In this article you can find a comprehensive guide on hip pain.
Also known as coxalgia, hip pain is a very common symptom that affects individuals of all genders and ages.
Depending on the underlying cause, hip pain can be felt in the groin area, on the outer part of the hip or in the buttock area.
It can be particularly intense and acute, for example, in the case of a fracture or it can correspond to a dull and chronic sensation, as in the case of arthritis.
Hip pain may present in association with other symptoms, including:
- limping
- stiffness and reduced mobility of the joint
- sense of soreness
- difficulty sleeping on one side
- pain in the front of the thigh or knee.
In this article, you can find a comprehensive guide on hip pain to resolve all your doubts regarding:
- how to alleviate hip pain;
- hip replacement, the definitive treatment for curing pain;
- exercises for hip arthritis;
- hip arthritis and sports: friends or foes?
1 – How to relieve hip pain
The hip plays a fundamental role in movement, and if you experience severe pain, everyday activities such as walking, getting out of bed, or climbing stairs can become difficult, if not impossible.
The solution is to consult a specialist in hip and its pathologies, including arthritis, to understand the severity of the pain you are experiencing.
Its severity can be classified into three levels based on the progression of the condition:
- mild: an initial wear of the cartilage and the pain is localized only in the hip area;
- moderate: symptoms become more intense, appearing during movement and even at rest. The pain also extends to the groin area and the front of the thigh;
- severe: chronic, intense and widespread pain and hip movements are significantly compromised.
The specialist, depending on the stage of the pathology, can recommend appropriate treatments and therapies.
Hip pain: what tests should you undergo?
To understand the extent of hip pain the orthopedic specialist conducts an examination through a physical assessment, medical history and imaging diagnostics.
The physical assessment and medical history provide important information about the characteristics of the pain, the triggering event and risk factors.
Imaging diagnostics allow for the evaluation of the health of the hip joint and the muscle-tendon elements interacting with it.
Typically the evaluation of pain includes:
- X-rays
- MRI (Magnetic Resonance Imaging)
- Ultrasound
- CT scan
Conservative treatment
Once it is determined that the pain is caused by osteoarthritis, initial management typically involves conservative treatment, although this therapy cannot halt the progression of osteoarthritis.
The most commonly used treatments for hip pain can be categorized into five main groups:
- medications: painkillers and anti-inflammatory drugs help manage symptoms, such as pain and swelling and can slow down joint degeneration;
- injections: corticosteroid injections can provide relief and reduce inflammation, while hyaluronic acid injections act as a lubricant;
- physical therapy: this aims to improve muscle efficiency, increase range of motion and flexibility and offer preventive and protective benefits for the joints;
- regenerative medicine: treatments like PRP (Platelet-Rich Plasma) and stem cells leverage the regenerative potential of tissues. While they do not regenerate cartilage in cases of osteoarthritis, they have anti-inflammatory effects;
- weight loss: reducing body weight helps decrease the load on the joints. A proper diet, combined with supplements containing glucosamine and chondroitin sulfate, can be beneficial.
Discover more details about conservative treatments for hip pain qui.
2 – Hip replacement, the definitive treatment for curing the pain
When the pain is resistant to conservative therapies, it is time to consider surgery.
The outcome of the operation is the permanent removal of pain and the full recovery of joint movement.
Who needs surgery?
Surgery is specifically recommended for patients with any of the following symptoms:
- pain resistant to pain relief therapies;
- limited joint mobility;
- impairment of daily activities;
- significant difficulty rising from a seated position;
- difficulty sleeping at night due to pain;
- pain while walking;
- limited or no benefit from conservative treatments.
The stages of hip replacement surgery
The surgery is planned through preoperative computer-assisted planning and the execution of an X-ray that allows the selection of the appropriate prosthesis based on your age, bone quality and the shape of the natural joint.
In hip replacement surgery the damaged bone and cartilage are removed and replaced by implanting prosthetic components firmly fixed to the bone. The goal is to have a new stable joint.
The technical duration of the surgical procedure usually varies between 45 and 60 minutes, although in reality about 3 hours pass from when you are brought into the operating room to when you return to your room and it can be outlined as follows:
- anesthesia: administration of drugs intravenously, monitoring of vital signs spinal anesthesia;
- positioning of the patient on the operating table on the side;
- disinfection of the limb and skin incision;
- removal of worn bone and cartilage;
- placement of prosthetic components;
- maneuvers to test the new joint;
- closure of the skin with glue and dressing.
Minimally invasive hip replacement
Minimally invasive techniques allow for the implantation of hip prostheses through an incision of about 10 cm, closed with glue, with bone sparing, especially on the femur.
