Pain from the hip joint most commonly causes pain in the groin and the front of the thigh, although occasionally pain can refer all the way down the leg. The most common cause of hip pain in older people is osteoarthritis (arthritis). Although physiotherapy can be effective in relieving the symptoms from mild to moderate arthritis, sometimes a total hip replacement is required to improve symptoms. Please see the information below for details about hip replacement surgery.
Pain on the outside of the hip is most commonly caused by a condition called Trochanteric pain syndrome (sometimes called trochanteric bursitis). Please see the section below for more information about trochanteric pain syndrome.#
Osteoarthritis (arthritis) is caused by the gradual thinning of the smooth cartilage that lines all of our joints. This is a normal process that happens as we get older, however, it can cause joint pain and stiffness. Using the affected joint will not cause more wear and in-fact too much rest will cause more pain and stiffness in the joint and weakness in the surrounding muscles.
Although arthritis cannot be cured, symptoms can be improved by keeping active and performing regular exercise. Exercising keeps the muscles around the joint strong and flexible which can help to reduce pain and maximise your functional ability. Losing weight can also help with pain from arthritis. If you would like advice about diet and weight loss, community health trainers can give practical advice and support with this. Further information about arthritis can be found here on the Arthritis Research UK website.
Total hip replacement surgery
In a total hip replacement the orthopaedic surgeon will cut away the arthritic hip “ball and socket” joint and replace them with a prosthetic joint. The physiotherapy staff on the ward will teach you exercises to help you regain the movement and strength in your hip. Outpatient physio is not always required, unless you are having ongoing problems. Have a look at our exercise video section, where details of targeted exercises can be found.
With any total hip replacement there is a small risk of dislocating the joint in the first few months after surgery. Because of this, there are certain restrictions which you should follow for the first three months after the surgery:
- Do not cross your legs
- Do not twist around with your operated leg kept still on the floor
- Do not bring your operated leg past the middle of our body
- Do not bend your hip past 90o (your knee should always be kept lower than your hip).
For more information about hip replacement surgery, please visit the Arthritis Research UK website.
Trochanteric pain syndrome (trochanteric bursitis)
Pain on the outside of the hip is commonly caused by a combination of wear and tear to the tendons around the hip joint. Sometimes pain is also caused by inflammation of the bursa (bursitis) of the hip. Bursae are thin, fluid-filled structures which help to reduce friction between muscles and bones. This condition can be improved by performing specific stretching and strengthening exercises for the muscles around the hip. This stimulates the body to strengthen the tendons and reduce pain. Your physiotherapist will advise you which exercises will be most helpful for you to perform and videos of the exercises can be found in our exercise video section.
Lower limb fractures (broken bones in the leg)
Fractures are breaks or cracks in bones. They can be treated conservatively by immobilising the limb in a cast or may be surgically repaired. Your orthopaedic surgeon will decide which option is best for you, based on your x-ray or scan findings. Once the surgeons are happy with how the fracture is healing you will usually be referred to physiotherapy to help you get the movement, strength and mobility back into your leg.
Because broken bones have to be immobilised in order to heal, it is usual for the joints around the fracture to become stiff and the muscles to become weak. This can cause pain in around the joint initially, however this usually improves once you get things moving. Once your fracture has healed you should try and walk as normally as possible, however, you may have to gradually re-introduce more difficult activities (e.g. jogging). If you have any concerns about specific activities, discuss this with your physiotherapist. Occasionally, broken bones can cause a condition called Complex Regional Pain Syndrome (CRPS).