Hip Pain: Easing Discomfort with Proven Solutions

By: Bryan Whitfield, MD
Date: Sep 17, 2018

It May Not Be Your Hip

True hip pain culprits include impingement, labral tear, bursitis, pain coming from the gluteal tendon, and osteoarthritis.

“One of the major things we immediately try to differentiate between is if it’s actually a hip condition—or is the pain coming from the back?”

Causes & Symptoms of a Hip Condition

Sometimes the shape of the bones leads to impingement—the socket and ball essentially running into each other and tearing cartilage around the rim. A fall can sprain the hip and tear tendons.

“Most people think their hip is on the back and on the side, what we would call the flank,” states Dr. Whitfield. “It turns out, conditions within the ball and socket are usually felt in the groin, more on the front than the back.” Typically, patients experience discomfort going from a seated position to a standing one. Pain can be triggered by certain activities or accompany every step.

Getting a Diagnosis

If there’s nothing else going on with the body, most normal aches and pains should go away within two weeks. If pain is holding on after two to six weeks, it’s time to get it checked out.

“When diagnosing hip issues, we really take into account an entire view: history, physical, imaging, and response to treatment,” explains Dr. Whitfield. “That helps us determine where exactly the pain is coming from and what condition is most relevant.”

Treatment Options

Some patients just want to be reassured nothing major is to blame and will often do nothing more if the pain is not limiting. However, Dr. Whitfield finds injections in the symptomatic location to be quite helpful.

“The other approach I routinely take is physical therapy. Much of the pain individuals experience is from muscle imbalances,” states Dr. Whitfield. “Physical therapy can help to correct that.”

Anti-inflammatory medications and avoiding activities that exacerbate the pain are also options. If significant pain continues over a long period of time, surgery should be considered.

Hip Surgery

When a patient has arthritis, the only reliable answer is to remove the damaged cartilage in the underlying bone and replace it with different material such as metal and plastic, which is hip replacement.

Pain may also be a result of a tear in the labrum from a sprain or bones impinging, or because of a torn tendon. “If there’s no significant arthritis in the hip, I can go in and remove some of the bone that is impinging and repair the labrum,” explains Dr. Whitfield. “Oftentimes, that’s very effective in taking away the pain.”

Benefits of Total Hip Replacement

In terms of risk versus reward, total hip replacement is considered one of the most successful surgeries and is effective in easing the majority of osteoarthritis pain.

“As techniques have advanced, we’ve changed our approach. A direct anterior procedure is minimally invasive and does not require any muscle detachment,” states Dr. Whitfield. “This allows for a quicker recovery.”

How Long Does a New Hip Last?

“I tell people it’s like a car,” says Dr. Whitfield. “If you’re just driving slowly on Sundays, the tires will never wear out. However, if it’s a sports car and you’re going off the line and around corners quickly, those tires are probably not going to last the life of the car. In my opinion, if a new hip doesn’t last a good 15 to 20 years, I’m disappointed. My hope is that it can last up to 30 years or more.”

For more information about hip pain and treatment, please visit emoryhealthcare.org.

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