Hip pain 

Most cases of hip pain in adults are caused by osteoarthritis, the most common type of arthritis in the UK.

This page aims to give you a better idea of whether osteoarthritis or something more unusual is causing your hip pain, and what you can do about it.

However, don't try to diagnose the cause of your hip pain yourself – this should always be a matter for your doctor or Camden MSK specialist.

  • Symptoms of osteoarthritis

    The main symptoms of osteoarthritis are joint pain and stiffness. Some people also experience swelling, tenderness and a grating or crackling sound when moving the affected joints.

    The severity of osteoarthritis symptoms can vary greatly from person to person, and between different affected joints.

    For some people, the symptoms can be mild and may come and go. Other people can experience more continuous and severe problems which make it difficult to carry out everyday activities.

    Almost any joint can be affected by osteoarthritis, but the condition most often causes problems in the knees, hips and small joints of the hands.

    You should see your GP or self-refer to physiotherapy if you have persistent symptoms of osteoarthritis so they can confirm the diagnosis and prescribe any necessary treatment.

    Read more about the symptoms of osteoarthritis.

  • Causes of osteoarthritis

    As part of normal life, your joints are exposed to a constant low level of damage. In most cases, your body repairs the damage itself and you don't experience any symptoms.

    But in osteoarthritis, the protective cartilage on the ends of your bones breaks down, causing pain, swelling and problems moving the joint. Bony growths can develop, and the area can become inflamed (red and swollen).

    The exact cause isn't known, but several things are thought to increase your risk of developing osteoarthritis, including:

    • joint injury – overusing your joint when it hasn't had enough time to heal after an injury or operation
    • other conditions (secondary arthritis) – osteoarthritis can occur in joints severely damaged by a previous or existing condition, such as rheumatoid arthritis or gout
    • age – your risk of developing the condition increases as you get older
    • family history – osteoarthritis may run in families, although studies haven't identified a single gene responsible
    • obesity – being obese puts excess strain on your joints, particularly those that bear most of your weight, such as your knees and hips
  • Diagnosing osteoarthritis

    To help determine whether you have osteoarthritis, your GP/physiotherapist will first ask you about your symptoms and examine your joints.

    Your GP/physiotherapist may suspect osteoarthritis if:

    • you're aged 50 or older
    • you have joint pain that gets worse the more you use your joints
    • you have stiffness in your joints in the morning that lasts less than 30 minutes, or no stiffness at all

    If your symptoms are slightly different from those listed above, this may indicate another joint condition. For example, prolonged joint stiffness in the morning can be a sign of rheumatoid arthritis.

    Further tests – such as X-rays or blood tests – aren't usually necessary, but may be used to rule out other possible causes, such as rheumatoid arthritis or a fractured bone.

  • Treating osteoarthritis

    Osteoarthritis is a long-term condition and can't be cured, but it doesn't necessarily get any worse over time and it can sometimes gradually improve. A number of treatments are also available to reduce the symptoms.

    Mild symptoms can sometimes be managed with simple measures including:

    • regular exercise
    • losing weight if you're overweight
    • wearing suitable footwear
    • using special devices to reduce the strain on your joints during your everyday activities

    If your symptoms are more severe, you may need additional treatments such as painkilling medication and a structured exercise plan carried out under the supervision of a physiotherapist.

    In a small number of cases, where the above treatments haven't helped or the damage to the joints is particularly severe, surgery may be carried out to repair, strengthen or replace a damaged joint.

    Read more about treating osteoarthritis.

  • Living with osteoarthritis

    As osteoarthritis is a long-term condition, it's important you receive support to help you cope with any issues such as reduced mobility, and advice on any necessary financial support.

    Some people may find it helpful to talk to their GP, physiotherapist or others who are living with osteoarthritis, as there may be questions or worries you want to share.

    Read about living with osteoarthritis.

     

    Preventing osteoarthritis

    It's not possible to prevent osteoarthritis altogether. However, you may be able to minimise your risk of developing the condition by avoiding injury and staying as healthy and active as possible.

    Exercise

    If you have pain try to Avoid excessive amounts of exercise that puts strain on your joints and forces them to bear an excessive load, such as running and weight training (running and weight training are good forms of exercise as long as they are done in a moderated way and are not causing joint pain)Instead, try exercises such as swimming and cycling, where your joints are better supported and the strain on your joints is more controlled.

    Try to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (such as cycling or fast walking) every week to build up your muscle strength and keep yourself generally healthy.

    Read about health and fitness – including tips on simple exercises you can do at home.

    Posture

    It can also help to maintain good posture at all times and avoid staying in the same position for too long.

    If you work at a desk, make sure your chair is at the correct height, and take regular breaks to move around.

    Read about common posture mistakes and fixes.

    Losing weight

    Being overweight or obese can increase the strain on your joints and increase your risk of developing osteoarthritis. If you're overweight, losing weight may help lower your chances of developing the condition.

