Hip pain treatment options: from simple to surgical

By ShareMD Connect

Is hip pain giving you grief? From mild irritation to total debilitation, it’s essential to understand the severity of your injury if you want to minimize the pain and long-term damage. That starts by understanding your treatment options.

At-Home Treatments

In less severe cases, at-home treatment can work well for hip pain. Rest, exercise, ice packs, and heating pads can sometimes do wonders to help relieve pain and reduce inflammation. If your pain is caused by muscle strain, tendonitis, or osteoarthritis, certain over-the-counter (OTC) NSAID pain medications might help too.

NSAIDs, or non-steroidal anti-inflammatory drugs, are intended to ease the inflammation contributing to pain. NSAIDs include aspirin, ibuprofen, and naproxen. Acetaminophen is not an NSAID, but it can still help relieve pain, even if it doesn’t directly target inflammation at the source. Before taking any over-the-counter medications, it’s important to discuss them with your hip care provider to understand any risks or drug interactions you may need to be aware of.

Nonsurgical Treatment Options 

For less severe hip conditions, an orthopedist may recommend a combination of the following: 

  • Minimizing certain activities. Switching from high-impact activities (such as running or basketball) to lower-impact activities (such as biking or swimming) will apply less stress on your hips. Reducing these types of activities may slow the progression of certain conditions, such as osteoarthritis.
  • Weight Loss. Losing weight can help reduce stress on the hip joint, resulting in less pain and increased function.
  • Physical therapy. A physical therapist can create an individualized exercise program to help increase your range of motion and flexibility and strengthen your hip and leg muscles. 
  • Supportive devices. Using walking devices such as a cane, crutches, or a walker can greatly improve mobility and independence. Other assistive aids like a long-handled reacher to pick up low-lying things can also help you avoid movements that may cause pain.
  • Pain relieving medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve pain and reduce inflammation. Over-the-counter NSAIDs include naproxen and ibuprofen. Your orthopedist may prescribe you a more potent form of NSAIDs.
  • Corticosteroids. This is also known as cortisone and is a powerful anti-inflammatory agent that can be taken by mouth or injected into a painful joint. When used as an injection, some orthopedists may use an ultrasound to help guide them to the exact location of the pain in your hip joint. 
Surgical Treatment Options

For more severe hip conditions that do not respond to nonsurgical treatment, there are two general types of surgical treatments for hip pain: hip arthroscopy and total hip replacement.

Hip Arthroscopy is a minimally invasive procedure. During this procedure, the surgeon makes one or more small incisions, usually no more than an inch or two long. From there, the orthopedic specialist inserts a video scope the size of a pencil into the incisions, along with small surgical tools, allowing them to examine and repair the hip joint. 

This type of surgery often involves a technique called ‘debridement,’ where a tool removes frayed or loose bits of cartilage around the hip joint. A smooth joint surface allows for more comfortable, unrestricted movement in the hip joint, helping relieve pain.

Total Hip Replacement (THR) If you experience chronic hip pain because of joint damage caused by arthritis and have difficulty walking or exercising because of joint stiffness, an orthopedist may recommend this surgery to remove the diseased joint and replace it with durable prosthetic parts.

While this procedure is more invasive than arthroscopy, a total hip replacement may dramatically improve your quality of life by alleviating pain and restoring the hip's stability and range of motion.

A THR is done under spinal or general anesthesia. During the procedure, an incision is made along the hip's front, side, or back to access the hip joint- depending on the type of surgical approach your surgeon feels is most appropriate for you.

The surgeon then removes the damaged femoral head and replaces it with a metal stem placed into the femur's hollow center. The femoral stem may be either cemented or "press fit" into the bone. A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.

The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place. A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth, gliding surface. The surgeon then injects pain medication into the surrounding tissues of the hip to help control pain and closes the incision with stitches.

The good news is that with quality care and a good understanding of your condition, living with hip pain can be a thing of the past. Treatment options are available, ranging from simple at-home remedies to more invasive surgery. But to start living your pain-free life, you must take the next step. Start by taking our short assessment to see whether you need to see a specialist or by scheduling a free call with a ShareMD nurse to learn more about your condition or how to navigate care.