As we age our bodies change. This can affect a number of our healthy systems and can lead to long-term issues. Weight gain and hormonal changes can affect our overall health as well as some common conditions related to aging. We can mitigate some of the effects of the natural aging process by maintaining a healthy diet and committing to regular exercise. However, hip pain continues to be a major health challenge, especially for older adults in the United States. A hip replacement can help with hip pain in some cases, but only after other less-invasive pain management options have been tried.

What causes hip pain?

Approximately 15% of people over the age of 65 report hip pain. The pain can be the result of:

  • A fracture
  • Osteoarthritis
  • Osteoporosis
  • Bursitis
  • Lack of blood flow
  • A fall or other injury to the hip

This video gives a brief overview of hip pain and its major causes.

For individuals over the age of 65, hip pain is most likely to be caused by osteoporosis or osteoarthritis. Let’s take a closer look at these common causes of hip pain in the elderly.

What is osteoporosis?

Osteoporosis is a chronic condition that causes the bones to become weak and brittle. With severe cases of the disease, simple and natural ranges of motion can cause a break in the bone. These fractures are most likely to occur in the spine, wrist, or hip. Our bones, just like the rest of the living tissues in our body, regenerate throughout our lives. As we age, our bodies no longer produce all of the natural building blocks for healthy bones. This is why maintaining a calcium-rich diet is important for the health of our skeleton. According to the National Osteoporosis Foundation 54 million people in the United States are living with or at high risk for osteoporosis and it causes many of the cases of hip pain in the elderly. Post-menopausal women are at the highest risk with Caucasian and Asian women leading the statistics for the U.S.

Early bone loss has no notable symptoms, which is why prevention is more important than early detection of the disease. As the condition progresses, patients can develop back pain, loss of height due to spinal compression, a hunched over posture, and increased risk of fractures of the bone. It is important to note that often patients can have osteoporosis without any symptoms and may not know about the condition until they experience a fall or other injury that results in a break.

When osteoporosis affects the hip, it can cause a great strain on a person’s ability to walk. This can be exacerbated by being overweight or having other chronic pain conditions that affect other areas of the body.

Treating osteoporosis

While hip replacement surgery may be necessary in the final or chronic stages of this condition, there are better ways to treat it earlier.

The best way to treat or avoid osteoporosis all together is to maintain a diet rich in calcium and vitamin D. Regular exercise and an overall healthy lifestyle will help older adults avoid the negative results of osteoporosis long-term.

Some women may be able to mitigate the effects of osteoporosis with hormone therapy. There are also several medications on the market that can help reduce or eliminate the risk of osteoporosis. Talk with your pain doctor about a bone density test to determine if you’re at risk for osteoporosis and what treatments can work best for you.

What is hip osteoarthritis?

There are many forms of arthritis—a condition that causes inflammation in joints. Osteoarthritis is considered to be caused by long-term wear and tear of the body. Hip osteoarthritis occurs when the protective cartilage between bones in the hip begins to wear down, causing the bones to rub uncomfortably together. This leads to inflammation and long-term pain problems. It can affect any joint but due to the way we move our bodies regularly it is most likely to be found in the hands, neck, lower back, knees, and hips. According to the Centers for Disease Control (CDC), over 13% of adults over the age of 25 have been diagnosed with the condition. Over 33% of adults in the U.S. over the age of 65 experience the effects of osteoarthritis.

Because osteoarthritis is degenerative, symptoms develop slowly and get worse over time. Common symptoms include:

  • Pain in the joint after movement
  • Tenderness in the area when pressure is applied
  • Joint stiffness after periods of inactivity
  • A loss of flexibility in the joints
  • A grating sensation of the bones during movement
  • The development of bone spurs

Osteoarthritis in the hip may cause difficulty standing or walking. It also can cause cases of hip pain in the elderly population. Patients may experience more pain when waking up in the morning after sleeping on the hip. Like most conditions related to aging, additional body weight can affect pain levels.

Treating hip osteoarthritis

Because osteoporosis is degenerative and caused by the natural wear and tear on the cartilage between joints, it can be difficult to prevent. Before attempting hip replacement surgery, there are less invasive options to consider.

For less severe cases, non-steroidal anti-inflammatory drugs (NSAIDs) can provide temporary relief of the pain. Physical therapy can help restore full range of motion in the affected joints and occupational therapy can help patients suffering from osteoporosis of the hip restore their regular daily functions. Another helpful treatment includes orthotics for the shoes that change the posture to relieve some of the stress on the damaged joints.

Finally, hip injections can help prevent pain in the hip. With a combined injection of anesthetic and steroids, they can reduce inflammation in the area. Find out more about this treatment option here.

What is hip replacement surgery?

In the U.S. alone more than one million hip and knee replacement surgeries are performed annually. While the sheer number of replacements has made the surgery more commonplace and the techniques more advanced, hip and knee replacement is not for everyone. So how do you know if it’s right for you?

If a patient has hip joint damage that inhibits their ability to function normally, hip replacement surgery may be recommended. This is only after other options have been tried to no effect. This surgery uses metal, plastic, or ceramic materials to replace the ball and socket joint that allows the hip to have normal motion. This surgery is complex. It requires extensive recovery time and physical therapy but can help some patients return to their normal daily lives once they are fully healed.

However, hip replacement surgery can sometimes result in additional long-term hip pain in the elderly especially. Chronic pain resulting from a surgical procedure is more delicate and needs specialized treatment. Some factors could influence whether hip replacement surgery is right for you.

Could A Hip Replacement Help With Your Hip Pain? | PainDoctor.com

1. You are a woman

At the 2015 annual meeting of the American Academy of Orthopaedic Surgeons a new study revealed that women have much better outcomes following a total joint replacement (TJR) of the hip or the knee. In the study of over 97,000 total hip and knee replacement surgeries at an Ontario hospital, researchers found that men:

  • Were more likely to return to the emergency room within 30 days of surgery
  • Suffered from more heart attacks
  • Needed a revision of their surgery more often
  • Were more likely to be admitted to the hospital or suffer a serious infection following surgery

Lead study author Bheeshma Ravi, MD, PhD, an orthopaedic surgery resident at the University of Toronto debunked the previous myths that women suffered more after total hip or knee replacement:

“Despite the fact that women have a higher prevalence of advanced hip and knee arthritis, prior research indicates that North American women with arthritis are less likely to receive joint replacement than men. In this study, we found that while overall rates of serious complications were low for both groups, they were lower for women than for men for both hip and knee replacement, particularly the latter. Thus, the previously documented sex difference utilization of TJR cannot be explained by differential risks