Hip pain

The hips take on a considerable degree of wear and tear over the course of a person’s lifetime. Whenever you walk, run, or move your legs, the cartilage in your hips reduces friction between your bones and helps prevent pain and stiffness.

Hip pain can happen when there are problems with the hip bones, cartilage, or the muscles and tendons in the area. Arthritis-related hip pain is more common in older adults, whereas muscle and tendon injuries can happen to anyone.

At Thornbury Hospital in Sheffield, our orthopaedic specialists can diagnose and treat hip pain, as well as advise you on how to prevent symptoms from getting worse over time.

This state-of-the-art Circle Health Group facility offers private services for people living in Sheffield, South Yorkshire and the surrounding area. 

If you are experiencing hip pain, you might be referring to pain or discomfort around the hips, groin, or upper and inner thighs. Sudden or acute pain may be the result of an injury, whereas a long-term ache might be a sign of arthritis.

Hip pain can also spread to the buttocks, groin and back, especially if you are putting more strain on these areas to compensate for pain or stiffness in the hips.

You may notice particular things trigger your hip pain, such as cold weather or sitting or standing for long periods.

Describing your hip pain symptoms and keeping a log of what movements or situations make the hip pain worse will help your doctor diagnose the underlying cause sooner.

Professor Mark Wilkinson, consultant orthopaedic surgeon at Circle Health Group’s Thornbury Hospital in Sheffield, spoke to us about the possible causes and treatment options for hip pain. An international expert in hip and knee osteoarthritis, he is also one of only 100 members of the International Hip Society, who are the leaders in the field. There are many possible causes of hip pain and discomfort, which we will go into in further detail below.

Minor injuries

Short-term hip pain is common after minor injuries, like strained or torn muscles. With some injuries, you may feel the pain immediately. With others, you may notice an ache after — hours or even a day later.

Professor Wilkinson notes that there is a “wide range of injuries you can get in relation to sports and movement.” They include tendonitis — which is simply the inflammation of a tendon — or structural damage, like labrum tears.

These are usually exercise-related, says Professor Wilkinson, and are “typically in younger individuals who do a lot of sporting activity.”

Minor injuries treatment

In the case of most minor muscle and tendon injuries, Professor Wilkinson advises “rest, the gradual reintroduction of sports, using anti-inflammatory tablets and gels as required.”

You can also follow the ‘RICE’ method, which stands for:

• Rest
• Ice
• Compression
• Elevation

If you find a muscle or tendon injury isn’t getting any better, you might need to speak to a doctor. 

“Another common group of hip disorders that is not sports-related is trochanteric bursitis,” says Professor Wilkinson. While anyone can get bursitis, he notes that it most commonly affects women over 50 and people who are heavier.

The word ‘bursitis’ comes from the protective pouches of fluid on each hip, called ‘bursa’. Trochanteric bursitis causes pain on the outward sides of your upper thigh, often just on one side. The pain can also radiate upward or downward.

The bursa may become inflamed or irritated from repetitive movements, like cycling or standing for long periods.

Professor Wilkinson notes that trochanteric bursitis can be “worse at night and if you lie on the affected side. It can also cause pain while walking, and it can be associated with a clicking sensation.”

Trochanteric bursitis treatment

Trochanteric bursitis is not related to arthritis, but is due to inflammation from sprains and irritation. The treatment for this inflammation, Professor Wilkinson says, is non-operative and can include “anti-inflammatory tablets or gels. If those don’t work, a corticosteroid injection can be quite effective.”

It is also essential to avoid any activities that make the hip pain worse while you are healing.

People with severe pain sometimes find a walking stick helps relieve some pressure on the hip. A physiotherapist can also recommend modifications to your usual exercise to help you recover sooner. 

Lateral hip pain affects the gluteal muscles on the outside of the hip. These muscles help control the pelvis when walking, standing or moving the hip out to the side.

Tendons attach the gluteal muscles to the outer edge of your hip bones. Lateral hip pain — pain outside the hip that can radiate down the outside of the thigh toward the knee — can occur when these tendons become inflamed.

Lateral hip paint treatment

In most cases, you can treat lateral hip pain at home. The hip pain should resolve over time, but do take care to avoid:

• Crossing your legs while sitting
• Sitting with the feet splayed out but the knees together
• Putting more weight on one leg than the other while standing
• Lying on the hip that hurts

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.

Arthritis affects about 10 million people in the UK. It is more common in women than men. The most commonly affected joints are the ones that bear weight — the hips and the knees.

About 50% of the risk of developing osteoarthritis comes from hereditable factors, which means your family history of the condition. Professor Wilkinson advises that anyone with a family history of osteoarthritis wanting to reduce their risk “eat healthily and get regular exercise.”

“Even if you have arthritis, doing exercise is actually good for it. There's this general misconception that if you've got arthritis, you shouldn't exercise. Well, actually, that’s the last thing you want to not do. Because if you don't exercise you put on weight and your joints aren't kept moving. You've got to keep arthritic joints moving as much as you can.”

