The hip is one of the most vulnerable joints in the body to develop arthritis-particularly osteoarthritis. The lifetime risk for hip osteoarthritis is about 1 in 5 for men and 1 in 4 for women, according to the centers for disease control and prevention (CDC) [1].

The hip joint can withstand repeated motion and a fair amount of wear and tear. This ball-and-socket joint, the body's largest, fits together in a way that allows for fluid movement [2].

Whenever anyone use the hip (for example, by going for a run), a cushion of cartilage helps prevent friction as the hip bone moves in its socket. With age and use, the cartilage can wear down or become damaged. Muscles and tendons in the hip can get overused. Bones in the hip can break during a fall or other injury. Any of these conditions can lead to hip pain [3].

A number of studies conducted in different parts of India reveal widespread ignorance and misconceptions about the hip pain among people. As this disease largely relies on prevention and the right information at the right time is essential to bring about a behavioral change when the population is most receptive. Hence, this study was undertaken with the objective to assess the knowledge about risk and preventive factors for hip pain among Ortho OPD patients in civil hospital Rohru.

Objectives of the Study

To evaluate the awareness of patients attending Ortho OPD towards risk and prevention of hip pain in civil hospital Rohru.

Research Methodology:

• Research approach-descriptive
• Research design-descriptive survey design
• Setting of the study-Ortho OPD of civil hospital Rohru
• Study duration- between Aug-December 2020
• Study population-Ortho OPD patients in civil hospital Rohru
• Sample size-400 Ortho OPD patients
• Sampling technique-convenience sampling technique

Sampling criteria- first five patients attending the Ortho OPD of civil hospital Rohru everyday were selected till the completion of sample size after explaining the purpose of the study. Informed consent/assent was taken from them and confidentiality of the selected participants was also maintained:

• Inclusive criteria-patients selected during the day of data collection in study setting and who were willing to participate in the study.
• Exclusion criteria: Patients who were not willing to participate in the study 
• Development of tool-knowledge related questionnaires
• Description of tool

Section A-Socio-demographic characteristics of the patients (age, gender etc.).

Sections B-Questions regarding awareness of risk & preventive factors for hip pain validity of tool-by the experts in this field:

• Permission- obtained from the concerned head of the civil hospital
• Data collection by myself and patients was given 5 minutes time to complete that questionnaire and collected at the end of the prescribed time
• Data analysis with appropriate statistical test in terms of frequencies & percentage

The present study was non-experimental descriptive study carried out to evaluate the awareness of risk and preventive factors for hip pain in civil hospital Rohru.

In the present study 35% (140) of the patients fall were below 40 years of age while 65% (260) were above 40 years. 54% (216) of patients were male and 46% (184) were female (Table 1).

Among the total study participants, 55(13.75%) didn’t know about any risk factor of hip pain. 286 (71.5%) respondents told that abnormal gait while walking is the major risk factor for hip pain followed lack of physical activity/exercise 265(66.25%), prolonged sitting 235(58.75%), driving or traveling long distances without break 207(51.75%), bad posture while sitting 202(50.5%), hip injury/dislocation 189(47.25%), nerve compression 184 (46%), inadequate amounts of dietary calcium and vitamin D intake 123(30.75%), overweight/obesity 102(25.5%), Hip muscle weakness/strain 101(25.25%), Heavy physical overload 89(22.25%), hip Bone deformity/Mal-positioning 34(8.5%) and unhealthy diet 23(5.75%) (Table 2).

Table 1: Knowledge about risk factors of hip Pain

Table 2: knowledge of patients towards prevention of hip Pain

Among the total, maximum 290 (72.5%) respondents told that maintaining normal gait while walking is the major preventive factor for hip pain followed by exercise of hip regularly  270 (67.5%), frequent position change and stretching while working 256 (64%), frequent breaks while working on chair 245(61.25%), frequent breaks while travelling long distances 242 (60.5%), maintaining good posture while sitting 209(52.25%), avoid hip injury/sprain        194 (48.5%), calcium and vitamin D supplements 127 (31.75%), maintain ideal weight 106 (26.5%), Avoid heavy lifting 93(23.25%) and eating healthily and balanced diet 24(6%). Still 52(13%) respondents didn’t know any preventive factor for hip pain among participants.

