Psoriatic arthritis (PsA) is a chronic autoimmune arthritis that affects people with the skin condition psoriasis. It can cause inflammation in both small and large joints and, in rare cases, the spine. This means PsA can sometimes cause hip pain.
PsA affects about 30% of people with psoriasis.
In PsA, the immune system attacks parts of the body, primarily the skin and joints. It may also cause the fingers and toes to swell and nails to become pitted or to separate from the nail bed. It can also cause the heels to ache.
Environmental factors and genes may play a role in triggering PsA. The condition affects men and women equally, and it usually develops after the age of 30, although it can begin in childhood.
This article looks at whether PsA can cause hip pain, other possible hip pain causes, PsA symptoms, diagnosis, and treatment.
PsA can cause hip pain, although the condition rarely occurs in the hips.
PsA mainly develops in the knees, ankles, wrists, and fingers and can cause pain, warmth, tenderness, and swelling on different sides of the body.
If PsA affects the hips, people may experience stiffness, difficulty walking, and pain in either one or both hips. They may also feel pain in their outer thigh, buttocks, and groin.
People can have hip pain due to a variety of causes other than PsA. Common sources of hip pain include:
Spondyloarthropathies
Spondyloarthritis is a form of arthritis that attacks the spine and sometimes the arms and legs. It may also involve the intestines, eyes, and skin.
The main symptom of the condition is lower back pain and pain in the sacroiliac joints, which connect the spine, sacrum, and hips.
Spondyloarthritis differs from other types of arthritis in that it affects areas where ligaments and tendons attach to bones, called entheses.
Other symptoms usually involve pain and stiffness due to inflammation in the spine and bone destruction, causing deformities of the spine and poor hip and shoulder function.
Reactive arthritis
Reactive arthritis can affect the lower back, hips, heels, toes, fingers, and joints of the knees and ankles. It occurs mainly in men aged 20–50 years.
The condition usually resolves on its own, but it can become a prolonged, severe, chronic condition.
Reactive arthritis causes inflammation in the joints and occurs as a result of a reaction to a bacterial infection somewhere in the body.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is a chronic condition that causes inflammation in the joints, usually affecting the spine, knees, jaw, hands, wrists, and feet.
It can lead to swelling, stiffness, loss of function, and pain. It is one of the inflammatory arthritis conditions that most often cause symptoms in the hip.
In people with RA, the surface of the hip joint, called the synovium, thickens, swells, and produces chemical substances that attack and destroy the cartilage that covers the bone.
Osteoarthritis
Osteoarthritis (OA) is the most common type of arthritis. People sometimes call it “wear and tear” arthritis.
It is a chronic condition resulting from the breakdown of cartilage, which cushions the ends of bones at the points where they meet to form joints. The bones then rub together, which can cause pain, stiffness, loss of mobility, and bony overgrowths called spurs.
Pain from hip OA is often also felt in the thigh and groin and may affect a person’s ability to walk.
PsA can develop slowly, beginning with mild symptoms that can quickly become severe.
These symptoms can include:
- pain, swelling, and tenderness over tendons
- swollen fingers and toes
- fatigue
- pain, throbbing, and stiffness in one or more joints
- changes in nails, such as pitting or separation from the nail bed
- reduced range of motion
- a skin rash, although there is little connection between the severity of psoriasis and the severity of PsA
There is no definitive test for PsA, so if a person experiences hip pain, a doctor needs to make a diagnosis through elimination.
PsA symptoms are similar to those of reactive arthritis, RA, and other conditions and may all cause hip pain.
A doctor may establish a diagnosis by:
- taking personal and family medical history
- performing a physical examination
- ordering an MRI scan
- ordering X-rays
- taking blood tests
There are various medications a doctor may prescribe to ease pain and inflammation. These often include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These help reduce pain and swelling and can be prescription or nonprescription, depending on their potency. Prescription NSAIDs for arthritis include celecoxib, and over-the-counter NSAIDs include aspirin and ibuprofen.
- Corticosteroids: A doctor may inject corticosteroids into the affected joints to quickly reduce pain and swelling.
- Disease-modifying antirheumatic drugs (DMARDs): These can prevent arthritis from worsening and reduce pain and swelling. DMARDs that may be part of a treatment plan for PsA include methotrexate, which reduces swelling in joints, and injectable biologics, which can prevent arthritis from progressing and may also treat psoriasis.
Besides medications, other treatments may include:
- Physical, occupational, and massage therapies: These therapies can make it easier for a person to move around. They can also alleviate pain.
- Exercise and rest: Arthritis-friendly exercises may help reduce pain and restore mobility. Rest is also essential during a flare-up.
- Protective devices: A doctor may suggest supports, braces, or splints to protect the affected joints and prevent more damage. These devices can help stop painful movements, and support the affected areas.
- Surgery: If a person’s joints are badly damaged or do not respond to other treatments, surgery is a potential option. A surgical procedure may lessen pain and improve movement, but it also involves downtime and risks.
PsA is a chronic autoimmune arthritis that occurs with the skin condition psoriasis. Symptoms include pain, swelling and tenderness over tendons and joints, fatigue, skin rash, and changes in the nails.
PsA can develop in various joints in the body, including the hips. However, this is rare.
Doctors diagnose hip pain due to PsA through a process of elimination, as there is no definitive test. Many conditions have similar symptoms, including spondyloarthropathies, reactive arthritis, RA, and OA.
A doctor can treat PsA using physical, occupational, and massage therapies, different medications, such as NSAIDs and corticosteroids, or surgery.