    To find out whether you're overweight or obese, use the healthy weight calculator.

  • Falls and hip fractures

  • Symptoms of a hip fracture

    Symptoms of a hip fracture after a fall may include:

    • pain
    • not being able to lift, move or rotate (turn) your leg
    • being unable to stand or put weight on your leg
    • bruising and swelling around the hip area
    • a shorter leg on the injured side
    • your leg turning outwards more on the injured side

    A hip fracture won't necessarily cause bruising or prevent you from standing or walking.

  • When to seek medical help for a hip fracture

    If you think you've fractured your hip, you'll need to go to hospital as soon as possible. Dial 999 for an ambulance.

    Try not to move while you're waiting for the ambulance and make sure you keep warm.

    If you've fallen, you may feel shaken or shocked, but try not to panic. Try to get someone's attention by:

    • calling out for help
    • banging on the wall or the floor
    • using your aid call button (if you have one)
  • Hospital assessment

    After arriving at hospital with a suspected hip fracture, your overall condition will be assessed. The doctor carrying out the assessment may:

    • ask how you were injured and whether you had a fall
    • ask if this is the first time you've fallen (if you did fall)
    • ask about any other medical conditions you have
    • ask whether you're taking any medication
    • assess how much pain you're in
    • assess your mental state (if you fell and hit your head, you may be confused)
    • take your temperature 
    • make sure you're not dehydrated

    Depending on the outcome of your assessment, you may be given:

    • painkilling medication
    • local anaesthetic injection near your hip
    • intravenous fluid (fluid through a needle into a vein in your arm)

    The healthcare professionals treating you will make sure you're warm and comfortable. After a while, you may be moved from the emergency department to a ward, such as an orthopaedic ward.

    To confirm whether your hip has been fractured, you may require imaging tests such as:

  • Treating a hip fracture

    Surgery is usually the only treatment option for hip fractures.

    The National Institute for Health and Care Excellence (NICE) recommends that someone with a hip fracture should have surgery within 48 hours of admission to hospital.

    However, surgery may sometimes be delayed if the person is unwell with another condition and treatment would significantly improve the outcome of the operation.

    In about half of all cases, a partial or complete hip replacement is needed. The other cases require surgery to fix the fracture with plates and screws or rods.

    The type of surgery you need depends on a number of factors, including:

    • type of fracture (where on the femur it is)
    • your age
    • your level of mobility before the fracture
    • the condition of the bone and joint – for example, whether or not you have arthritis

    Read more about treating a hip fracture.

  • Recovering from hip surgery

    The aim after surgery is to speed up recovery to help regain your mobility.

    Either on the day of surgery or the next day, you will havea physiotherapy assessment and be given a rehabilitation programme that includes realistic goals for you to achieve during your recovery. The aim is to help you regain your mobility and independence so you can return home as soon as possible.

    Read more about your care after discharge from hospital.

    How long you'll need to stay in hospital will depend on your condition and mobility. It may be possible to be discharged in three to five days.

    Evidence suggests that prompt surgery and a tailored rehabilitation programme that starts as soon as possible after surgery can significantly improve a person's life, reduce the length of their hospital stay and help them recover their mobility faster.

    Read more about recovering from a hip fracture.

    It may also be useful to read your guide to care and support – written not only for people with care and support needs, but their carers and relatives too. It includes information and advice on:

  • Complications of hip surgery

    Complications can arise from surgery, including:

    • infection – the risk is reduced by using antibiotics at the time of surgery and careful sterile techniques; infection occurs in about 1-3% of cases and requires further treatment and often further surgery
    • blood clots – can form in the deep veins of the leg (deep vein thrombosis, or DVT) as a result of reduced movement; DVT can be prevented using special stockings, exercise and medication
    • pressure ulcers (bedsores) – can occur on areas of skin under constant pressure from being in a chair or bed for long periods

    Your surgeon will be able to discuss these and any other risks with you.

  • Preventing hip fractures

    It may be possible to prevent hip fractures by taking steps to prevent falls and by treating osteoporosis.

    You can reduce your risk of falling by:

    Read more about preventing falls.

  • Hip protectors

    Hip protectors can be used to reduce the impact of a fall, and are particularly useful for preventing hip fractures in older people.

    Hip protectors are padded material and plastic shields attached to specially designed underwear. The pads absorb the shock of a fall and the plastic shields divert the impact away from vulnerable areas of the hip.

    In the past, one of the biggest issues with hip protectors was that many people found them uncomfortable and stopped wearing them. Modern hip protectors have tried to address this by having a more comfortable fit and additional features, such as ventilation to reduce sweating.

    NICE suggests that hip protectors may be useful for older people in care homes who are considered to be at high risk of a fall. They're thought to be less effective for elderly people who remain active and live in their own home.