Narrative-based Medicine for Development of Home Exercise to Prevent Surgery in Hip Osteoarthritis: Consideration of Pericapsular Soft Tissue as a Pain Generator

In many cases of hip osteoarthritis (OA), patients exhibit symptoms that are discordant with radiography and magnetic resonance imaging findings. We have observed two distinct types of pain in hip OA: motion pain and walking pain. Motion pain typically improves with exercise therapy, whereas walking pain may require surgery. Many patients with motion pain have Kellgren-Lawrence grade 3 or 4 findings. Therefore, the combination of narrative-based medicine and evidence-based medicine is important for selecting the most suitable treatment for patients with hip OA.