Just because awful hip pain lands you in an orthopaedic surgeon’s office doesn’t mean hip replacement surgery’s a must. Here’s how non-surgical treatments can help some of the most common types of hip pain, like hip impingement, and when surgery could be your best bet.
Hip pain is a universally common problem affecting people of all ages, explains DR GAVIN O’NEILL, a senior consultant orthopaedic surgeon at Altius Clinic Sports and Orthopaedic Surgeons. Even as a surgeon, however, he always offers a non-surgical approach as the first line of treatment. He feels that a complete course of physiotherapy should always be done before considering surgery, as it is fundamentally important in managing hip conditions. Here are three of the most common ones.
#1 Hip impingement
This painful pinching sensation occurs when the ball and socket of the hip joint don’t fit together properly. It usually affects the groin area and is aggravated by flexing the hip. This makes it hard to play sports.
When it comes to managing hip impingement, Dr O’Neill says, “the vast majority of patients’ symptoms will resolve with physiotherapy.” They can then usually return to all their previous activities without pain.
However, the first step should be a detailed clinical examination by an experienced hip surgeon. This is to ensure the origin of the pain is from the hip and not somewhere else. Investigations may include x-rays and an MRI scan.
#2 Hip bursitis
This type of chronic hip pain is not necessarily associated with an injury but rather caused by a combination of wear and tear of the large tendons around the hip, and inflammation. Signs of hip bursitis may include joint pain and tenderness, with pain presenting on the outer side of the hip.
This condition rarely requires surgery, says Dr O’Neill. Management usually involves a combination of anti-inflammatory medication, physiotherapy and, in persistent cases, steroid injection under ultrasound guidance.
#3 Hip arthritis
Arthritis is the process whereby the cartilage inside the joint wears away. This causes pain and stiffness in the groin and at the side of the hip – sometimes all the way down to the knee. The pain usually progresses over a period of months or years to a point where it can be debilitating and affect all daily activities, including sleep.
“Physiotherapy is excellent at reducing pain and increasing function,” says Dr O’Neill. “Some patients also find Pilates and yoga helpful in maintaining their hip range of motion.”
Additionally, he recommends avoiding high-impact and contact sports. And losing weight can help reduce symptoms if the patient is overweight.
When hip replacement surgery is a solution
If hip pain continues to affect your quality of life, despite non-surgical efforts, the next step would be to consider surgery, says Dr O’Neill. Luckily, these days it’s possible to treat hip conditions with minimally invasive methods such as hip arthroscopy – a keyhole procedure to repair tears and reshape the bone for lasting pain relief and improved range of motion. It can be just the solution for the small group of patients who suffer from persisting pain even after non-surgical treatments have been tried for hip impingement.
Hip replacement surgery has come a long way since your grandma got one in the 1980s! That’s good news for patients who experience persistent arthritis pain even after conservative treatments have been tried.
No longer reserved for just “old people”, Dr O’Neill says that hip replacement surgery is an “excellent procedure that consistently removes pain, returns function and significantly improves your quality of life.”
Full recovery usually takes three months, with many patients returning to all sports they played previously. However, Dr O’Neill adds that a “surgeon’s experience is the most crucial factor in ensuring the best outcome.”
This article first appeared in the June 2023 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!