Hip Care

Our orthopedic experts will pinpoint the root cause of your hip pain and then work with you to create an individualized treatment plan based on your diagnosis and your goals. Maybe your goal is to return to biking, play with your grandkids or just sleep better at night without pain.

We'll start you off with a program of conservative therapy options (physical therapy, medical management, massage therapy, acupuncture) designed to meet your goals.

Should surgery be necessary, our surgeons are pioneers in minimally invasive and computer-navigated procedures for both hip repair and hip replacement.

Common Causes of Hip Pain

Pain in the front of the hip, or groin, or even in the buttock and down the leg, can be from the hip joint.

Common sources of pain include:

• Degenerative arthritis (also called osteoarthritis) and labral tears, involve the wearing or tearing of the ring of connective tissue at the rim of the hip socket:
  • Osteoarthritis occurs when the protective smooth material (cartilage) in the space between the bones decreases which results in a "bone on bone" rubbing causing pain and inflammation. Osteoarthritis develops and progresses over time.
  • A labral tear is when the cartilage surrounding the hip joint is damaged or torn and can be the result of repetitive motion or trauma like that experienced during a sports injury.
• Hip tendonitis and bursitis are conditions that usually cause pain on the side of the hip and are due to inflammation of a tendon or bursa (a normal fluid sac that limits friction between structures)
• Pain in the buttock or back portion of the hip is often not caused by the hip joint, but rather by conditions of the lower back, sacroiliac joint, hip girdle muscles, hamstring tendon, among other causes.

Diagnosing Hip Pain

Health history and physical examination are most important. X-rays can be helpful to assess for arthritis, congenital joint deformity, and other bone conditions.

For soft tissue conditions, MRI or high-definition diagnostic ultrasound are helpful.

For labral tears, an injection of dye into the joint (arthrogram) before having an MRI is usually required to identify this condition.

Hip Pain Treatment

There are a variety of treatments to alleviate hip pain including exercises, medications, injections and surgical procedures.

Pain Relief Options

Treatment for hip pain often begins with activity modification or rest and use of modalities such as ice. To treat pain, either Tylenol or NSAIDs (anti-inflammatories such as ibuprofen or naproxen) can be considered.

If that does not help, manual treatment with a physical therapist, chiropractor, or massage therapist can be helpful in conjunction with therapeutic exercise to improve flexibility, strength, and control.

Alternative Hip Pain Treatments

Some patients find benefit from acupuncture, dry needling and natural medications. You and your provider will discuss all pain relief options, including the benefits and risks, to find the best treatment for you and your lifestyle.

Hip Injections

In some cases, injections of corticosteroids (steroids) and/or numbing agents may be considered. With some conditions, surgery may be an option if these treatments are not adequate. This can help treat your hip pain in two ways:

• Placing numbing medication into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. If you obtain complete relief of your main pain while your joint is numb, it means this joint is likely your pain source.
• Time-release cortisone will be injected into this joint to reduce any inflammation. This can, on many occasions, provide long-term pain relief.

With some conditions, surgery may be an option if these treatments are not adequate.

Injection of platelet rich plasma (PRP), one's own blood cells that contain natural healing proteins called growth factors, has shown promise to treat certain peripheral joint conditions such as tendonitis and arthritis.

Hip Replacement Surgery

If joint replacement surgery is the answer, our skilled orthopedic surgeons lead the region in minimally invasive and computer-navigated surgical techniques that will get you back to your life faster and with less pain.

Our Joint Replacement Program will provide everything you need to prepare for surgery and rehabilitation.

EvergreenHealth also has the only surgeons on the Eastside offering the direct anterior approach for hip replacement.