Frozen Hip Joint: Causes, Symptoms, Treatment, Exercises, Recovery

Frozen Hip Joint which is also referred to in medical terms as Adhesive Capsulitis of the Hip is a rare pathological condition of the hip which is quite similar to frozen shoulder in which the mobility of the hip is severely affected.¹ Frozen Hip Joint is mostly seen in people in the age range of 35-55 years and affects females more than males. There has been no clear cut cause identified for Frozen Hip Joint, but it can be caused due to an injury or a trauma and even after some sort of surgery to the hip joint. People with diabetes are more prone to develop Frozen Hip Joint than the other population. Frozen Hip Joint results in severe pain in the hip joint which may radiate to the groin and the buttock along with stiffness of the hips. The range of motion of the hips namely flexion and rotation are also significantly affected and restricted. Initially an individual with Frozen Hip Joint will have acute pain but will have certain movement of the hip but as the disease condition advances the mobility of the hips decrease and the pain increases with any motion of the hips and ultimately the hip joint “freezes.” Once the “freezing” phase of Frozen Hip Joint is over then gradually the pain calms down and then there is restoration of movement. Depending on the age and overall health of the individual, Frozen Hip Joint may take from months or even years to completely resolve.

Why Frozen Hip Joint occurs is something which is still not very clear but what has been believed as far as Frozen Hip Joint is concerned is that this condition has an inflammatory basis, which adversely affects the synovial lining tissue of the hip joint followed by progressive fibrosis of hip capsule. Due to this fibrosis of the hip capsule, there is capsular tightening which ultimately results in loss of motion and pain in the hip joint leading to what we call as Frozen Hip Joint.

The classic presenting feature of a Frozen Hip Joint is severe pain and loss of movement of the hip. The affected individual will have difficulty in sitting with the legs crossed or sitting in certain positions. Person with frozen hip joint will also find it difficult to bend to tie their shoes or wear pants. Pain due to Frozen Hip Joint will increase with external rotation of the hip. In some cases, Frozen Hip Joint may also cause ambulation difficulties as well.

Frozen hip joint results in many functional limitations. These functional limitations will differ depending on the severity of the condition and the overall age and health of the individual. Some of the functional limitations experienced by people with frozen hip joint are:

• Difficulty with performing day to day tasks due to lack of movement in the hips and severe pain is a symptom of frozen hip joint
• Difficulty with lower extremity dressing like putting on socks, tying shoe laces, wearing pants
• Difficulty with sitting with the legs crossed
• Difficulty sleeping on the one side
• Difficulty with standing with the hip externally rotated or abducted
• Difficulty with prolonged sitting
• Difficulty with driving a car
• Ambulation difficulties
• Difficulty with recreational activities.

Frozen Hip Joint is diagnosed totally on the basis of the presenting symptoms. The physician will first take a detailed history of the patient as to when the symptoms started and how severe the symptoms are. The physician will also ask the individual as what makes the pain better or worse and whether the pain interferes with the sleep of the individual. Radiological studies may then be ordered in the form of x-rays, CT or MRI scans of the hip to look at the internal structures of the hip to see whether there is any inflammation or other causes that may be provoking the symptoms. The radiological studies are also done to rule out arthritis as this is the only condition that will have similar symptoms to that of Frozen Hip Joint.

Frozen Hip Joint is a condition which is self limited and resolves on its own in most cases and hence treatment for Frozen Hip Joint is mostly supportive. Conservative treatment for frozen hip joints involves making the patient comfortable, taking plenty of rest, and avoiding activities that may aggravate the condition. This is done till the time the pain associated with frozen hip joint calms down and the patient is able to move the hip joint to some degree. Gentle massage in the hip region is also of benefit in calming down the pain and improving range of motion of the hips. Application of heat is also very effective in treating Frozen Hip Joint. You can apply heat to the hip area for 15-20 minutes two to three times day for about one week. Apart from this the physician may also recommend some pain medications in the form of NSAIDs to calm down the pain and restore range of motion. Gentle stretching of the hips will also be recommended for restoration of functional range of motion.

In cases if the above measures are ineffective in treating frozen hip joint then the physician may recommend steroid injections. The physician will start with one injection and if that proves to be effective in reducing pain and increasing range of motion then a series of steroid injection will be tried.

Another option for treatment for Frozen Hip Joint is a manipulation of the hip under anaesthesia. This is usually in cases where there is severe stiffness of the hip and the patient is not able to move the hip at all due to Frozen Hip Joint.

Once the pain resolves and there is some motion of the hip restored with the above mentioned treatment modalities, an individual must progress to doing some basic stretching exercises to make the hips more mobile and improve range of motion of the hips. It should be noted that these exercises for frozen hip joint should only be performed after getting a go ahead from the treating physician and should be performed only if there is no pain while performing the exercises. Some of the exercises for frozen hip joint to improve hip mobility are:

Hip Flexion Exercise for Frozen Hip Joint: This exercise is quite helpful in stretching the hip and improving mobility of the hip joint and reduces stiffness caused due to frozen hip joint. To do this exercise, just take your knee towards the chest as far as possible without aggravation of pain. Do this about 10 times at least two to three times a day.

Hip Abduction Exercises for Frozen Hip Joint: This exercise is also helpful in increasing mobility of the hips. To do this exercise, keep the knee straight and take your leg to the sides as far as possible without aggravating the pain. Make sure that the kneecap and the toes are pointing towards the ceiling while doing this exercise. Repeat this about 10 times and do this about three times a day.

Hip External Rotation Exercise for Frozen Hip Joint: This is quite an effective exercise for increasing the mobility of the hips affected by frozen hip joint. To do this exercise, keep the knee bent and foot flat on the floor. Now, take the knee to the side as far as possible without aggravating the pain. Repeat this about 10 times and do this about two to three times a day.

As stated, Frozen Hip Joint is a self limiting condition and resolves on its own. For people in the age range of 35-50 years, the recovery period make take about 10-12 weeks before you get back your range of motion without pain, whereas for people above the age of 50, the recovery period may take much longer than that with time ranging to even a year or two before they can get back their hip motion and get rid of the pain caused by Frozen Hip Joint.

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