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

Arthritis in women

Asked why postmenopausal women are most at risk of osteoarthritis, Professor Wilkinson said:

“There's a number of reasons for that. First, the loss of oestrogen means that the joint is less protected against some of the chemical messengers that are bad for joint health. When you go through the menopause, you also put on weight and that is a key element. And when you put on fat in particular, there are chemical messengers in fat that are actually bad for bones, and they increase the amount of inflammation in joint tissues…

“Extra weight also increases the mechanical loading on the joint. So there's increased pressure, there are changes in the chemical signals, and changes in the hormones [...] when you add them all together, it's like a triple whammy of negative consequences for women.”

Some women experience joint stiffness in perimenopause (the years of irregular periods leading up to the menopause). In some cases, it is self-limiting, which means that the symptoms end once they no longer have periods.

Hip arthritis treatments

For most cases of arthritis, Professor Wilkinson recommends trying to lose weight as a first response.

“The core treatment for arthritis in anybody, whether it's hip or knee or any other site, is to reduce your weight if you’re overweight.”

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

Non-surgical treatments for hip arthritis

Non-surgical treatment options for improving hip arthritis include:

• Losing weight with a healthcare provider’s support if you are overweight
• Increasing your overall fitness by doing gentle exercises, such as swimming and yoga, which do not strain the joints
• Seeing a physiotherapist
• Taking painkillers when necessary
• Using a walking stick

The important thing to remember about exercising with hip arthritis is to do low impact activities.

“Running is a bad idea, because that's pounding all the time. That's high impact exercise. Try low impact exercises, like walking, swimming, cycling,” Professor Wilkinson advised.

He also noted that “there's no specific magic about physiotherapy, it's just that it helps you exercise and build up muscle strength,” which will reduce the strain on your hips. “What you're really trying to do is build up the quadriceps muscles because muscle strength seems to be an important factor in [limiting the progression of arthritis].”

While people can take paracetamol on a regular basis, Professor Wilkinson found that it is not often effective. Anti-inflammatory medications such as ibuprofen can be harmful if taken long term, but anti-inflammatory gels are available. Crucially, there is no evidence that injectable hyaluronic acid has any effect — it simply “does not work,” he states.

If the hip pain is no longer manageable with exercise, physiotherapy and painkillers, you may need surgery. The surgery will replace the bone and cartilage of one or both hips with prosthetics.

Hip surgery recovery

Patients can increase their chances of a successful recovery following hip surgery by adhering to their rehabilitation program and getting to a healthy weight before the surgery.

A consultant will create a personalised rehabilitation program that may include instructions on resting, returning to exercise and what medications to take.

Physiotherapy is an important part of recovery. Here, you will learn to bend and pick things up safely, and do exercises to gradually rebuild your muscle strength.

While serious complications, such as dislocation or breakage, are rare, following the recovery plan will reduce these risks as much as possible.

If you fracture your hip, the first response should be to go immediately to the hospital. A hip fracture will cause:

• Intense pain
• Trouble standing or putting weight on one leg
• Swelling
• Bruising
• One leg staying at an odd angle

Hip fractures usually come from falling or having an accident. The NHS states that falls are most common in people over 80 years old. As you age, your vision and balance are reduced, and the bones are more susceptible to breaks.

Bone fractures are also more common in women, for the same reasons that arthritis is more common. Post-menopausal women have an increased risk of osteoporosis, a condition which makes the bones more fragile.

Fracture treatment

It is uncommon for private hospitals to treat emergencies like a hip fracture. If you have fractured your hip, call an ambulance to take you to A&E.

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 also do a variety of tests, such as X-rays.

In some cases, a person may wish to have surgery privately. Some people also experience chronic fractures and can benefit from specialist treatment in a private hospital.

The National Institute for Health and Care Excellence (NICE) recommends treating hip fractures with surgery within 48 hours of the patient being admitted to hospital. According to the NHS, about 50% of all hip fractures require a full or partial hip replacement.

With our specialist consultants and comfortable facilities in Sheffield, you will get expert advice and treatment from the initial diagnosis to the final check-up.

Our team will work together to minimise any risks and help you have a successful outcome.

Thornbury Hospital is also home to the Hip Revision Centre of Excellence — the first facility of its kind in the UK.

Diagnosis

If you’re based in or around Sheffield and suffering from hip pain, you don’t need to wait months to get answers. At Thornbury Hospital, we offer quick and easy access to appointments.

During your first appointment, our consultants will ask a few questions about your health and hip pain symptoms to help diagnose and treat the cause of your hip pain.

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

In some cases, your consultant may also ask for blood tests to see whether the cause of your hip pain is inflammatory or an infection.

Hip pain treatments

The hip pain treatment you will receive at Thornbury Hospital will depend on what is causing your hip pain.

Thornbury Hospital offers a number of personalised treatment options, including:

• Hip replacement surgery
• Revision hip replacements
• Hip arthroscopy
• Hip injection treatments
• Physiotherapy

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

Book your appointment online today.