Dear doctor, my mother suffers from persistent hip pain. Does she need surgery?
06 February 2018
Q: My mother suffers from persistent hip pain and her range of movement seems to be getting more restricted. It’s affecting her daily life as she finds it difficult to get out and about. Does she need surgery?
A: The symptoms you describe of deteriorating pain and function in the hip are very common. Although there are many causes of hip pain, this is most commonly due to osteoarthrosis, also referred to as 'arthritis'.
Firstly, it is important to establish the diagnosis, which a GP can do by taking a patient history, x-ray and carrying out an examination. If the symptoms and tests suggest further investigation is required, your mother will be referred to a specialist orthopaedic surgeon.
One of the most common alternative causes is pain referred from the spine, however in circumstances where it is still not clear, the orthopaedic surgeon may choose to arrange to have the hip joint injected with local anaesthetic and steroid. This is a very quick and simple day procedure performed with the patient usually awake, using a special 'real-time' X-ray viewer. Once it’s established that the hip pain is due to hip osteoarthrosis, the orthopaedic surgeon will determine whether surgery is suitable.
As osteoarthrosis is not reversible, the only real surgical option is total hip replacement (THR). For that reason, all other options have to be exhausted first including; pain killers, walking aids and modifying her activities - if close to retirement, it is often useful to see if merely retiring helps calm the symptoms.
The injections may be sufficient to keep the symptoms at bay in milder forms of the condition, alternatively THR is usually recommended. Although a major operation, it is well established with around 95% of patients reporting high satisfaction.
Mr Advait Gandhe is a Consultant Orthopaedic Surgeon practising at Spire Portsmouth Hospital.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.