Hip pain: diagnosis and treatment

We recently spoke with leading consultant trauma orthopaedic surgeon, Mr Sam Heaton, to discuss hip pain.

Mr Heaton uses the MAKO robotic system for his private patients to ensure that the pre-operative plan can be enacted with the most accuracy. Have a read of our discussion below.
 

How common is hip pain?

Hip pain is more common in the elderly but it can occur in people of all ages. It is becoming more common as people are living longer and people are having higher expectations of what they want throughout their life, particularly in retirement.

Can the location of hip pain suggest the cause?

Pain in the hip region can be due to various causes, usually the hip joint but also the spine, muscles around the hip joint and systemic inflammation. Patients who present with arthritic hips have pain in their groin. They often have pain when resting, pain at night, can walk less far and become reliant on painkillers.

When should someone see a specialist for their hip pain?

Typically, at the first sign of hip pain you don’t necessarily have to see an orthopaedic surgeon. Many of the patients I see have managed their hip pain perfectly well at home with pain relief, modifying their activities, or even resorting to using a walking stick. They’ll often start by seeing a physiotherapist or a general practitioner. If none of those things are working, that’s when they’ll find their way to me.
 

How do you diagnose the cause of hip pain?

Hip pain can be difficult to diagnose. I always take a very detailed history to find out when it started, how it started and what the effects on the patients quality of life are. Once I’ve done that, I examine that patient. A combination of a decent history and a good examination will tell me the diagnosis in about 95% of cases. Once I’ve got that information, I will usually order an X-ray and very rarely further imaging (MRI or a CT scan) which almost always gives me enough information to make a diagnosis.
 

Is surgery always necessary for hip problems?

Surgery isn’t always necessary to treat a problem in the hip. It’s commonly manageable at home with walking aids, modifying your activities, staying active, low impact exercises (for example, using a bicycle or swimming) and weight loss. If those aren’t working, we may well need to look for a surgical solution, that’s particularly common in osteoarthritis, the wear and tear form of arthritis. It’s also used for inflammatory arthritis / rheumatoid arthritis, trauma, a fracture or dysplasia (abnormal growth of the hip).
 

What factors do you take into account when creating a treatment plan for hip pain?

When I treat patients with hip pain, both the patient and I will come up with a plan that suits the patient. It can often involve a trial of non-surgical treatments, which include physiotherapy, painkillers and activity modification. If those haven’t worked or the patient has already tried them, we usually come up with a plan together that involves a surgical solution in the form of a hip joint replacement. I now recommend a robotic-assisted hip replacement which uses robotic 3D planning and robotic assistance for reliable accurate results.
 

For more information, we recommend getting in touch with a leading expert in hip pain such as the highly experienced orthopaedic surgeon, Mr Sam Heaton. Click here to visit his profile for more information on his expertise and appointment availability.