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steven asked...

Whom should I see first for hip issues a physio or msk unit or surgeon?

Whom should I see first for hip issues a physio or msk unit or surgeon? I have been diagnosed with moderate right hip osteoarthritis and an impingement can physio help and how. When is exercise detrimental? What exercise would be good?

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The answer

Thank you for your question, we are sorry to hear you have been suffering with your hip.

It’s important to understand what Osteoarthritis (OA) is in order to answer your question.

Osteoarthritis is a condition that affects your joints, by damaging the outer layer of cartilage that protects a joint. The body tries to make up for that loss by repairing the area with more bone. What this causes is that a join which previously worked well and smoothly will now have a few “bumps” to deal with. These bumps will lead to a larger wearing of the cartilage and the cycle starts over. This is what an impingement is basically, your joint does not do its regular motions in a smooth way. Osteoarthritis is a chronic condition.

Now that we know how it works we can tackle your question. Which specialist you should see depends entirely on how far ahead your arthritis is.

Exercise will improve your condition by strengthening the support around your joints. Muscle and tendons will help support the joint as the wearing away progresses. Exercises that don’t put too much stress on the joints are recommended (swimming and cycling) whilst running and weight lifting are discouraged.

The surgeon offers a different solution. When it comes to a point where your joint is not effectively doing its job it’s necessary to repair the joint or replace it all together.

To summarize, and using your questions, physiotherapy will help you by showing you exercises that will strengthen the support around your joints to take some of the stress away from them. Exercise will be detrimental depending on it’s type, impact to the joint should be avoided to protect them.

Anyway, rest assured that any option you wish to take will probably involve the other discipline if needed be. The physiotherapist will tell you when you should see a surgeon and the surgeon will tell you when he feels that physiotherapy will help more than surgery.

Please check the links below for further information.

Osteoarthritis - NHS

Arthritis research

Answered by the Health at Hand nurses