Hip pain: Symptoms, causes, management, treatment

Find out everything you need to know about hip pain, from how to treat it yourself at home to when it’s time to seek professional help. Including expert advice and a video from consultant orthopaedic surgeon Mr Sebastian Dawson-Bowling, a specialist in treating hip pain.

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Hip pain is a very common complaint and can happen to people of any age. However, it becomes more likely as you get older.

The most common causes of hip pain are injury, overuse and arthritis (in its various forms).

Often hip pain can be managed or reduced with lifestyle changes such as exercise and better nutrition. However, some hip pain needs professional treatment.

What is hip pain?

The hip is a ball and socket joint that allows for fluid movement. It’s a very durable joint but it’s not infallible. Like any other joint, it can be damaged.

Our hips are two of the joints we use the most. Just going about your daily life, your hips are hard at work, absorbing the stress and strains of the day. Hip pain is more common in older people, whose joints have been working for longer.

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You might experience pain in one or both of your hip joints for a wide variety of reasons. These will generally fall under the categories of injury, overuse or arthritis.

If you have damaged your joint, you may experience pain, stiffness or swelling. This might result in reduced movement in the joint.

People experience hip pain in different ways. For example, some people are woken up by hip pain at night, while others only experience pain while exercising. You might have pain in just one hip or feel it in both of them.

Common causes of hip pain

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Often hip pain is a short-term problem, caused by overuse or a small bang or overextension.

Try resting your hip for a week to see if it improves. If not, speak to your GP to get a diagnosis. The most common causes of hip pain include:

Osteoarthritis

Osteoarthritis is caused by wear and tear on your joints over time. This is the most common type of arthritis in the UK and one of the most common causes of hip pain and stiffness.

There are other forms of arthritis, including rheumatoid arthritis and septic arthritis, but they are much less common.

Bursitis

Bursitis happens when you damage the bursa in your hip. A bursa is a fluid-filled sac near your joint that reduces friction between bones and tendons.

Tendonitis

Tendonitis can develop when your tendons and muscles are overworked. Your tendons can become stiff and won’t work as well, and you may have pain, too.

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Fracture

Hip fractures are relatively common after high impact injuries or falls. You will normally need urgent treatment at the hospital, and many people need surgery.

It is also possible to develop a small fracture without notable trauma. This might happen to athletes due to overuse, or to older people after a smaller knock or fall. Again, you may need surgery.

Osteonecrosis

Osteonecrosis, also known as avascular necrosis, is a disturbance in the blood flow to the hip. Causes include injury, long term steroid use and excessive alcohol consumption.

Impingement and hip labral tears

Hip impingement means your hip is misaligned, which can result in increased friction when you move. This can in turn damage the labrum (a rubber seal around the hip joint).

The Consultant's View

Mr Sebastian Dawson-Bowling is a Consultant Orthopaedic Surgeon at BMI The London Independent Hospital.

Common causes of hip pain and how to avoid them

Arthritis is a common cause of hip pain. This means that the coating on your joint has worn away.

Other patients may experience muscular pain, nerve pain, or inflamed ligaments or tendons. Some people experience strains due to sporting injuries.

Increasingly we’re starting now to understand that in some younger patients there can be impingement between the top of the thigh bone and the outside of the hip, which can cause secondary damage to the labrum.

Another group of patients experiences pain that feels like it’s coming from the hip joint but is actually coming from the joint above (the spine) or the joint below (the knee).

Other causes of hip pain can include rheumatoid arthritis, psoriasis, and even inflammatory bowel disease (IBD).

For most people, the best way to reduce or avoid hip pain is to increase their activity levels. There are very few instances where less exercise is the best response.

Of course, if there are particular activities or movements that repeatedly make your hip hurt, it’s best to avoid them.

But in general, regular exercise in the long term will improve the health and flexibility of your joint, boosting function and reducing pain.

When should I seek help for hip pain?

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Most hip pain will be short-term and will get better on its own. Rest the joint and, if you feel you need it, use over the counter painkillers or anti-inflammatories while it heals.

If you’re still in pain after a week’s rest, if the pain is in other joints as well as your hip(s), or if you also develop a rash or fever, it’s time to seek medical advice.

Often hip pain, even hip pain that lasts longer than a week, can be managed by lifestyle changes. But some of the less common causes of hip pain can be very serious.

That’s why it’s always best to book and appointment with your GP, a physiotherapist or a specialist consultant. They’ll help you identify what’s wrong and, if needed, build a treatment plan tailored to you.

What treatments are available for hip pain?

The type of treatment you are recommended for your hip pain will depend on the cause as well as the severity of your symptoms.

If you have an injury, for example, your consultant may well build a recovery plan for you. This will help you get back to normal as soon as possible, and could involve a mix of treatments, from physiotherapy to complementary therapies to surgery.

If your pain is due to mild osteoarthritis, you may decide that simple lifestyle changes are the bets approach for now.

However, if your condition is more advanced and becoming very disruptive, you may be recommended more invasive treatments, such as surgery.

Managing hip pain with lifestyle changes

Certain lifestyle factors can increase the risk of hip pain. These include being overweight, smoking, having a poor diet, and not getting enough exercise.

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Making small changes to improve your health will likely be the first advice you are given to try and reduce or even cure your joint pain.

For example, losing weight can ease the pressure on your joints.

Low impact exercises can strengthen the muscles around your hips as well as improving your flexibility.

Making small changes like this can significantly reduce your pain in the long term, and even stop you from needing more invasive treatments in future.



Non-surgical treatments for hip pain

Sometimes you will need a little more than lifestyle changes to get your hip pain under control. There are various non-surgical treatments you may be prescribed.

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Physiotherapy is a highly effective treatment for many people. A physiotherapist will show you exercises and stretches that could significantly improve the health of your hip joint, improving flexibility and reducing pain without doing further damage.

There are also medications that might be recommended. These include painkillers (both over the counter and prescription), anti-inflammatories and joint injections.

Surgery for hip pain

Surgery will only be recommended if you and your consultant both think it’s the best choice for you.

There are different types of hip surgery available. The procedure you are recommended will be based on your individual circumstances as well as the cause and severity of your joint pain.

For example, a hip labral tear may be treated with laparoscopic (keyhole) surgery. Another form of keyhole surgery, a hip arthroscopy, can be used to both diagnose and treat certain conditions.

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If you have very advanced arthritis and your pain or lack of mobility is stopping you from doing the things you love, you might be recommended hip replacement surgery. This involves removing your damaged hip joint and replacing it with a prosthesis.

This is a common and very successful surgery. At BMI we perform thousands of hip replacements each year, some even using robotic technology.

Hip replacement surgery can have huge benefits to a person’s quality of life, but it won’t be recommended unless you’ve tried less invasive methods and they haven’t worked.

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