There are many different options for hip pain treatment.
Here are a list of many of the more common ways to manage your painful hip issue.
Advice & Education
Often the most powerful treatments for musculoskeletal hip pain is getting the right advice, at the right time. An important early step in any recovery is understanding what the problem is and how you can best help in your own journey. Any other treatments will be less effective if you are doing things that continue to cause a problem. For example, advice around workplace setup, sporting and recreational choices and schedules, and recovery after exercise.
All Hip Pain Professionals will be able to provide important advice and education about different aspects of your problem and rehabilitation.
Exercise & Rehabilitation
Exercise is a cornerstone of rehabilitation for management of most hip pain problems. Exercise can improve health of problem tissues, as well as address issues that may have contributed to the problem, such as muscle weakness or poor range of motion. There are many different ways that health professionals can provide exercise.
The best type of general exercise for you will:
- Target your individual problems
- Be appropriate for your age
- Match your current level of physical conditioning
- Fit within your lifestyle and financial situation
- And most importantly, be something you enjoy
Group classes provide a fun atmosphere where you can gain the benefit of a supervised exercise session, while you connect with others who may have similar problems. Class-based exercise often provides a more cost-effective way to exercise.
Just take note that
not all group classes will provide the same benefit.
Choosing a class run by a qualified Health Professional means that:
- The instructor will understand your musculoskeletal problem
- You won’t be asked to do exercises that are unsuited for your age-group or level of physical condition
- Your instructor will ensure correct exercise technique
- Your safety will be a priority
- You are more likely to achieve the result you need in the shortest amount of time
Hydrotherapy & Aqua Exercise
Hydrotherapy is exercise performed in the water for
The unique properties of water include the decreased effects of gravity, the effects of buoyancy, water pressure, and warmth (if in a heated pool). This often allows exercise with decreased pain which is particularly useful for those with a low level of fitness and/or those who find land-based exercises very painful.
Strength & Conditioning
Strength and conditioning exercise uses extra resistance from equipment such as weights, springs, pulleys and bands to maximise changes in muscle strength, size and power. This is particularly important for athletes or those returning to physical occupations or recreational activities.
Health Professionals may develop a program that you can do safely in a gym environment or provide individual or group training within their own clinics.
Health Professionals that provide Strength & Conditioning include:
Exercise using Pilates Equipment
Pilates equipment (eg. Reformer) can provide some unique opportunities to exercise your body in different ways to gym-based training. Slings and springs allow movement through all ranges of movement, whilst in a multitude of different positions.
- Springs can be added or removed to make exercises easier or more challenging.
- Almost any part of the body can be targeted.
- Slow movement allows focus on alignment, breathing and control.
- Stretching and strengthening can be achieved.
Persistent Pain Management
Pain is a multifaceted issue. Acute pain felt at the time of injury may require a primary focus on the specific body part involved in the injury. Persistent pain, (pain that has been there for more than 3 months) may need a more comprehensive approach that deals with interactions between the nervous and musculoskeletal systems. Pain is an output from the brain that does not always match the severity of the injury. Fear, stress and anxiety can all impact on pain. Pain management may include:
- Pacing and gradually progressed programs for building physical capacity
- Coping strategies
- TENS (Trancutaneous Electrical Nerve Stimulation)
- Minor medical procedures
All HPP’s provide pain management, but more severe, unremitting pain may require assistance of a Pain Medicine or Rehabilitation Specialist. A Psychologist or Occupational Therapist may be able to provide education on other forms of coping strategies.
Pain Management clinics provide a multidisciplinary approach to pain management either on an inpatient or outpatient basis.
Manual Therapy is a hands-on therapy approach used by a range of therapists including Physiotherapists, Chiropractors, Osteopaths and some Medical Doctors. Manual Therapy may include:
- Moving joints in specific directions and at different speeds to regain movement (joint mobilization and manipulation)
- Muscle stretching
- Passive movements of the affected body part
- Having the patient move the body part against the therapist’s resistance
- Selected specific soft tissue massage techniques may also be used to improve the mobility and function of tissue and muscles – different terms may be used for this form of treatment, including remedial massage or myofascial therapy.
Real Time Ultrasound
RTUS allows the capturing of real-time pictures of structures inside the body, using high frequency sound waves. This amazing technology is widely used in medicine for assessing internal organs, blood vessels and developing babies. Ultrasound is also extremely useful for imaging muscles, tendons and ligaments, when assessing the consequences of an injury or the cause of persisting musculoskeletal pain.
Twenty years ago, physiotherapists began using ultrasound not only to look at the size and health of muscles, but to look at activation patterns of muscle groups. There is now a large volume of scientific research confirming the validity, reliability and usefulness of such techniques. Real time ultrasound provides a unique window into the function of our deep muscles during movement. This level of information cannot be provided by visual assessment, palpation or any other imaging process to date. This type of feedback helps you see instantly if you are doing an exercise correctly, helping you learn what to do and how to do it quickly, easily and effectively.
Investigations can help you on your journey of diagnosis and treatment of your hip or pelvic pain. There are different forms of investigation which each have their own specific indications. Certain forms of investigation maybe the best to look at one thing but not at another. Your Hip Pain Professional will help guide you on this or refer you to a specialist who is more specifically trained to make these decisions.
Investigations may include Xray, Ultrasound (US), MRI (magnetic resonance imaging), CT(computed tomography), nuclear medicine scans and/or blood tests.
Women’s & Men’s Pelvic Health
This most often relates to treatment of bladder, bowel and pelvic floor dysfunction, including incontinence. Pelvic pain is often also associated with dysfunction of these area or can affect sexual function. Typical conditions relating to women’s and men’s health are:
- Incontinence or leakage – bowel or bladder
- Pelvic Organ Prolapse
- Overactive bladder
- Prostate issues
- Pelvic and sexual pain
Treatment will often include exercises to address the pelvic floor muscles and gentle manual therapy for overactive muscles in some cases. Real time ultrasound can be used to help guide people in how best to get these muscles working. Education to improve understanding and management strategies are essential to the client.
Injections are a way of introducing a substance, usually a medication, deep into the tissues, usually with the aim of reducing pain and/or inflammation or to stimulate a healing response. Common injections include:
- Corticosteroid injections are commonly used to produce rapid reductions in pain and inflammation. However, sometimes cortisone may slow or reduce long term recovery, particularly if repeated injections are undertaken. Also, injections do little to improve underlying impairments such as muscle weakness, poor movement patterning or joint restrictions, in which case the problem is likely to recur.
- Local anaesthetic injections numb the area that is injected and may help relax the muscles in that area or may help in diagnosis (to determine if the area injected was associated with the pain).
- Epidural injections involve injecting an anaesthetic and/or an anti-inflammatory medication, such as a steroid (cortisone), near the affected nerve. These may be used for back-related hip and pelvic pain.
- PRP (Plasma rich protein) injections are used by some physicians but with conflicting evidence on their use published in the scientific literature. Some of your own blood is taken and spun in a centrifuge then reintroduced into the damaged area, with the theoretical objective being to stimulate local healing in the tissues.
Surgery for hip pain is usually reserved for those who do not respond to other management techniques but at times early surgery may be indicated for severe problems or acute traumas. Hip surgery is most commonly performed by an Orthopaedic Surgeon. Groin and pelvic surgeries may involve a general surgeon or a gynaecologist. Surgical interventions may include:
- Radiofrequency Neurotomy is a technique that is generally done under surgical conditions by a Pain Medicine Physician, Orthopaedic Surgeon or Radiologist. The technique temporarily disrupts the nerve supply to an area by destroying small sensory nerves. It can assist with pain and allow a window for rehabilitation in some people.
- Hip Arthroscopy (where surgeons view the hip through small, keyhole incisions, using an arthroscope)can be done on the interior of the hip joint through these small incisions.
- Hip Resurfacing is where a capping is placed over the hip joint surfaces, reducing the amount of bone removed compared to a total hip replacement
- Total Hip Replacement is where both surfaces of the hip joint bones are removed and replaced.
There are other modalities that are being used with variable levels of success and some with developing evidence in the medical literature. These include:
- Neuromuscular Electrical Stimulation
When you use our Find a Hip Pain Professional Search, have a closer look at the results. Each Hip Pain Professional will specify which hip pain management they provide from the above list.