Eight signs you may need a hip replacement

If your hip has been causing you pain, you’ll know first-hand how much of an impact it can have on your life. Your mobility may be limited and you may find that you can’t enjoy or take part in some of your favourite activities. This can even affect your mental health. 

In some instances, the pain caused by your hip may disappear on its own with management using pain medication. However, in other cases, hip replacement surgery may be needed.

Hip replacement surgery is undertaken when the hip joint has become worn or damaged for a variety of reasons and a surgeon advises that it’s best to replace the ball-and-socket joint with a prosthetic one.

Things to consider when opting for hip replacement surgery

Hip replacement surgery is a common procedure. According to the National Joint Registry more than 110,000 people in England, Wales and Northern Ireland had hip replacement surgery in 2019. 

As having your hip replaced involves major surgery and rehabilitation, it’s usually only undertaken if other treatments haven’t been successful. The goal of hip replacement surgery is to improve your quality of life by reducing your hip pain and improving your mobility. And in most cases, these results are achieved after surgery followed by physiotherapy and rehabilitation, with the prosthetic hip joint lasting on average for 15 years and offering durable results. 

If you think you may need hip replacement surgery, here are a few factors to consider: 

• After 10–20 years, your prosthetic hip may become loose and need replacing
• You may have to use a walking aid for a couple of weeks after surgery
• You may need to make adaptations to your home to accommodate your recovery period
• You will need physiotherapy to teach you how to move with your new hip
• You will not be able to drive for a few weeks 

The most important factor when considering surgery is how much the daily pain and discomfort caused by your hip is affecting your quality of life. 

How do you know you might need a hip replacement?

There are a number of symptoms that suggest you may need a hip replacement, although some symptoms can vary. It’s important that you talk to a doctor for a diagnosis first if you are experiencing any of the below symptoms.

1. Hip stiffness 

Do you experience stiffness when you try to walk? Does bending and moving your hip joint really hurt? Do you find it almost impossible to lift or move your leg? Is it increasingly difficult to bend over and pick something up from the floor?

If you answered yes to any of these questions, your hip stiffness could be a sign that your hip joint is damaged. You may also notice that your hip clicks, pops or grinds when you move it.

Soreness, stiffness and inflammation of your hip joint are all indicators that sooner or later, your hip may begin to interfere with your ability to carry out everyday activities. This may make it difficult for you to sleep, enjoy your hobbies and socialise, which can affect your mental health.

Speak to your doctor so they can assess your hip joint, make a diagnosis and create a treatment plan.

2. Loss of motion 

If you’re experiencing hip pain, you may also have a loss in the range of motion in your hip. If you are no longer as mobile as you want to be — or used to be — you may find life and all the activities you enjoy doing are harder. You may have difficulty completing everyday tasks, such as sitting in the same chair for a long period of time or getting in or out of a car, chair or bath.

3. Reduced mental wellbeing

Never underestimate the effect that reduced physical mobility can have on your mental wellbeing. Dealing with pain on a daily basis and having your sleep disturbed can be stressful. If your hip pain has reduced your mobility and this prevents you from working, you may also be facing the mental strain of financial hardship. This can leave you feeling irritable and disheartened.

Over time, whether that’s months or years, hip pain and reduced mobility can wear you down. Chronic (long-term) pain is linked to a greater risk of depression and anxiety. Signs of depression to look out for include persistent feelings of sadness or hopelessness, loss of interest in activities you normally enjoy, an inability to sleep or sleeping too much, fatigue, restlessness and weight gain. 

If you feel that your mental health has been affected by your symptoms, speak to your GP or a mental health professional.

4. No relief from other treatments 

There are many conditions, including certain types of arthritis, that do not need hip replacement surgery. Your doctor will usually suggest non-surgical solutions first, such as physiotherapy, exercise, weight loss, steroid injections, painkillers and anti-inflammatory medication to reduce swelling and pain.

These treatments are not cures but can help you manage your pain and increase your mobility. However, there comes a point where these treatments are no longer effective — this is when surgery may be recommended.

5. Pain in the hip and groin 

Sometimes a problem with your hip joint can cause hip pain and pain in your groin. This pain can be present when you’re active and when you’re resting, both in the day and at night.

It can prevent you from walking distances that you normally do or cause you to limp. The measure of whether your hip and groin pain is affecting your ability to walk a reasonable distance depends on what is normal for you — strolling to the shops may be all you need to enjoy life, while for others a daily five-mile walk is essential. 

You may find that you need a walking aid to compensate for your hip and groin pain. Your painful hip may also make other everyday activities difficult too, such as going up and down the stairs, falling asleep at night and getting out of bed.

Pain in your hip and groin may also flare up during or after exercise, such as jogging, swimming, dancing or other activities. This may prevent you from being as active as before. If the cause is hip arthritis, the pain will usually be limited to the area from your hip to your knee. If the pain extends lower than this, towards your ankles, it may instead be caused by back problems. 

6. Can’t support your body weight on one leg

There is a quick test you can do at home called the one-leg test which can give you an idea of whether you need to see a doctor about your hip.

When doing this test, make sure there is someone else around in case you need help. For balance, hold onto a chair or door frame with one hand, then lift the leg on the side of your body that doesn’t have hip pain off the ground. If you can’t support yourself on your other leg, you may have a problem with the hip on that side of your body.

Other exercises you can try to test whether you need treatment for your hip include lying on your back or sitting down and bringing your knee up to your chest — you can use your hands to help complete this exercise. You can also try lying on your back and seeing if you can move your leg out to the side without moving the rest of your body. Alternatively, you can sit on a chair, try to place your ankle on top of the opposite knee and see how far you can drop your knee down.

7. Visible changes and sounds 

There may be visible changes to the outer surface of your hip, such as redness and swelling caused by inflammation. Sometimes, you may hear a grating, grinding or popping sound when you move your hip — this is called crepitus. It is caused by the bones in your hip joint rubbing against each other or air bubbles popping between the joints. If any of these symptoms are causing you discomfort, pain or worry then see your GP. 

8. Your doctor has ruled out other health issues

Hip pain and stiffness can sometimes be caused by other problems with other parts of your body, such as your back, spine or knees. Tight muscles or tendon problems can also cause hip pain and stiffness. If your doctor has already ruled out these conditions, then there may be a problem with your hip that needs treatment.

If any of these signs are familiar to you or non-surgical treatments for your hip pain aren’t enough anymore, it’s worth discussing the next steps with your doctor. A hip replacement may improve your quality of life and restore your mobility so you can get back to doing the things you love.