Hip Pain in Adults: Causes and When Hip Replacement Is Needed

Hip pain is easy to misjudge. People often blame the back, the knee or “a pulled muscle” for months before the hip itself is examined. Knowing where the pain sits, and what it does when you climb stairs or put on shoes, can point you to the right diagnosis much sooner.

Where hip joint pain is felt

Pain from the hip joint itself is typically felt in the groin or inner thigh, and it can radiate to the knee. Pain on the outer side of the hip, especially when lying on that side, is more often a tendon or bursa problem. Pain in the buttock may come from the lower back.

Common causes in adults

• Osteoarthritis: the cartilage cushioning the joint wears down; the most common reason for hip replacement.
• Avascular necrosis: the ball of the hip loses its blood supply and can collapse; risk rises with steroid use, heavy alcohol intake or injury.
• Inflammatory arthritis: such as rheumatoid arthritis or ankylosing spondylitis, often in younger adults.
• Femoroacetabular impingement and dysplasia: shape differences that pinch or overload the joint.
• Fracture: especially the neck of the femur after a fall in older adults, which is a surgical emergency.

Symptoms that suggest the joint is the problem

• Difficulty putting on socks or shoes, or getting in and out of a car
• Morning stiffness that eases as you move
• A limp, or pain when you take your first steps after sitting
• Night pain that wakes you, or pain at rest
• Reduced ability to walk your usual distance or climb stairs

How the hip is assessed

Your doctor will examine movement, especially rotation, which is usually the first thing lost in hip arthritis. A standing pelvis X-ray shows joint space and bone shape. An MRI may be added if avascular necrosis or a tendon problem is suspected, as X-rays can look normal early on.

Treatment without surgery

In early and moderate disease, weight management, regular low-impact activity (walking, cycling, swimming), strengthening of the hip and core, a walking stick in the opposite hand and pain medication prescribed by your doctor can keep you active for years. Our physiotherapy and rehabilitation team builds programmes around your stage of disease.

When hip replacement makes sense

Hip replacement is one of the most reliable operations in orthopaedics for the right patient. It is worth discussing when pain limits daily life, disturbs sleep, and X-rays show advanced damage, and when non-surgical measures no longer help. In hip replacement surgery, the damaged ball and socket are replaced with implants, restoring smooth movement and reducing pain.

The decision is personal rather than age-based: a fit 65-year-old in constant pain may benefit more than a 55-year-old with mild symptoms. If it is your knee rather than your hip that limits you, our guide on when knee replacement is necessary explains a similar decision.

What recovery looks like

Most patients are helped to stand and walk within a day or two of surgery. A walker or stick is used for a few weeks while physiotherapy restores strength and gait, and most people return to light daily activities over roughly 6 to 12 weeks. Following the rehabilitation plan is as important as the surgery itself.

For an independent, detailed patient guide, see the American Academy of Orthopaedic Surgeons page on total hip replacement.

Living well with hip arthritis before surgery

• Walk regularly on flat ground; gentle movement feeds the joint cartilage and keeps muscles strong
• Swimming and cycling are kind to the hip because they carry your body weight for you
• Use a stick in the hand opposite the sore hip to reduce load through the joint
• Raise low chairs and toilet seats, and sit on a firm cushion to make standing easier
• Ask your doctor before taking regular painkillers, especially if you have heart, kidney or stomach conditions

Common questions before hip replacement

Will I be able to sit cross-legged, drive and climb stairs afterwards? Most patients climb stairs and return to driving after a few weeks once they have good control of the leg, but your surgeon will give specific precautions (for example, on deep bending or crossing the legs) based on the technique used.

Are there risks? As with any operation, risks include infection, blood clots, stiffness, differences in leg length, implant loosening over time and anaesthetic risks. Your surgeon reviews your health, treats conditions like diabetes beforehand and uses preventive measures to keep these low. A candid discussion of risks and benefits is part of every consultation.

Is age a barrier? Not by itself. Fitness and overall health matter more than the number on your birth certificate.

Hip specialist in Wakad, Pune

Dr. Nirmal Patil, MS (Ortho), brings 16 years of experience in joint and spine care at Precision Ortho Spine & Rehab Clinic in Wakad, Pune, seeing patients from Hinjewadi, Baner, Balewadi, Pimple Saudagar and Pimpri-Chinchwad. Whether you need reassurance, a rehabilitation plan or a surgical opinion, the first step is a proper examination.