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Hip Pain (Adults)


Most cases of hip pain in adults that are treated with surgery are caused by osteoarthritis, the most common type of arthritis in the UK.

COVID-19 Adjusted Treatment Pathways

Community Physiotherapy are now injecting all patients, both high and low risk with the only caveat is that we will leave 2 weeks prior or after vaccination to inject (June 2021)

Steroid joint injections are not currently being performed at UHCW in Musculo-Skeletal / Orthopaedics / Radiology. Please do not currently refer to UHCW for this purpose.

Referral to Adult Physiotherapy Service

If patients have ongoing musculoskeletal hip pain and have not improved with relative rest or analgesic advice consider referral to the Adult Physiotherapy Service for assessment & treatment with:

  • Advice
  • Specific exercises
  • Mobilisations/ soft tissue techniques
  • Acupuncture
  • Injection – for lateral hip/ GTPS only – No hip joint injections provided
  • Appropriate walking aids
  • Investigations or secondary care referral if appropriate
Hip Pain Referral Guidelines

These guidelines are divided into three categories:

Non Arthritic Hip

Moderate/ Severe Hip Arthritis

Previous Hip Replacement with pain or reduced function

Non Arthritic Hip                      

Clinical Examination


  • Asymmetrical range of movement
  • Pain on rotation and flexion
  • Hip joint pain: described as deep or groin
  • Lateral soft tissue tenderness: identified to direct palpation



  • X-Ray within 6 months: AP Hips
    If normal consider MRI Hip


  • Trial of Physiotherapy and analgesia
  • Then consider referral to Hip Preservation Surgeon if non-arthritic hip pain

Moderate/ Severe Hip Arthritis                                         


Clinical Examination

  • Loss of the range of movement
  • Pain on rotation and flexion
  • Pain described as deep or groin
  • Pain can radiate down anterior thigh
  • Pain sometimes only causes ‘knee’ pain
  • Not pain to direct palpation laterally over trochanter



  • X-Ray within 6 months: AP Hips (request templating marker to be applied, if possible)
  • Note: MRI scan is not helpful for assessing arthritis


  • Consider trial of Physiotherapy and analgesia (if appropriate)
  • Referral to Hip Surgeon if fit enough and willing to consider surgery and consistent with Low Priority Procedure Guidelines (see right)


Previous Hip Replacement                          

With pain or reduced functionpage4image7657280

Clinical Examination

  • Concern if pain on standing from a sitting position or on weight bearing
  • Note: Hip joints should not be painful after a joint replacement, however trochanteric pain is common



  • X-Ray within 6 months: AP Hips + Lateral Hip


Management plan

  • Referral to Revision Hip Surgeon if specific hip joint concerns
  • Referral to Physiotherapy and encourage Weight Loss if specific trochanteric pain



Post Operative Joint Replacement Management

See link right for full leaflet


Antibiotics may mask the joint infection temporarily but they are unlikely to cure it.

They will also compromise the success of any further treatments.

Therefore, if you have any queries or concerns please leave a voice mail message on the number below for advice.

We will organise the necessary investigations and arrange an appointment if required.

Contact: 024 7696 8333

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