most common course of treatment for rheumatoid arthritis. There is a wide variety of drugs, used in combination, available on the market.

In extreme cases, surgery may be an option, but it is not the usual or recommended course of treatment for RA. Newer prescription medications, approved by the U.S. Food and Drug Administration (FDA) since 1998, are being used to treat RA. These medications fall into a class of drugs known as tumor necrosis factor inhibiters (blockers).

Tumor necrosis factors (TNF) are proteins produced by the body. People with RA and other similar conditions have higher levels of TNF proteins in their blood. These newer drugs are designed to suppress TNF proteins. 3 Tumor necrosis factor inhibitors on the market include: Remicade (infliximab), Enbrel (etanercept), Humira (adalimumab), Cimzia (certolizumab pegol) and Simponi (golimumab). 4

Short-term side effects of tumor necrosis factor inhibitors include “localized rashes with itching and burning.” 5
Tumor necrosis factor inhibitors may cause cancers and serious bacterial, fungal, viral and other infections. These drugs pose an increased risk for lymphomas and skin cancer — and potentially for other types of cancer as well. Rare neurologic complications may also occur. 6

As always, be sure to discuss all of your symptoms, medications, treatment options and risks with your doctor.

Osteoarthritis Damages Knee and Hip Joints

Unlike rheumatoid arthritis, osteoarthritis is commonly associated with the gradual wear and tear of joints over time. This joint disease often targets the knees, hips, hands and spine. 7

Osteoarthritis is the most common type of arthritis. Millions of people worldwide are affected and there is no cure. 8

Osteoarthritis wears down the cartilage in joints. Cartilage is a type of protective cushioning that covers the ends of bones in a joint, offering a slippery surface over which bones can move easily and serving as a shock absorber. 9

When cartilage is worn down, bones can rub together causing friction, inflammation and pain. This rubbing can damage the joint permanently. 10

Osteoarthritis pain may be mild to moderate and manageable with medication and exercise, or it can be debilitating. When the pain has become unbearable and function has become practically nonexistent, surgery may seem to be the most effective solution. 11

Osteoarthritis symptoms include:

  • Pain
  • Tenderness
  • Stiffness
  • Loss of flexibility
  • Grating sensation
  • Bone spurs 12
  1. http://www.arthritis.org/arthritis-facts/understanding-arthritis.php 

  2. https://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Joint_Surgery/ 

  3. American College of Rheumatology. Anti-TNF. (Jun. 2012). https://www.rheumatology.org/Practice/Clinical/Patients/Medications/Anti-TNF/. Accessed March 6, 2015. 

  4. American College of Rheumatology. Anti-TNF. (Jun. 2012). https://www.rheumatology.org/Practice/Clinical/Patients/Medications/Anti-TNF/. Accessed March 6, 2015. 

  5. American College of Rheumatology. Anti-TNF. (Jun. 2012). https://www.rheumatology.org/Practice/Clinical/Patients/Medications/Anti-TNF/. Accessed March 6, 2015. 

  6. American College of Rheumatology. Anti-TNF. (Jun. 2012). https://www.rheumatology.org/Practice/Clinical/Patients/Medications/Anti-TNF/. Accessed March 6, 2015. 

  7. http://www.arthritistoday.org/about-arthritis/signs-and-symptoms/types-of-pain.php 

  8. http://www.mayoclinic.org/diseases-conditions/osteoarthritis/basics/definition/con-20014749 

  9. https://www.nlm.nih.gov/medlineplus/osteoarthritis.html  

  10. http://www.niams.nih.gov/health_info/Osteoarthritis/osteoarthritis_ff.asp

  11. http://www.arthritistoday.org/about-arthritis/signs-and-symptoms/types-of-pain.php 

  12. http://www.mayoclinic.org/diseases-conditions/osteoarthritis/basics/symptoms/con-20014749