How to manage pain by body part > News > Yale Medicine


How is it : The hip is a ball and socket joint that is cushioned and protected by smooth cartilage during movement. When this cartilage breaks down due to overuse, aging, stress on the body from obesity, and/or a number of other factors, bone rubs against bone, causing pain. and other symptoms. It is a common space for OA to develop. And, although rheumatoid arthritis usually starts in the small joints, it can also appear in the hip.

“The hip really drives the boat,” says Dr. Gibson, who specializes in hip and knee disorders. “If the hip isn’t working, the feet and ankles are under tension and it becomes more difficult to move the knee. A person may notice a “locking” sound with movement, decreased range of motion, limping, and groin pain that may travel down the leg and up the back. You might eventually start walking with an altered gait.


Self-care: Start an exercise program (or modify the one you have to avoid high-impact sports, like running or tennis), maintain a healthy diet, and lose weight if necessary.

Dr. Gibson suggests trying “a gentle cyclical loading program,” such as walking or low-impact aerobics. These types of activities have been shown to be joint protective. Talk to your doctor about taking an over-the-counter pain reliever, such as a nonsteroidal anti-inflammatory drug (NSAID), but remember they’re meant for short-term use.


What does a specialist do: See a professional when your hip arthritis limits daily functions or regular activities, says Dr. Gibson. For example, a patient might say, “I like hiking, but now it’s harder.”

A specialist will start with non-invasive treatments, including physical therapy and oral medications. If these simple treatments don’t work, more invasive treatments like corticosteroid injections into the hip can minimize symptoms and preserve function. One caveat is that the injections are “a double-edged sword” in that they relieve inflammation and relieve acute pain, but they can be toxic to the areas where they’re given, says Dr. Gibson. “So you don’t want to do too many, maybe two or three at most in any given year.”


If you are considering surgery: Hip replacement is considered one of the most successful operations in orthopedics, says Dr. Gibson. It is minimally invasive and can be performed on an outpatient basis in many cases. “It’s really a dramatic and transformative operation that allows us to take someone who’s been sedentary and bring them to a place where they can do pretty much anything again,” he says.

Replacement hips use implants – made of a combination of metal, plastic and ceramic – which last for decades. One operation, called a direct anterior approach, avoids cutting a muscle to replace a hip, and surgeons say it makes rehabilitation easier.

Whichever approach a patient chooses, the key is to find a surgeon who has performed a high volume of that particular operation and is comfortable performing it, adds Dr. Gibson.

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