Minimally invasive approaches involve the use of smaller prostheses combined with modern pain management techniques and blood conservation strategies, along with rapid rehabilitation protocols, enabling immediate recovery.
Patients start walking on the same day of the surgery and can return home independently within a few days.
For further details on the procedure and prosthesis lifespan, visit this page.
This procedure can be performed privately, through health insurance or in agreement with the National Health Service (S.S.N).
In Tuscany you can consult Dr. Vanni Strigelli, who practices in various facilities in Florence and Pontassieve and performs surgical procedures at Valdisieve Hospital, privately and under NHS (SSN) agreement.
Read this article to learn more about hip replacement surgery with Dr. Vanni Strigelli.
3 – The importance of exercises for hip osteoarthritis
Before surgery it’s important to maintain a balanced weight and engage in regular physical activity to keep mobility good.
There are some exercises to help alleviate pain that can be practiced at home to strengthen the muscles that stabilize the joint.
The advice is to start slowly, especially if you don’t regularly exercise; remember to breathe correctly and respect the breaks between each set.
Listen to your body and gradually increase the number of sets and duration, aiming for consistency in physical activity.
In addition to exercises you can take anti-inflammatories and pain relievers during the acute phase and attend physiotherapy sessions to keep symptoms under control.
Stretching exercises help improve flexibility in the muscles around the hip, reduce trauma and prevent injuries.
Strength training exercises, on the other hand, should be performed to stabilize the joint and promote mobility, thus limiting pain and maintaining proper posture.
The fundamental exercises for a proper and speedy recovery
Below are some exercises you should do for a quick recovery, with sets of 10 repetitions, three times a day.
Ankle Flexion-Extensions
Slowly move your ankle, foot and toes up and down. These can be repeated several times throughout the day to reactivate the venous pump of the calf.
Knee Flexion
Without lifting the pelvis flex and extend the knee (keep the knees slightly apart) by sliding the heel on the bed. Once maximum flexion is reached, bring the knee outward and hold for 5 seconds.
Gluteal Muscle Strengthening
Bring your arms along your body, bend your knees slightly apart and lift your buttocks off the mattress, making a “bridge.”
Contract your buttocks and hold the contraction for 5-10 seconds, then relax.
Quadriceps Muscle Strengthening
Sit on the edge of the bed with your legs hanging off. Keep your knees slightly apart.
Extend and flex your knees actively, alternating legs.
If you want more information about exercises after a hip replacement, read this article as well.
4 – Hip osteoarthritis and sports: friends or enemies?
If you suffer from osteoarthritis, exercising is important because it alleviates pain, improves the course of the condition, joint mobility and consequently, your quality of life.
Staying active and avoiding a sedentary lifestyle is important for your body’s health and also for your joints, as it keeps your heart healthy, strengthens bones and muscles, increases flexibility and improves balance.
Exercise is your friend, because moderate training and an active lifestyle ensure better joint “aging,” maintaining good mobility and muscle tone over time.
While advanced osteoarthritis may limit participation in certain sports you enjoy, it doesn’t preclude exercise.
Engaging in exercise, preferably under the guidance of a physiotherapist initially, is effective in reducing osteoarthritis symptoms, as is physical activity without weight-bearing on the lower limbs (such as cycling, swimming, water aerobics).
There are some strategies to follow in the case of hip osteoarthritis:
- avoiding overweight, as excessive weight load can lead to progressive joint degeneration and osteoarthritis;
- staying active, because inactivity only leads to joint stiffness;
- avoiding sports that put excessive strain on the joints after a certain age, such as football, rugby, running, as they involve prolonged weight-bearing movements over time and the risk of contact injuries;
- maintaining a balanced diet.
What sports can you practice if you suffer from hip osteoarthritis?
Targeted gymnastics is useful for correcting posture, strengthening muscles, increasing tissue elasticity and oxygenation, improving balance and recovering joint mobility.
Yoga and Pilates are two recommended and easy-to-practice activities that offer all these benefits.
All water activities are excellent options because the joints are unloaded and not subjected to full weight, as is also suitable for cycling.
Walking and dancing are also recommended, because they help maintain well-being.
After hip replacement surgery, what sports can you engage in without pain?
After rehabilitation you can resume various sports with a hip prosthesis:
- bicycling – stationary cycling;
- unlimited walking;
- gymnastics;
- golf;
- dancing;
- swimming;
- bowling;
- hiking;
- skiing;
- doubles tennis;
- rowing;
- sailing.
Because sport is not an enemy to your joints, quite the opposite; it’s the perfect ally to keep you active, healthy and youthful, if practiced with the right attention and intensity.
If you suffer from hip arthritis and experience pain, consult Dr. Vanni Strigelli to improve and treat your condition.
