Alternatives To A Hip Replacement

Overview

Hip replacement is a surgery where a damaged hip joint is replaced with an artificial one. But it is not the only option. Many people with hip pain can improve with non-surgical treatments such as exercise, pain management, and lifestyle changes. These alternatives can help you stay active, reduce pain, and may even delay or avoid surgery altogether.

Yes. Hip pain and arthritis are very common. Many people explore alternatives to hip replacement, and only a small number of those with hip arthritis end up having surgery.

It affects people of all ages, but it is more common in older adults. Younger people with hip injuries or certain conditions may also look for alternatives. It is especially relevant for people with early or moderate hip arthritis.

Symptoms

Common symptoms

• Pain in the hip, groin, or thigh, especially when walking or standing
• Stiffness in the hip, especially after sitting for a while
• Reduced range of motion, such as difficulty putting on shoes or socks
• A feeling that the hip is 'catching' or 'grinding'
• Limping or walking with a changed gait
• Pain that wakes you up or makes it hard to sleep

Symptoms in children

• Hip pain in children is less common, but it can happen. It may start as a limp, or pain in the thigh or knee.
• Conditions like hip dysplasia or Perthes disease may affect children. If your child complains of hip pain or limps, see a doctor.

Symptoms in older adults

• In older adults, hip pain often comes on gradually and is linked to wear and tear. Activities like walking, climbing stairs, or getting out of a chair may become difficult.
• Sometimes a fall can cause a hip fracture, which needs urgent attention.

Causes

Main causes

• Osteoarthritis: the most common cause, where the protective cartilage in the hip wears down over time.
• Rheumatoid arthritis: a condition where the immune system attacks the joints, including the hip.
• Previous hip injury, such as a fracture or dislocation.
• Avascular necrosis: loss of blood supply to the bone in the hip, causing it to collapse.
• Childhood hip conditions like developmental dysplasia, which can cause early wear.

Risk factors

• Getting older
• Being overweight or obese
• Having a family history of hip arthritis
• Past hip injury or surgery
• Activities that place repeated stress on the hip

When to see a doctor

See a doctor urgently if:

• You have sudden, severe hip pain after a fall or injury.
• You cannot put any weight on your leg, or the leg looks misshapen.
• You have hip pain with a high fever, chills, or hot red skin over the joint.

Book a routine appointment if:

• You have persistent hip pain that lasts more than a few weeks.
• The pain limits your daily activities, such as walking, dressing, or sleeping.
• You feel stiffness that is getting worse over time.
• Over-the-counter pain relief is not helping.

Diagnosis

Your doctor will ask about your symptoms, medical history, and how the pain affects your life. They will examine your hip and watch how you walk. Then they may suggest imaging tests to look at the joint structure.

Tests that may be done

• Physical examination of your hip, including checking your range of motion and tenderness.
• X-rays: to look at the space between the bones and signs of arthritis or damage.
• MRI or CT scan: for a more detailed picture of the hip, especially if the X-ray is unclear.
• Blood tests: sometimes used to check for inflammation or infection.

What to expect at your appointment

The appointment usually takes 20 to 30 minutes. The doctor may refer you to a physiotherapist or an orthopaedic specialist. You do not need to push for surgery at this stage—many people explore alternatives first.

Treatment

Treatment for hip pain does not always mean surgery. The first line is usually a combination of lifestyle changes, physical therapy, and safer ways to manage pain. These approaches aim to keep you mobile, reduce stiffness, and slow down further joint damage.

Self-care at home

• Stay active with low-impact exercises like walking, swimming, or cycling.
• Use heat packs or ice packs to soothe a painful hip.
• Use a walking stick or cane in the opposite hand to reduce load on the hip.
• Maintain a healthy weight to reduce pressure on the joint.
• Rest during flare-ups, but try not to stay still for long periods.
• Adjust your home: for example, raise chair heights or use a reacher to pick up items.

Medical treatments

Medical treatments include physiotherapy (exercises and hands-on care), occupational therapy (advice on daily tasks), pain-relieving medicines that your doctor can recommend (but no specific drugs are mentioned here), and steroid injections into the hip joint. Some people also benefit from 'lubricating' injections that temporarily improve joint movement. These are usually considered before surgery.

When is surgery considered?

Surgery is not the first choice. It may be considered later if severe pain and stiffness continue despite trying these alternatives, and if the condition is seriously affecting your quality of life. The decision is always shared between you and your orthopaedic surgeon.

Living with this condition

Living with hip pain means making small changes to your routine. Break tasks into smaller steps, rest before you become too tired, and avoid heavy lifting or high-impact activities. Use the handrail when going upstairs, and consider a shower stool if standing for a long time is hard.

Lifestyle tips

• Keep an active lifestyle with regular low-impact exercise.
• Avoid standing or sitting in one position for too long.
• Wear supportive, flat shoes with good grip.
• Talk to a physiotherapist about strengthening the muscles around the hip.
• If you smoke, think about stopping—smoking can affect bone health and healing.

Diet and exercise

A balanced diet rich in vegetables, fruits, whole grains, and lean proteins supports overall health and weight management. Being a healthy weight reduces strain on your hip. Regular exercise is also important: aim for a mix of strength, flexibility, and aerobic exercises, but choose activities that are gentle on the joints, such as swimming, cycling, or yoga.

Mental health and emotional wellbeing

Living with constant pain can affect your mood and energy. It is normal to feel frustrated or anxious. Talk to your healthcare team about your feelings. They may suggest counselling or connect you with a support group. Looking after your mental health is just as important as managing the physical pain.

Prevention

You cannot always prevent hip arthritis, but you can lower your risk of hip pain and slow joint damage. Keeping a healthy weight, staying physically active, and avoiding repetitive high-impact activities can help. Strengthening your hip and thigh muscles also gives your joint better support.

Vaccines

There is no vaccine that prevents hip arthritis. However, staying up-to-date with routine immunisations reduces your risk of infections that could affect your joints.

Screening programmes

There is no routine screening test for hip arthritis. You can, however, check in with your doctor if you notice new or worsening hip symptoms.

Complications

If left untreated

• Pain may gradually increase and become constant, even at rest.
• The hip joint may become stiffer, making walking and bending harder.
• Muscle weakness can develop as you avoid using the leg.
• Falls are more likely because the hip is less stable.
• You may become less active, which can affect your heart, blood sugar, and mood.

Long-term outlook

The outlook for people with hip pain is often good. Many people manage well with non-surgical treatments and are able to delay or avoid hip replacement. For those who still need surgery, hip replacement is a very successful operation that can dramatically improve movement and quality of life. The goal is to find the approach that works best for you.

Find support

International organisations

• Arthritis Foundation (US) ↗
• Versus Arthritis (UK) ↗

Local organisations

• NHS ↗ · United Kingdom

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