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Hip pain

Find out more about the causes and treatments available for hip pain

The hip is the largest joint in the body and takes on a considerable amount of wear and tear over your lifetime. Whenever you walk, run, or move your legs, the cartilage in your hips prevents painful friction between the bones and allows you to move with ease.

Hip pain can occur when there are problems with the hip bone, cartilage, or the muscles surrounding the area. Hip pain due to wear and tear is more common in older adults, whereas muscle injuries commonly occur in younger people or athletes.

At The Blackheath Hospital, we are proud to have orthopaedic specialists who can diagnose and treat hip pain, as well as help you prevent your symptoms from getting worse over time.

This state-of-the-art Circle Health Group facility offers private services for people living in Greenwich, Lewisham and Bexley. 

Hip pain can refer to any pain or discomfort around the hips, groin, or parts of the upper and inner thighs. It is helpful to identify exactly where the pain occurs and how it feels. For example, sudden or shooting pain may be an acute injury, whereas a long-term ache might be arthritis.

Pain in the hip can also radiate to other areas, like the buttocks, groin, and back, especially if you are straining these areas to compensate for the lack of mobility in the hip.

Some causes of hip pain have common triggers, like sitting or standing for long periods, or being exposed to cold weather.

Dr Mike Thilagarajah, a Consultant Orthopaedic & Trauma Surgeon at The Blackheath Hospital in Greenwich, notes that “getting that diagnosis is fundamental for tailoring the appropriate treatment that makes sense”.

Knowing how to describe your symptoms and keeping track of what movements or situations make the hip pain worse will help a doctor correctly diagnose the underlying cause. This can save time and unnecessary tests, and can get you feeling better sooner. 

There are many possible causes of hip pain and discomfort. Finding out what the underlying cause is will probably involve seeing a hip pain specialist.

We will take a closer look at some common hip pain causes in the sections below.

Minor injuries such as hip flexor pain

Hip flexor pain can occur when the hip flexor muscles are pulled, strained, torn, or injured.

Dr Thilagarajah noted that in younger patients, “the actual joint surface of the hips are usually good, so the pain more likely comes from the tissues around the hip. These include ligaments, muscles, tendons.”

Short-term hip pain is common after a minor injury, such as a strained or torn muscle or tendon. You may not have noticed the injury when it first occurred, or may have had some sharp, acute pain that got better over time.

Hip flexor pain treatment

In the case of most minor muscle strains, rest and gentle stretching after a few days will help the injury heal. For these types of injuries, follow the ‘RICE’ method:

  • Rest
  • Ice
  • Compression
  • Elevation

It may be difficult to elevate your hip, but be careful not to lie down on the side that is causing you pain or discomfort. If the pain does not subside or is severe, seek advice from a doctor.

Trochanteric bursitis

“There's a very common condition called trochanteric bursitis, in which a protective little pouch of fluid around the outside of the hip gets inflamed,” say Dr Thilagarajah.

When asked about the most common non-arthritic issues with the hips, Dr Thilagarajah immediately noted trochanteric bursitis as a possibility. While anyone can get bursitis, it is more common in women and older people.

The protective pouches of fluid are called bursa, and there is one on each side of your hips. You might feel the pain on the outward sides of your upper thigh, often just on one side. The pain can also radiate higher or lower.

“Most cases of [trochanteric bursitis] are non-arthritic related — they’re due to inflammation from sprains and irritation. They are usually reversible through non-surgical means, which would normally entail physiotherapy among other things.”

The bursa may become irritated from repetitive movements, like cycling, jumping or even standing for long periods. Inflammation can also come from repetitive movements or from sports injuries.

The pain may be worse at night, when you lie down, or if you try to stand up after sitting for a while. Some people find the pain is worse after doing movements that strain the hips, like hiking, walking, or doing squats.

Trochanteric bursitis treatment

People can usually treat trochanteric bursitis at home with ice and anti-inflammatories (such as ibuprofen) to reduce the swelling. It is also important to avoid doing any activities that make the hip pain worse.

In more severe cases, you may wish to use a cane or other assistive device to help you walk. A physiotherapist can recommend exercises and modifications to your usual movements to speed up recovery.

If you are in a lot of pain, a doctor may also provide a corticosteroid injection directly to the area. While corticosteroid injections quickly reduce swelling, they come with their own risks and are not recommended for repeated or long-term use.

Lateral hip pain

The gluteal muscles on the outside of the hip help control the pelvis when walking or standing, and also facilitate hip abduction, which is when you move the hip out to the side.

The gluteal muscles are attached to the outer hip bone by tendons. If these tendons become inflamed or sensitive, you may feel lateral hip pain — pain outside the hip that can radiate down the outside of the thigh toward the knee.

Lateral hip pain treatment

Lateral hip pain should resolve without medical treatment. To speed up recovery and prevent lateral hip pain in the future, avoid:

  • Crossing your legs
  • Sitting with the knees together and feet splayed, particularly on low chairs
  • Standing with more weight on one leg
  • Lying on the side that is in pain

If lateral hip pain continues, speak to your doctor for further guidance.

Arthritis

There are several different types of arthritis which can cause hip pain, but osteoarthritis is the most common. Osteoarthritis occurs when the cartilage cushioning the bones begins to wear down and be damaged with age.

Rheumatoid arthritis, on the other hand, is an inflammatory condition that occurs when the body mistakenly attacks healthy joints, causing pain and inflammation.

Arthritis affects about 10 million people in the UK and is more common in women. This is because bones gradually get weaker as levels of oestrogen fall. Some women experience joint stiffness in perimenopause, and in some cases it is self-limiting, meaning that their symptoms end once menopause symptoms subside.

