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What’s causing your hip pain, and what can you do to relieve it?
But, in more severe cases, you may require decisive treatment like surgery to recover from hip pain and maintain a good quality of life. Many people suffering from hip pain visit the Alexandra Hospital in Manchester for diagnosis and treatment each year.
Our specialist team of orthopaedic surgeons is on hand to help them manage their pain and regain movement in their hip.
Dr Tahir Mahmud, Consultant Orthopaedic Surgeon explains, “Osteoarthritis is a progressively degenerative condition which will inevitably get worse over time, although the rate of progression can vary greatly between individuals.”
Pain is the most common symptom of hip osteoarthritis. It can vary from a dull ache, to severe pain radiating down the leg. Joint stiffness is also regularly reported among osteoarthritis sufferers.
Pain can worsen during periods of activity or at the end of the day. Joints can also stiffen after rest, but will loosen up once you begin moving around. Levels of discomfort vary for no apparent reason, but you may notice specific movements or activities exacerbate your symptoms.
Osteoarthritis can cause swelling in your hip joint, which often appears as solid and knobbly. It is caused by the joint thickening and fluid build-up inside the joint capsule. You may also notice a grating or cracking sound when you move.
While the exact cause of osteoarthritis is unknown, certain risk factors impact the likelihood of developing the condition. The most widely agreed upon include:
Ageing causes changes that affect joint function and structure, often referred to as “wear and tear.” While age increases susceptibility to the condition, other risk factors usually contribute to osteoarthritis development:
The heavier you are, the more load you place on your hip, back, and knees. A high body mass index (BMI) is more commonly noted as a risk factor for knee osteoarthritis but increases the likelihood of developing the condition in all weight-bearing joints.
Prolonged overload on these joints results in excessive wear and tear and a worsening of symptoms. Reducing your weight to a healthy level will help reduce these symptoms.
Several studies conclude genetics play an important role in predicting the development of osteoarthritis. One particular study demonstrated having a first, second, or third-degree relative who undergoes a total hip replacement (referred to as total hip arthroplasty) increases the risk of requiring the treatment yourself.
Physically demanding careers involving heavy manual labour, such as building or gardening, are linked to a higher risk of osteoarthritis later in life. Participating in high-impact sports, which put your joints under repetitive stress and overload, is also a risk factor.
Those who have suffered previous fractures or soft tissue injuries to the hip are at increased risk of osteoarthritis. This is due to changes in how the joint is loaded after an injury.
One is on the outside of the hip, known as the trochanteric bursa, and the second located on the inside of the hip, called the iliopsoas bursa. Hip bursitis is the inflammation of one or both of these bursae.
When the bursa located on the outside of the hip is inflamed, it’s known as trochanteric bursitis (or greater trochanteric pain syndrome - GTPS), which is treated easily.
Hip bursitis affects approximately 5 in every 1000 adults and is more likely to impact those above middle age. Overuse of the hip joint causes friction which can cause this painful condition, so those who regularly run or cycle are particularly susceptible.
Anyone can develop hip impingement, but it’s more common in younger adults who are particularly active. Sporting activities or manual labour can exacerbate symptoms.
Hip impingement may increase the risk of osteoarthritis in later life, but no significant studies have taken place to verify this.
If you’re worried about your symptoms, you should arrange to see a specialist. Especially if any of the following apply:
Most cases of hip pain can be diagnosed by an experienced specialist, who will investigate the background of your symptoms and complete a thorough physical examination.
Other practical diagnostic tests are used to analyse your joint and tissue structures to find the cause of your pain.
X-rays can show any degenerative changes to the hips and can determine the extent of those changes. X-rays can also be used to evaluate the shape and angles of hip joints. This helps provide your specialist with information about whether there are any defects in your hip (a potential cause of hip impingement) or whether there is any sign of a hip fracture.
CT scans are very similar to X-rays, but provide a detailed 3D perspective of your bone structure. It will show any fractures or bone defects and can also show bone density – providing useful information about the strength and condition of your bones.
MRI scans are often used where a soft tissue injury is suspected. Commonly, hip cartilage (labral) tears or where the suspected cause of the hip pain is in tissue outside the hip itself.
Primary bone cancer means the tumour originates in the bone. This is different from secondary bone cancer, which spreads to your bones from another body area.
Common symptoms of bone cancer:
Bone pain - This pain can be a persistent, dull ache that is the same during the day and night. You may also find the area tender to touch, and it may also become swollen. If you experience this type of pain for two or more weeks, you should see a specialist as soon as possible.
Weakened bones - Cancer can cause weakening of the bones, which means they’re easier to fracture. These fractures can occur even if you haven’t had an obvious accident or trauma to the bone. Hip fractures can also occur due to osteoporosis (where the bones lose density and begin to wear away) so you should also consider this.
Increased calcium level - Cancer can cause calcium from your bones to leak into your bloodstream. This is known as hypercalcaemia and will be detected by a blood test.
Common symptoms of hypercalcaemia are tiredness, nausea, constipation, increased thirst, and confusion.
Steroid injections - If you cannot control your pain with over-the-counter medicines, your clinician may prescribe steroid injections. Steroids can be used to treat particularly painful hip problems and are sometimes offered when other treatments have failed to manage symptoms.
The injection is administered directly into the affected area, but you will usually be given a local anaesthetic to numb and minimise sensation. Steroid injections are fast-acting and can reduce pain for several weeks or even months.
Assistive devices - If osteoarthritis is making mobility difficult, several devices could help you.
Special footwear or clinical insoles for your shoes can help spread your weight evenly and reduce the impact on your joints as you walk.
If hip osteoarthritis makes walking painful, you may be offered a walking aid, like a stick or cane. Holding it on the opposite side of your body to the affected joint will help relieve some of the weight being placed on it.
Hip replacement (total arthroplasty) - If your quality of life is significantly impacted and pain management isn’t relieving your symptoms, a hip replacement might be your best option.
During arthroplasty, your orthopaedic surgeon will remove your affected joint and replace it with an artificial joint made of special clinical metals and plastics. These artificial joints can last up to 20 years before beginning to wear out. For this reason, specialists rarely offer hip arthroplasty to younger patients.
A newer type of joint replacement surgery has been developed, which is more suited to younger patients called resurfacing. This type of surgery only uses metal parts for the new joint.
Minimally invasive hip replacement - In some cases, your surgeon may prefer what is known as a minimally invasive approach to your hip replacement surgery.
Your surgeon uses smaller incisions to access your hip joint. They then use specially designed equipment to help perform a hip replacement.
The potential benefits of minimally invasive hip replacements are smaller scars, less post-operative pain and less risk of damage to surrounding muscles and tendons.
Minimally invasive surgery is not always the best option for everyone but ask your specialist if you want to know more about it
Any hip problem can potentially affect your ability to do the things you enjoy. As a result, your quality of life is impacted, which in turn affects your physical and emotional wellbeing.
The Alexandra’s dedicated orthopaedic team can help with all mobility problems. With painful hips affected by daily movements such as getting out of bed or into a car, it’s reassuring to know we are just a call away to help you.
We also cover the regions around Greater Manchester, including Trafford, Stockport, Cheshire East Tameside, and the surrounding areas