Hip pain is extremely common and is something most of us can 'look forward to' as we get older! In most cases it is caused by arthritis – 'wear and tear' of the bones that form the hip joint.
The hip joint is a ball and socket type joint. The 'ball' is the head of the thigh bone ('femur') and the 'socket' is part of the pelvis. Normally the surfaces of the bone that face each other are covered in very smooth cartilage and separated by a film of special fluid ('synovial fluid'). This allows the bones to smoothly glide over each other with minimal friction and no pain.
Unfortunately as time passes the cartilage that lines the joint can become damaged and worn and the bones of the joint can start to rub against each other. This causes discomfort and a 'creaking' feeling when bending or standing. Eventually as the joint wears out further the hip can become more and more stiff and painful, and that is when we need to consider what to do about it.
Initially arthritis of the hip is treated 'conservatively' – in other words with gentle exercise and painkillers. This reduces the stiffness after you have been resting and the discomfort and pain when you move. This is very helpful in keeping people comfortable and mobile for months or even years after the problem first appears.
Unfortunately there is nothing that can be done to stop the arthritis progressing and with time the stiffness and pain no longer responds to these simple measures and we need to consider what else can be done. This is where hip replacement surgery comes in.
What are my options for treatment?
Painkillers and anti-inflammatories can help temporarily, but the side effects are sometimes unpleasant. We can inject a local anaesthetic and steroid to reduce the pain for a few months, but this is not a permanent solution. Sometimes the hip can even collapse which then makes surgery more complex. Keyhole surgery can be an option for certain conditions and your suitability for this type of procedure can be determined with an MRI scan.
The basics of treating hip pain are straightforward. Once a diagnosis has been made that the problem is arthritis of the hip joint we know that over time the artritis will get worse, your symptoms will get worse, and eventually you will need a total hip replacment.
And whilst hip replacment surgery is very safe and one of the most successful of all operations that surgeons perform, it is still of course an operation, and no-one would wish to have a surgery unless it was absolutely necessary.
So our goal is to keep you as mobile and as comfortable and pain-free as possible, to keep you active and with a good quality of life. We do this with regular painkillers, excercise and physiotherapy.
Unfortunately, the arthritis will continue to get worse - sometimes quickly, sometimes slowly. But eventually simple treatment will no longer be effective and the time will come to consider a hip replacement.
Click here to find out more about hip replacement surgery