Hip arthritis treatments

For milder cases of arthritis that are causing hip pain, Dr Thilagarajah recommends general fitness, physiotherapy, and simple painkillers.

It is best to avoid surgery unless the hip pain is having a significant impact on your mobility and quality of life, as surgery comes with its own set of risks.

How to relieve hip pain from arthritis

Non-invasive treatment options for how to relieve hip pain include:

  • Losing weight with a doctor’s advice if you are overweight
  • Increasing your overall fitness by doing gentle exercises, such as swimming and yoga, which do not strain the joints
  • Taking painkillers when necessary

“Paracetamol can actually be taken on a regular basis quite safely,” says Dr Thilagarajah. Anti-inflammatories such as ibuprofen are fine for occasional use, but have ‘real risks’ associated with more frequent or long-term use.

“I wouldn't recommend being on anti-inflammatories long term. I would say that if your need for anti-inflammatories is greater, it probably means that you're heading more towards surgery in any case.”

Hip replacement surgery is an option for severely arthritic hips. During surgery, the surgical team will replace the bone and cartilage with prosthetics. You may need one or both hips replaced.

Hip replacement recovery

According to Dr Thilagarajah, the best thing a patient can do to increase their chances of a successful recovery following hip surgery is to adhere to their rehabilitation program.

Before your surgery, your medical team will create a personalised rehabilitation program that may include instructions on rest, exercise and medications. Sticking to this plan and regularly checking in with your doctor after surgery is vital for your recovery.

Physiotherapy  is often a vital part of the recovery process. The physiotherapist will teach you how to bend and pick things up safely, as well as provide exercises to gradually rebuild your muscle strength.

Dr Thilagarajah advises that while serious complications such as dislocation or breakage are “fortunately very rare, you can modify your activities to lower the risk of these problems. Most important is adhering to the advice that the physiotherapist gives you at the beginning.” 

In the unlikely event that you fracture your hip, the first response should be to go immediately to the hospital.

Breaking a hip causes:

  • Pain
  • An inability to stand or put weight on one leg
  • Swelling
  • Bruising
  • The affected leg staying at an odd angle

Older people and those with existing hip problems are more likely to experience a hip fracture. This type of injury usually comes from falling or having an accident.

Falls that incur a risk of hip fracture are most common in people over the age of 80. At this age, your vision and balance are reduced, and the bones are no longer as strong as they once were.

Fractures are also more common in women. Hormonal changes in women after menopause increase the risk of developing osteoporosis, a condition which makes the bones more fragile.

What to do if you think you have fractured your hip

If you have fractured your hip, call an ambulance to take you to the hospital. Stay warm while you wait and try not to move — you may need to get someone’s attention by shouting, banging on a wall or pressing your alert button if you have one.

Once you are at the hospital, the medical team will ask a number of questions, such as whether you have existing arthritis and if this is your first fall. They will take X-rays and do other tests to determine the best course of action.

Hip fracture treatment

The National Institute for Health and Care Excellence (NICE) states that anyone who has experienced a hip fracture should have surgery within 48 hours of their injury. According to the NHS, about half of all cases require a full or partial hip replacement.

As with planned hip replacements, you can increase your chances of a smooth recovery by sticking to your custom rehabilitation plan.

With our specialist consultants and comfortable facilities at The Blackheath Hospital, you will find exactly the help you need — from the initial diagnosis to the final check-up.

Knee surgeries are one of the main private treatments offered at the hospital, so you will be welcomed by experienced experts in the field.

Hip pain diagnosis

If you’re based in Greenwich or nearby, and you are suffering from hip pain, we’re here to help. At The Blackheath Hospital, we offer quick and easy access to appointments. 

During your initial appointment, one of our specialist consultants will ask some questions about your hip pain symptoms and general health.

They will also perform a thorough physical examination and may carry out imaging tests such as X-rays, MRIs, CT scans or ultrasounds.

This will help your consultant to diagnose and suggest the best course of treatment for the cause of your hip pain.

Hip pain treatments

The hip pain treatment that is most suitable for you will depend on the underlying cause of your hip pain.

At The Blackheath Hospital, we offer a number of treatment options, including:

Your consultant will take you through your options for treatment and help you to decide on the most suitable treatment for you.

Specialists offering Hip pain

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Mr Matthew Gee

Consultant Orthopaedic Surgeon

MBBS, BSc (Hons), MSc, FRCS (Tr&Orth)

The Blackheath Hospital 1 more Shirley Oaks Hospital

View profile Book online

Mr Jonathan Walczak

Consultant Orthopaedic & Trauma Surgeon

MBBS Bsc FRCS(Eng) FRCS(Orth)

Chelsfield Park Hospital 3 more Shirley Oaks Hospital The Sloane Hospital The Blackheath Hospital

View profile Book online

Mr Yathish Shenava

Consultant Orthopaedic Surgeon

MBBS, MS, FRCS (Orth)

The Blackheath Hospital 1 more Shirley Oaks Hospital

View profile Book online

Mr Rahij Anwar

Consultant Orthopaedic Surgeon

CCT, FRCS (Tr & Orth), Dip (Tr & Orth), MSc (Trauma), MRCS, MS (Orth), MBBS

The Blackheath Hospital

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Mr Panamoottil Anil Kumar

Consultant Orthopaedic Surgeon

MBBS, MS Orth, D Orth, Dip NB Orth, FRCS (Glas), FRCS (Tr &Orth)

The Blackheath Hospital

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Mr Samuel Orakwe

Consultant Orthopaedic & Trauma Surgeon

MBBS, FRCS (Ed), FRCS (Orth)

The Blackheath Hospital 1 more The Sloane Hospital

View profile Book online

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