It’s not unusual for people who are in their fifties or older to experience hip pain. The decades can take a toll on a person’s bones, muscles and joints, leading — in some cases — to osteoarthritis.
Younger people can also have hip pain, of course. Sometimes joint injuries can cause discomfort years later. So can extra body weight and repetitive movements (e.g., those made while training for and playing sports). Low back issues and genetic factors can play a role in hip pain. Even a difference in leg length, which may affect more than half of the population, can cause gait problems. These issues may eventually lead to the need for hip replacement.
So how do you know if your hip pain is caused by a temporary injury to the soft tissues around the joint, or an issue such as uneven hips, which might be addressed through the use of orthotics, or something longer term, like arthritis, that may warrant surgery?
Sometimes the location of the pain can help determine what’s causing it. Sharp discomfort in the groin area or on the inside of the hip is often an indication of a problem with the hip joint itself, whereas pain on the outside of the hip or in the upper thigh or outer buttock area may be associated with the soft tissues (ligaments, tendons, muscles, etc.) that surround the hip joint.
If you have persistent pain and/or stiffness in one or both of your hips, it’s a good idea to have it checked by a medical professional. Depending on the underlying cause, it may just need some extra attention. Not all hip pain calls for surgery or a joint replacement.
There are some warning signs, though, that could indicate a hip replacement may be necessary. We’ve compiled a list of five common hip replacement symptoms to be on the lookout for.
1. Stiffness in your hip limits your normal range of motion
Your hip doesn’t move as freely as it used to, and the stiffness is bad enough that it keeps you from engaging in regular everyday activities — like going for a walk, or squatting down to pick up something. One leg might feel as though it’s dragging, compared with the other leg, and you might have an actual limp. Maybe you wobble when you walk.
Your hip joint might feel as though it sticks, or locks up, especially when you start to stand up after sitting for a while. The stiffness might be worse in the morning, when you first wake up. You may also have a dull ache in your hip or groin, along with the stiffness.
Stiffness can come on gradually, and you might not notice it much in the beginning. These are common signs that you have stiffness in one or both of your hips:
- It’s harder to put on your shoes and socks.
- You can’t walk the same distance you normally would, or it takes you considerably longer.
- Getting out of a car is a challenge.
- It’s difficult to lift your leg in front of you, to the side, or behind you.
- You have to use your hands to push against something or pull yourself up when getting up from the floor.
2. Recommended treatments don’t relieve the pain
You’ve tried a variety of treatments to eliminate the pain — including medications such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, and injections of cortisone or hyaluronic acid. You may also have tried physical and/or occupational therapy, at-home remedies, transcutaneous electrical nerve stimulation (TENS) and even minor surgery.
Although these methods may provide some level of short-term relief, steadily returning pain is a hip replacement symptom to be aware of.
3. You have difficulty sleeping
Pain in your hip may make it hard to get in a comfortable position so you can fall asleep, particularly if you’re accustomed to sleeping on the side that is hurting.
Once you do go to sleep, the pain may cause you to toss and turn. The disruption in your sleep cycle can leave you feeling tired when you wake up and throughout the day.
4. Tests show that you have arthritis or joint damage
The hip is a ball-and-socket joint where the femur (thigh bone) joins the pelvis. The “ball” is the femoral head (the upper end of the femur), and the “socket” is the acetabulum, an area on the outer edge of the pelvis that is formed by three bones. The joint capsule, which is a connective tissue that attaches to the bones, and the muscles and ligaments that surround the hip joint stabilize the hip and provide support.
Cartilage separates the bones from each other and helps to cushion them as they glide back and forth across each other. The surface of the joint has a thin lining called the synovium, which produces synovial fluid that lubricates the cartilage and helps ease movement. Over time, the cartilage can break down, and as it wears away, the bones are left rubbing against each other. This is how osteoarthritis develops.
In people who have rheumatoid arthritis, an inflammatory disease can develop at any age, the synovium swells and becomes thicker, and as that occurs, chemical substances are produced that destroy the cartilage.
Soft tissues like cartilage don’t show up on an X-ray, but an X-ray can still be useful in diagnosing osteoarthritis. That’s because it will show hip arthritis symptoms such as narrowing of the space between the bones in the hip joint, as well as any bone spurs that might have formed around the joint.
For cases that are more complex, magnetic resonance imaging (MRI) may be appropriate. An MRI is a more detailed image that does show soft tissues, including cartilage.
5. You’re feeling emotional distress
Persistent pain can be debilitating. It can keep you from doing activities you enjoy and make it hard to get through the day. As the pain continues, you may start feeling frustrated, impatient and perhaps even a little hopeless.
Know that there is help. If it turns out that your symptoms do warrant a hip replacement, the surgery can rid you of the pain you’ve been experiencing and get you back to your normal activities. Depending on the type of surgery, you could be back in full swing in a matter of weeks.