What is the relationship between hip osteoarthritis and influenza (flu)?

From the Guidelines

There is no direct link between the flu and hip arthritis, and the relationship between the two is primarily coincidental or due to temporary exacerbation of existing conditions. While some people may experience temporary joint pain during or after a flu infection (called post-viral arthralgia), this typically resolves within weeks and doesn't cause permanent arthritis 1. If you're experiencing hip pain after having the flu, it's more likely that the flu temporarily exacerbated an existing condition, such as osteoarthritis, which is the most common form of joint disease and the leading cause of pain in older people 1.

For temporary relief, you can take over-the-counter pain relievers like acetaminophen (Tylenol) at 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) at 400-600mg every 6-8 hours as needed, apply ice for 15-20 minutes several times daily, and rest the joint. However, it's essential to note that oral NSAIDs and paracetamol are associated with gastrointestinal or cardiovascular complications and even increased risk of death, especially in older people with comorbidities 1.

If hip pain persists beyond 2-3 weeks, worsens, or is accompanied by fever, redness, or significant swelling, you should see a healthcare provider for proper evaluation. They may recommend imaging studies like X-rays to assess the hip joint. Some viruses can trigger reactive arthritis, but this is uncommon with influenza and typically affects different joints 1. True hip arthritis (osteoarthritis or inflammatory arthritis) develops over time due to factors like age, genetics, previous injuries, or autoimmune conditions rather than directly from viral infections.

Key considerations for managing hip osteoarthritis include:

• Exercise as a core therapy for management of knee or hip OA, as recommended by current National Institution for Health and Care Excellence and international guidelines 1
• Routine yearly influenza vaccines are recommended for all people aged 6 months or older, including those with inflammatory rheumatic and musculoskeletal diseases 1
• High-dose influenza vaccines may be more effective in rheumatic disease patients, although this is currently recommended only for adults age ≥65 1

From the Research

Relationship Between Hip Osteoarthritis and Influenza (Flu)

There is no direct evidence in the provided studies that establishes a relationship between hip osteoarthritis and influenza (flu).

Available Information on Hip Osteoarthritis

• Hip osteoarthritis is a prevalent condition responsible for significant pain and disability 2.
• Intraarticular corticosteroid injections have been used for decades to manage hip osteoarthritis, although evidence is scarce and controversies remain 2.
• Available randomized controlled trials show that intraarticular corticosteroid injections provide pain relief and functional improvement in hip osteoarthritis 2.
• The management of hip osteoarthritis typically involves a combination of nonpharmacological and pharmacological treatment modalities, including exercises, weight loss, education, and topical or oral nonsteroidal anti-inflammatory drugs (NSAIDs) 3.

Information on Joint Infections and COVID-19

• There have been cases of concomitant septic arthritis of the hip joint and femoral head avascular necrosis in patients with recent COVID-19 infection, particularly those treated with corticosteroids 4.
• Timely diagnosis and surgery can help save the hip joint in such cases 4.

Guidance Techniques for Intra-Articular Corticosteroid Injections

• Both ultrasound-guided and fluoroscopic-guided intra-articular corticosteroid injections are effective at reducing pain in patients with painful hip osteoarthritis 5.
• Network meta-analyses suggest that fluoroscopic-guided injections may be more beneficial, but further high-quality trials are needed to determine the preferred guidance technique 5.