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Hip pain and work or leisure activity

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Hip pain is commonly attributed to osteoarthritis but other causes include trochanteric bursitis and referred pain of spinal origin. There is only a weak relationship between hip pain and radiographic changes of osteoarthritis, radiographic changes being found in about a third to a half of adults with hip pain. A study based on two general practices in Cheshire has shown associations between lifetime activities during work and leisure and recent hip pain.

A total of 3847 subjects aged 18–85 years were randomly selected from the practice lists and the two practices gave a broad socioeconomic range. Postal questionnaires were sent to all subjects and 3385 completed replies were received (88% response). Three hundred and fifty two (10.4%) answered yes to the question “Have you experienced hip pain during the past month, lasting at least 24 hours?” and were deemed cases. The 3002 who answered “no” were controls (Hip pain status was uncertain for 31 subjects).

Occupational exposures significantly related to hip pain were: walking more than two miles a day on rough ground for at least seven years (odds ratio (OR) adjusted for age and sex, 2.65), lifting or moving weights (>23 kg) for at least 13 years (1.9), sitting for more than two hours at a time for 1 to 18+ years (1.9), jumping between different levels for at least 15 years (1.52), and standing for more than two hours at a time for at least 16 years (1.46).

Leisure activities significantly associated with hip pain were: track or field events with a cumulative exposure of more than 780 hours (OR 1.94), walking, cumulative duration more than 3250 hours (1.57), and running or jogging, cumulative duration more than 832 hours (1.82). On multivariate analysis three factors were independent predictors of hip pain. They were prolonged sitting at work for 1–18+ years (OR 1.9), lifting heavy loads at work for 13 years or more (1.74), and walking during leisure time for a cumulative duration at least 3250 hours (1.97). The population attributable risk associated with each of these activities was 21%, 13%, and 16% respectively.

The prevalence of hip pain in this study was similar to rates reported from previous population based studies. Associations between occupational heavy lifting and hip osteoarthritis have been reported previously but associations with recreational walking or prolonged sitting at work have not been reported before. One study found that a history of prolonged sitting at work was less common among cases awaiting hip arthroplasty. These three factors are common and their combined population attributable risk was put at 50%.

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