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Hip pain treatment

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When someone sees a physiotherapist about how to ease hip pain, the first thing to determine is which biomechanical problems may have contributed to the hip pain.

These problems may be local to the hip region, for example poor strength or inflexibility of the hip joint itself. Problems such as excessive knee, ankle or foot rotation may also be contributing factors to your joint pain.

Once determined, physiotherapists are able to advise on a series of hip pain exercises designed to correct the movement pattern. Hip strengthening programs are often prescribed to gradually increase the load on muscles and tendons.

This has two advantages in that it may improve problematic biomechanics, but also loading soft tissue increases the likelihood of optimal muscle and tendon healing following injury. Common examples are rotational hip exercises known as side lying clam exercises and pelvic bridging exercises.

Stretching programs for muscles may also improve mechanical efficiency of movements as well as release tension in muscles, which can be a contributory factor in causing hip pain. Common muscle groups targeted in patients with hip pain include the calf muscles, hamstrings and hip flexor stretches for pain.

Certain manual techniques may also be employed by physiotherapists to improve hip pain. Depending on the cause of hip stiffness (such as tight hip flexors), physiotherapists are able to provide hip joint mobilisation techniques, sometimes referred to as mobilisations with movement.

These techniques may be done using a belt or strap to increase leverage. If the hip stiffness is thought to be due to muscular and soft tissue restriction around the hip, then physiotherapists can work on deep soft tissue release techniques to reduce any overactivity to these tissues.

Your physical therapist will also be able to advise you on what hip pain exercises to avoid, and can give you stretches for lower back and hip pain.

Exercise for hip pain can help tackle stiffness in your hip joint and strengthen the muscles around your hip. You may also want to explore yoga for hip pain, as certain yoga poses can help strengthen and stretch muscles that are important in supporting aching joints.

As well as keeping your joint healthy, the NHS adds keeping active can assist with weight loss and maintain your overall health by reducing your risk of developing particular health conditions, such as type 2 diabetes and stroke. 

Sometimes, standard pain relief may not be as effective as desired. In these situations, your Consultant may advise an injection of a corticosteroid into the hip joint.

This steroid injection helps relieve pain and acts as an anti-inflammatory within the joint.

Many people find it helps relieve their pain and stiffness, although the effects will wear off over time.

Repeat injections tend to become less effective. This type of injection can be helpful when you need a period of good pain relief but is not usually a long-term strategy.

The most common form of surgery used to treat disabling levels of hip pain is a total hip replacement, sometimes referred to as a hip arthroplasty.

In recent years, hip replacement surgery has been deemed one of the most successful operations available based on improvements in quality of life. Tens of thousands of these operations are completed each year in the UK.

In recent years there has also been a drive to solve the dilemma of disabling hip osteoarthritis in younger people for whom a traditional hip replacement may be unsuitable due to their more active lifestyle and increased hip replacement wear rates.

Hip resurfacing techniques are now sometimes offered in these circumstances which replace the top of the thigh-bone (femoral head) with a small metal cap rather than a large, stemmed ball device used in a hip replacement.

This allows a resurfaced hip to be converted to a total hip replacement without complications later on in life, reducing the need for more complicated revision hip replacement operations. Hip cartilage (labral) tears and hip impingement syndromes have also seen a marked increase in operation rates in the last decade.

Keyhole surgery (hip arthroscopy) is used to access the joint. Surgeons are then able to examine and repair torn parts of the hip labrum, as well as shave excess bone from the area which is causing the impingement.

Other forms of hip surgery may be rarely used to treat large genetic structural variations of the hips to reduce the progression of osteoarthritis or to repair tendon tears around the hip region.

Orthotic insoles are medical devices often provided by orthotists, physiotherapists or podiatrists to help with a variety of musculoskeletal problems.

Insoles are designed to provide different forms of materials, which may provide more shock absorption or stability for the foot during weight-bearing tasks. Secondly, they are able to provide a certain degree of foot arch support or wedging towards the inside and outside of the heel or foot.

Depending on the exact structure of the insole this can alter the angle of the foot when in contact with the ground and may also enable better muscular stability around the ankle and foot. When there is evidence of a biomechanical problem contributing to hip nerve pain, orthotics may therefore be used to restore more normal biomechanics.

Insoles are often designed and used as a variety of off-the-shelf designs, which clinicians may select depending on the characteristic needed. However, they may also be customised from a variety of methods, including from force plate measurements and foam/ plastic moulds.

Specialists offering Hip pain treatment

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Mr Jeya Palan

Orthopaedic Consultant Surgeon

BSc (Hons), MB BS, PhD, FRCS (Tr & Orth)

The Huddersfield Hospital

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Mr Ben Brooke

Consultant Orthopaedic Surgeon

MBChB, MRCS, FRCS (Tr & Orth)

The Huddersfield Hospital

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Mr David Wood

Consultant Orthopaedic Surgeon

MB ChB, MRCS, FRCS (Tr and Orth)

Thornbury Hospital

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Mr Pardeep Sharma

Consultant Orthopaedic Surgeon

M.B.B.S., M.S.(Orth), M.Ch (Orth), FRCS (Tr & Orth)

Ross Hall Hospital

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Mr Sameh Sidhom

Consultant Orthopaedic Surgeon

MB BCh (Hons), MSc, FRCS (Eng), FRCS (Tr and Orth)

The Huddersfield Hospital

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