Background Osteoarthritis (OA) of the hip is a common condition which affects men and women of all ages. The cartilage becomes damaged. Stiffness and reduced range of movement are common. The pain experienced from OA of the hip may be felt in your lower back, buttocks and groin. You may also feel pain from your hip in your leg and down into your knee. This is called referred pain.The goals of OA treatment include alleviation of pain and improvement of functional status. Optimally, patients should receive a combination of nonpharmacologic and pharmacologic treatment. A physiatrist may help in formulating a nonpharmacologic management plan for the patient with OA. Guidelines from Osteoarthritis Research Society International (OARSI) advise that nonpharmacologic treatment of hip and knee OA include the following: patient education; heat and cold; weight loss; exercise; physical therapy; occupational therapy; unloading in certain joints (eg, knee, hip).
Objectives The aim of this study was to investigate the importance of exercise and TENS (Transcutaneous electrical nerve stimulation) therapy in patients with OA of the hip on the pain and functional status.
Methods This was a prospective clinical study involving 20 patients with primary hip OA treated stationary at the Center for Physical Medicine and Rehabilitation during 2016. On receipt of all the respondents filled out the social survey, quantification of pain was conducted by visual analogue scale (VAS) and function was evaluated through measurement of the range of motionin hip joint. After that, they received physical therapy (exercise and TENS therapy) for 21 days. TENSwas applied once a day for 30 minnuteson both hip joints, with the frequency of 85 Hz and with short-term pulses (4 ms) (appliance TENS-2, Electronic Design Medical, Serbia). Exercisewas applied once a day for 30 minutes, according to individually customized protocol; active and active-assisted exercises were used to the point of pain for strengthening the muscles of the lower extremities and to increase range of motion in the hip joints.One month after the inspection we tested functional status and pain.
Results There was 100% of women, mean age 64.15±4.06 years. The most represented were retirees, 60%, followed by workers and unemployed 10% and 30%.BMI was 27,3±4,22 kg/m2. After a month there was a statistically significant reduction in pain measured by VAS (at the beginning it was 6,7; at the end 3,2; p<0.001). At the end of the study there was a statistically significant increasingrange of motion for active flexion (p<0.05) and active abduction (p<0.0,5), while there was no statistically significant increasing for active extension, adduction, internal and external rotation in the hip joint (p>0.05).
Conclusions The ACR strongly recommends the following nonpharmacologic measures for patients with knee or hip OA: cardiovascular or resistance land-based exercise, aquatic exercise, weight loss, for overweight patients. TENS may be another treatment option for pain relief. Our study showed that exercise and TENS therapy led to a statistically significant reduction in pain as measured by VAS pain scale and improving range of motion in hip joint.
Disclosure of Interest None declared