When hip pain isn’t just ‘getting older’: 7 warning signs you shouldn’t ignore

When hip pain isn't just 'getting older': 7 warning signs you shouldn't ignore

Hip pain is often mis-sold as an inevitable part of getting older. But while the occasional brief bout of mild stiffness may be acceptable, any pain or discomfort that interferes with your daily activities and quality of life shouldn’t just be brushed off as an age-related issue – it should be taken seriously and addressed by a medical professional.

Hip pain can affect people of any age, though older individuals are more at risk of hip pain that is caused by conditions such as osteoarthritis (where the soft tissues that cushion the joints wear away through overuse or naturally with age) and fractures due to osteoporosis (a condition which affects one in five women, and one in 20 men over the age of 50). 

Mr Jerome Davison, Consultant and Orthopaedic Surgeon, says: “It’s important to distinguish between normal age-related changes and hip changes requiring medical attention, as the ‘just live with it’ mentality can lead to delayed care and worse outcomes.” 

In this article, we will explore the common causes of hip pain, signs that point to serious problems relating to hip pain, and when to see a medical professional.

Common causes of hip pain

Discomfort in the hip isn’t always serious. If you’re over the age of 50, you may experience joint stiffness due to inactivity, discomfort after a long walk or exercise, or short-term discomfort due to muscle weakness or imbalance if you aren’t frequently active. But severe or chronic pain is never normal, and should always be addressed.

There are many reasons why you might experience hip pain, and not all of them are linked directly to ageing. The most common causes include:

  • Osteoarthritis: This is a degenerative joint disease where cartilage wears down over time, leading to pain, stiffness and swelling. It is particularly common in people over 50, though young people can also experience osteoarthritis.
  • Rheumatoid arthritis: This is an autoimmune disorder that causes inflammation in the joints, and can eventually cause permanent joint damage and deformity if left untreated.
  • Fractures due to osteoporosis: Osteoporosis itself doesn’t usually cause pain; most people with osteoporosis receive a diagnosis after a fracture, which tends to occur after a knock or fall.
  • Stress fractures: Commonly seen in runners and other athletic patients, a stress fracture in the hip is caused by repetitive force. If not treated, it’s possible that the fracture may break the bone.
  • Bursitis: Inflammation of the small, fluid-filled sacs (bursae) that cushion the hip joint. This can cause sharp pain, especially when lying on the affected side.
  • Tendonitis: Overuse of the hip can lead to inflammation of the tendons, causing discomfort during movement or after long periods of activity.
  • Hip labral tear: A tear in the cartilage that rings the hip socket, often seen in people who are very active or those with underlying structural issues.
  • Referred pain: Sometimes, what feels like hip pain is actually caused by issues in the lower back or knees.
  • Failed hip replacement or worn hip implants: Sometimes, hip replacements can fail, dislocate or wear down, causing instability, ineffectiveness and pain.
  • Osteonecrosis: This is where blood flow to part of a bone is disrupted, and results in the death of bone tissue if left untreated. It is very common in patients with sickle cell disease and other blood disorders due to the increased risk of avascular necrosis.
  • Joint infection (septic arthritis): An infection can affect your hip joint if bacteria gets into the joint via an injury, surgery, or from somewhere else in the body. Symptoms include pain, swelling, fever and a change in skin colour around the joint. This is a serious condition and should be treated by a doctor immediately.

Cancer and hip pain

Other, rarer, causes of hip pain include those caused by cancer. Mr Jerome Davidson explains that those with secondary malignancy in the hip (a cancer that is now present in the bones of the hip but has originated from elsewhere in the body) “usually have ongoing pain, as well as other features like unexplained weight loss and lethargy”. 

Distinct from secondary bone cancer, primary bone cancer (also known as bone sarcoma) is a cancer that begins in the bone itself. It is rare, accounting for 0.2% of all cancer diagnoses in England. The different types of primary bone cancer include: 

  • chondrosarcoma, which grows in the cartilage
  • chordoma, which primarily forms in the base of the skull or base of the spine
  • Ewing sarcoma, which typically affects children and young adults during periods of rapid bone growth
  • and osteosarcoma, which, again, affects mostly children and young adults, and usually develops in the long bones of the limbs. 

