Non-surgical treatments available for hip pain

Q. I am only in my late ‘50s but have developed horrible left hip pain. It started as an ache about a year ago but has now really affected my lifestyle. I have pain at night that wakes me. I also have difficulty going up and down stairs as well as getting out of a chair. I saw a doctor who diagnosed me with arthritis of my hip and gave me some anti-inflammatory medicine. This has helped a little bit but my hip is still really hurting and I do not want a hip replacement just yet.

Are there any other alternative treatments?

A. Osteoarthritis of the hip is a condition caused by wearing down of the articular cartilage on the end of the hip bone and socket. The articular cartilage is the rubbery stuff on the end of a chicken bone and when this wears thin, it’s like a car tire losing its tread. This is known as osteoarthritis.

Anti-inflammatory medications such as you were given can help decrease the pain in some patients. Physical therapy is another alternative treatment, which could help maintain the range of motion of your hip and sometimes decrease your symptoms. Injections of Cortisone can be given in the hip joint but this is usually done under X-ray control, called “fluoroscopy’’ to make certain that the injection is in the right place. Some patients can have dramatic relief of symptoms for a number of months.

The indication for joint replacement surgery is when you can no longer live with the pain. Some patients find this to be the case when they cannot sleep well at night, others when they cannot participate in the activities of daily living that they enjoy. For others, it may be struggling to get out of a car, going up and down stairs or getting out of a chair.

When you have reached the point that you can no longer tolerate the symptoms, at that point hip replacement surgery can be a very effective option in relieving your pain.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to