The pain of hip arthritis cause can make it difficult for people with an arthritic hip to move around and manage their daily activities. Hip arthritis tends to cause more stiffness and pain in the morning or after resting for a while. Hip osteoarthritis usually develops gradually with time and may lessen range of motion [4].

Pain in the hip can result from a number of factors. Abnormalities of the skin, nerves, bones, joints, blood vessels and soft tissues of the hip can all result in pain. Sometimes diseases that affect other joints in the body, such as the inflammation resulting from arthritis, can be the cause of pain in the hip. Trauma or injury, including bone fracture, is also a cause of hip pain. Hip pain may also occur because of a problem with the back or spine [5].

In the present study, among the total, maximum 290 (72.5%) respondents told that maintaining normal gait while walking is the major preventive factor for hip pain followed by Exercise of hip regularly 270 (67.5%), frequent position change and stretching while working 256 (64%), frequent breaks while working on chair 245(61.25%), frequent breaks while travelling long distances 242 (60.5%), maintaining good posture while sitting 209(52.25%), avoid hip injury/sprain 194 (48.5%), calcium and vitamin D supplements 127 (31.75%), maintain ideal weight 106 (26.5%), avoid heavy lifting 93(23.25%) and eating healthily and balanced diet24(6%). Still 52(13%) respondents didn’t know any preventive factor for hip pain among participants.

Osteoarthritis is caused by general wear and tear on the hip joint, often simple lifestyle changes-such as losing weight or changing exercise plans to a lower-impact activity-can make a big difference in symptoms [6].

For the prevention of hip pain, don’t ignore minor injuries. Treat them so they don’t become major injuries, which can lead to hip pain down the road. For those working at a desk job, switching up your posture by changing chairs, standing while you work, or taking frequent walking or stretching breaks can help the onset of hip pain. Stretch before brisk exercise to ensure the joints are loose, your blood and joint fluids are circulating and the connective tissues are warm and elastic. Don’t forget to cool down afterward. Listen to your body. If you experience pain in your joints, you might be overdoing it. Take a break to stretch and check in with your joints and muscles. Wear appropriate shoes to cut down on stress not only to the feet, but to the ankles and knees, which can lead to hip problems. Avoid exercising on hard, unforgiving surfaces as well. Lose a few pounds; excessive weight puts pressure on the joints, making them less flexible. Rest adequately after periods of exercise to allow your joints and tissues complete recovery. Eat a healthy diet to ensure you are building strong bones [7,8].

Regular exercise helps keeps the muscles strong and improves circulation to all of the tissues; when muscles and tissues are flexible and strong, they are less likely to be injured. Physical therapy and regular moderate exercise can strengthen the muscles in hip and can also increase flexibility, both of which will improve ability to get around with less stiffness and pain [9,10].

Maintaining normal gait while sitting and walking, Exercise of hip regularly, frequent position change and stretching while working, frequent breaks while working on chair and travelling long distance helps in preventing hip pain. Clear understanding of risk and preventive factors of hip pain helps in prevention of complications.

1. Arthritis-health. "5 Risk Factors for Hip Arthritis." Arthritis-health. 

2. WebMD. "Hip Pain: Causes and Treatment." WebMD. https://www.webmd.com/pain-management/guide/hip-pain-causes-and-treatment.

3. Orthosportsmed. "Hip Conditions." Orthosportsmed. 

4. OrthoInfo. "Osteoarthritis of the Hip." OrthoInfo. 

5. MedicineNet. "Hip Pain Symptoms." MedicineNet. https:// www. medicinenet. Com/ hip _ pain/ symptoms. htm.

6. Versus Arthritis. "Osteoarthritis." Versus Arthritis. https:// www. versus arthritis. org/ about - arthritis/ conditions/ osteoarthritis/.

7. Coastal Ortho Team. "Hip Pain: Causes, Treatment and Prevention." Coastal Ortho Team. 

8. Medical News Today. "Hip Pain When Sitting." Medical News Today. https:// www. medicalnewstoday. com/ articles/ hip- pain-when-sitting.

9. Healthline. "Benefits of Flexibility." Healthline. https:// www. healthline. com/ health/benefits-of-flexibility.

10. MedicineNet. "Hip Pain: Causes and Treatment." MedicineNet. https:// www. medicinenet. com/ hip _ pain/ article.htm.