These cancers can cause malignant primary bone tumours. However, there are also benign tumours that can develop in the hip, such as giant cell tumours (GCTs). While benign, GCTs can result in bone destruction, as well as pain, swelling and restricted movement. Treatment usually involves surgery, but GCTs commonly recur and must be monitored.

Treatment for hip pain

Not all causes of hip pain require surgery. Depending on the issue, the pain may be treated with rest or physical therapy; medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs); steroid injections; or other pathways. 

When it comes to surgical treatment for hip pain, the type of surgery will depend on the cause of the pain. Common types of hip surgery include:

  • Hip arthroscopy: A minimally invasive procedure that involves inserting a tiny camera (arthroscope) and surgical instruments through small incisions around the hip joint. It’s used to diagnose and treat soft tissue injuries such as labral tears or cartilage damage.
  • Total hip arthroplasty (hip replacement): It replaces both the ball (femoral head) and socket (acetabulum) of the hip joint with prosthetic components. It’s often used to treat advanced osteoarthritis.
  • Partial hip arthroplasty: This replaces the ball of the hip joint, leaving the socket intact. It is commonly used in individuals who have fractured the femoral neck but have an otherwise healthy joint.
  • Hip revision surgery: Performed to replace or repair a previous hip replacement that has worn out, become loose or caused complications like infection or dislocation. It’s typically more complex and invasive than a first-time hip replacement.

Pinpointing the exact cause of your hip pain is key in finding the most effective treatment. That’s where a specialist assessment with an orthopaedic surgeon makes all the difference.

How do I know when my hip pain is serious?

If you’re unsure whether your hip pain warrants a visit to a specialist, here are seven clear warning signs to look out for. These signs suggest your discomfort may be more than just a temporary nuisance or short-term injury, and that it’s time to seek professional advice.

1. You’ve had an accident

Any recent accident or fall, especially if you heard a pop or felt a sharp pain at the time, should be assessed immediately. Even if you’re still able to move, fractures and soft tissue injuries can sometimes go unnoticed and worsen without early intervention.

2. Persistent pain

Pain that persists beyond a few days, worsens over time or significantly impacts your ability to walk, sit, sleep or carry out daily tasks should not be ignored. Chronic pain may indicate an underlying joint issue that could benefit from early treatment.

3. Radiating pain

Pain that radiates to your groin, buttocks, thighs or knees may suggest nerve irritation or structural problems in the hip joint. This type of pain isn’t typical of general stiffness and should always be checked out.

4. Swelling

Visible swelling around the hip joint, particularly if it’s accompanied by warmth, redness or tenderness, could be a sign of inflammatory arthritis, infection or fluid build-up. Swelling that doesn’t improve with rest and ice needs medical intervention.

5. Impacted mobility

If you find yourself avoiding certain movements or activities that previously felt manageable – such as tying your shoelaces, getting out of a chair, or walking up and down stairs – it could be a sign that your body may be compensating for an underlying issue that needs professional attention. Some people even find the basic act of lying in bed painful.

6. Reliance on pain relief

If you are regularly using over-the-counter painkillers just to get through the day, it’s a sign that your pain isn’t resolving naturally. Increasing dependency on medication can mask a problem rather than solve it.

7. Current treatments are no longer effective

Maybe you have already tried physiotherapy, exercise or medication, and found that it no longer helps, or perhaps that your symptoms have worsened. If your current treatment plan isn’t working, it could be time to consider other options, including surgical assessment.

When to see a doctor for hip pain

You should see a medical professional if your hip pain is:

  • Constant or getting worse
  • Affecting your ability to move, sleep or carry out daily activities
  • Accompanied by swelling, redness or warmth around the hip joint
  • Causing weakness in the leg
  • Not improving with rest, ice or over-the-counter medication

Seeking help early can prevent further damage and significantly improve your long-term outcome. Modern treatments such as minimally invasive hip surgery can offer excellent results with shorter recovery times and less disruption to your life.

You know your body best. If something doesn’t feel right, don’t dismiss it as ‘just getting older’. A professional assessment with a hip surgeon can help you understand what’s going on, and provide personalised treatment options designed to get you back to doing the things you love with comfort and ease.

To book a consultation with Mr Jerome Davidson, please call 020 8168 0111 or book online.