Each year, surgeons perform hundreds of thousands of total hip arthroplasties (hip replacements), and the most common reason is osteoarthritis of the hip. This condition isn’t caused by an underlying disease, rather it’s due to wear and tear of the hip joint from everyday activities over time. Not only can osteoarthritis of the hip be painful, but it can reduce the range of motion of the joint, making it difficult to move around. Most patients seek to avoid or delay surgery as much as possible, which drives many to seek chiropractic care. The question is: what can a doctor of chiropractic do to manage osteoarthritis of the hip?
Doctors of chiropractic receive training in the application of several manual therapies of varying force, depending on the condition, patient preferences, and the practitioner’s clinical expertise. In one study that included 60 hip osteoarthritis patients, researchers used a technique called long-axis distraction mobilization (LADM) at varying levels of force and found that high-force LADM yielded superior results with respect to range of motion of the hip joint, although low- and medium-force treatment led to similar improvements in pain.
A follow-up study by the same researchers with another group of 60 hip osteoarthritis patients found that low-force LADM performed better with respect to reducing pain sensitivity in the hip as well as the low back and knees. On the other hand, high-force LADM brought greater improvements in overall function. A systematic review from 2022 that included ten studies found that the combination of LADM with thrust manipulation and mobilization with movement (two-to-three treatments a week for two-to-six weeks) can provide even larger improvements with respect to pain and range of motion.
When managing a patient with musculoskeletal pain, chiropractors will often use a combination of several approaches—a multimodal approach—to achieve the best possible outcomes with respect to pain and function. This includes manual therapies, specific exercises, physiotherapy modalities, nutritional recommendations, and more. In addition to treatments directed at the hip itself like those listed above, doctors of chiropractic will also assess the motion of the joints in the lower back, knees, and ankle as abnormal mechanics in these areas can put added stress on the hip and affect recovery.