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...and one of these tips you can get from a sewing class!

"More than 100,000 Americans are unable to get from their bed to the bathroom without assistance because of problems related to their hip or knee." So says Dr. Nathan Wei, Clinical Director of the Arthritis and Osteoporosis Center of Maryland. He adds, "Too many people put up with pain when there are so many treatments available."

The hip joint plays a major role in weight-bearing and walking.

It's a ball-and-socket joint that combines great stability and a wide range of motion. This joint is comprised of the head of the thigh bone (femur) which is shaped like a ball. This sits inside a cup-like area of the pelvis called the acetabulum ("socket"). It is surrounded by powerful muscles that help maintain the body in an upright posture and also help with walking. Many ligaments also help support the structure of the hip.

The most common symptom with hip problems is pain

Pain due to hip problems may be felt in the groin, on the outside of the hip region, the buttock, inner part of the thigh, the front of the thigh, and even the knee. In fact, there have been patients who've had knee surgery... when the problem was really in the hip. NOT a good thing! Pain coming from the hip joint also needs to be distinguished from low back disorders as well as knee disorders. Activities of daily living that are affected by hip pain include going up and down stairs, getting out of chairs, getting out of bed, getting shoes and socks off and on, and sexual intercourse.

Hip pain is often aggravated by weight-bearing.

Besides arthritis, hip pain can be due to bursitis. The most common is trochanteric bursitis. Trochanteric bursitis is inflammation of the large bursa that sits on the side of the hip. It tends to come on in middle-aged people. The major symptom is a deep aching pain over the upper outer thigh. It is made worse by walking. It is often bad at night and is aggravated by lying on the affected side. The treatment consists of anti-inflammatory medication, physical therapy, steroid injection, and stretching exercises.

Another potentially serious condition is avascular necrosis of the hip.

Here, a patient will have severe pain- usually in the groin. Weight-bearing is excruciating and the pain may also be present at night. Avascular necrosis is a condition where the blood supply to the head of the femur ("the ball") is interrupted... ...and the head of the femur actually dies! The bone collapses. Remember the great athlete, Bo Jackson... he had avascular necrosis. The diagnosis is confirmed by MRI scanning and the treatment involves surgical procedures. In patient with an arthritis condition, treatment modalities should include anti-inflammatory medication, physical therapy, exercises, and weight reduction, if necessary.

Specific stretching exercises are helpful.

Dr. Wei says, "One of my favorite is called thread-the-needle. You cross one leg across the thigh of the other. Reach down through the hole formed by this crossing over maneuver with the same side hand as the leg you're using to cross over. Clasp fingers with the other hand behind the thigh and gently pull. You'll feel the stretch! Hold for 10 seconds. Repeat with the other side."

Joint replacement- known as hip arthroplasty- is still the resort of choice in patients with end-stage arthritis.

Indications for arthroplasty include: ?pain that hasn't responded to more conservative measures and...?loss of function in the hip.

In the past, the limiting problem was that the replaced hip was only good for 10 to 15 years with "normal" use.

Problems that limit the lifespan of hip replacements are?wear and... ?inflammatory response to particles that eventually cause loosening in some patients.

Dr. Wei (pronounced "way") is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians.