Hip Pain & Hip Disorders:
Causes, Symptoms, Diagnosis and Treatment Options
The hip joint is one of the body’s main weight-bearing joints, playing an important role in daily activities such as walking, climbing stairs, sitting, standing up, and standing for long periods. Pain, stiffness, limitation of movement, or limping felt in the hip can significantly affect both daily life, work and social life.
Professor Gemalmaz evaluates and plans treatment for hip pain and hip disorders across a wide spectrum, from early-stage complaints to joint-threatening conditions such as osteonecrosis and advanced osteoarthritis. In suitable patients, hip-preserving surgery and prosthetic surgeries can also be considered.
What symptoms lead patients to seek medical care?
Hip problems may not always present only as pain in the groin area; pain radiating to the lower back, thigh, or around the knee may also be observed. Patients frequently present with the following complaints:
- Pain in the groin or hip side when walking, standing for a long time, or going up and down stairs
- Difficulty and pain in sitting down and standing up, getting in and out of a car seat
- Morning stiffness or hip stiffness that improves with movement
- Limping while walking, a “catching” sensation when stepping, or a feeling of instability in the joint
- Pain radiating to the thigh, back of the hip, or knee
- Hip–groin pain associated with prolonged sitting
- Pain that becomes noticeable in the first steps when standing up and increases over time
- In advanced cases, pain that persists even at rest or during sleep
Since some of these complaints can be confused with lower back or knee problems, the hip joint is evaluated together with other regions during the examination.
Common causes of hip pain and disorders
Hip pain and hip disorders may be due to various causes. Among the commonly encountered conditions:
Hip osteoarthritis (coxarthrosis):
A condition which progresses with narrowing of the joint space, pain, and limitation of movement as a result of the wear of the cartilage tissue forming the hip joint over time.
Dysplastic hip disease:
A developmental disorder where a shallow or abnormally shaped hip socket fails to fully cover the femoral head, resulting in joint instability, sometimes dislocation, uneven pressure and accelerated cartilage wear.
Femoral head osteonecrosis (avascular necrosis):
It is a serious condition characterized by weakening of the bone tissue, risk of collapse, and pain due to impaired blood supply to the femoral head forming the hip joint.
Hip impingement syndromes and structural disorders:
Certain anatomical variations, such as femoroacetabular impingement, may cause pain and limitation of movement, especially in young and middle-aged individuals.
Muscle–tendon problems around the hip:
Pain felt especially on the outer side of the hip may be related to certain tendon and bursa problems.
Post-traumatic problems:
Conditions such as osteoarthritis, deformity, or limitation of movement that develop after hip fractures or traumas involving the joint.
Each condition differs and requires different treatment approach; therefore, detailed evaluation is important in cases of hip pain.
How does the diagnostic process work?
In the diagnostic process of hip pain and hip disorders, appropriate imaging methods are used along with clinical examination:
Detailed history and physical examination
Location and severity of pain, when it started, and which movements increase it
History of previous trauma, fracture, or surgery
Range of motion of the hip joint, painful directions of movement, presence of limping
Evaluation of joints close to the hip, such as the lower back and knee
Imaging methods
Weight-bearing plain hip radiographs (X-ray)
Evaluation of cartilage, bone, and soft tissue structures with MRI (magnetic resonance imaging)
If necessary, computed tomography and additional imaging methods in cases of suspected osteonecrosis or deformity planning
Additional tests
Laboratory examinations for infection or rheumatological diseases, when deemed necessary
The aim of the diagnostic process is not only to find the source of the pain, but also to evaluate the structural condition of the hip joint, determine whether there is a progressive disease, and foresee long-term treatment options.
Non-surgical treatment options for hip conditions
Surgery may not be required directly in every case of hip pain. In many patients, non-surgical treatment methods are evaluated first:
- Recommendations for modifying daily activities, appropriate rest, and reducing load
- Guidance on weight control if needed
- Pain relievers and anti-inflammatory medications when appropriate
- Exercise programs aimed at strengthening the muscles around the hip and maintaining joint mobility
- Physical therapy and rehabilitation applications
- Injection treatments for the hip joint when deemed appropriate by the physician (may help control pain in some cases)
Non-surgical methods play an important role in controlling symptoms in early-stage osteoarthritis, certain structural disorders, and specific stages of osteonecrosis. However, the response time and level may vary in each patient; therefore, close follow-up is important.
When is surgery necessary for hip conditions?
Hip surgery is not a standard step recommended for every patient. The decision for surgery is made by evaluating the clinical picture, imaging findings, and the patient’s quality of life together. In general:
- Hip pain that significantly limits daily life despite non-surgical treatments
- Advanced joint osteoarthritis and significant narrowing of the joint space in X-rays and other imaging
- Stages of femoral head osteonecrosis where the joint surface is at risk of collapse or has already collapsed
- Deformity, leg length discrepancy, or significant limping after trauma or developmental disorders
- The hip joint reaching a level where pain and limitation of movement disrupt sleep and basic daily activities
In such cases, surgical treatment options are evaluated and discussed in detail with the patient.
Surgical treatment options for hip disease
Surgical procedures for hip disorders are planned based on the patient’s age, joint structure, disease stage, and expectations. Common surgical methods include:
Total hip replacement
It is a surgery in which the joint surfaces are reconstructed with a prosthesis in cases of advanced osteoarthritis, advanced stages of osteonecrosis, or severe damage to the hip joint. The aim is to reduce pain and improve function.
Hip-preserving surgical approaches
Especially in certain stages of osteonecrosis and in appropriately selected patients, surgical methods aimed at preserving bone structure without completely replacing the joint with a prosthesis may be considered. These procedures require detailed evaluation and planning.
Revision hip replacement
These are secondary prosthetic surgeries performed in cases where a previously implanted hip prosthesis needs to be replaced due to loosening, wear, infection, or other mechanical reasons.
Deformity correction surgery
In cases of significant deformities that develop after trauma or congenital structural disorders, surgical interventions aimed at realigning the bone structure may be planned in appropriate patients.
Hip arthroscopy
This is a minimally invasive surgical procedure used to treat hip impingement and labral tears. This advanced technique aims to restore joint mechanics, alleviate pain, and reduce the risk of secondary osteoarthritis.
Before every surgical intervention, the purpose of the operation, the process, the recovery period, and possible risks are explained to the patient in a detailed and understandable manner.
Professor Gemalmaz's Approach to Hip Problems
Professor Gemalmaz emphasizes evaluating each patient with hip problems not only based on imaging results, but also together with their daily life, expectations, accompanying diseases, and long-term plans.
During treatment planning:
Non-surgical methods are prioritized in early-stage conditions
Personalized treatment plans are developed
Advanced surgical techniques are considered when necessary
Clear communication is maintained regarding treatment options
The goal is not to apply the same treatment to every patient, but to determine the most appropriate solution based on scientific evidence and individual needs.
This page has been prepared for general informational purposes. The information here does not replace a diagnosis or treatment recommendation specific to any individual.