Is surgery right for hip pain?
Hip pain can be scary, especially when it starts limiting walking, sleep, work, or the activities that make you feel like yourself. The good news is that many causes of hip pain improve with education, exercise-based rehabilitation, and smart activity changes, and surgery is usually saved for more specific situations.¹⁻⁴ ⁷ ⁸
- Pain and stiffness keep you from daily life, even after a well-designed course of conservative care (like physical therapy and strengthening).⁵ ⁶ ⁹
- You have mechanical symptoms (like catching or painful “pinching” in the front of the hip) that match a clear diagnosis such as femoroacetabular impingement syndrome or certain labral problems.³ ⁴
- Imaging and your exam suggest advanced hip osteoarthritis, and symptoms remain very limiting despite comprehensive non-operative care.⁵ ⁶
- There is an urgent or high-risk condition like septic arthritis (joint infection) or a high-risk femoral neck stress fracture, where quick surgical decision-making may protect the joint and your overall health.¹⁰⁻¹²
Surgery is not an automatic “next step” just because a scan shows changes. For example, cam or pincer bone shapes are common on imaging, even in people with no symptoms, so decisions should be based on your story, your exam, and how you respond to a structured rehab plan.⁴
A helpful mindset is shared decision-making: you and your clinician weigh what is most likely to help, what the risks are, and what “success” means for your life.
Common surgical options for hip pain
The type of surgery depends on what is causing your hip pain. Here are the most common options you might hear about:
- Hip arthroscopy (for femoroacetabular impingement syndrome or some labral problems): A minimally invasive procedure where a surgeon uses small instruments to address bone shape that may be contributing to pinching and to treat labral or cartilage issues.³ ⁴
- Total hip replacement (total hip arthroplasty) for advanced hip osteoarthritis: The damaged joint surfaces are replaced with artificial components. This is usually considered when pain and stiffness severely limit life despite comprehensive non-operative care.⁵ ⁶
- Surgical fixation for femoral neck stress fracture: Metal screws or devices stabilize the bone when the injury is high risk (especially tension-side injuries) or displaced.¹¹ ¹²
- Urgent washout and drainage for septic arthritis: When a hip joint infection is suspected or confirmed, urgent treatment often includes draining the joint and starting antibiotics to prevent rapid cartilage damage.¹⁰
What to expect during recovery
Recovery looks different depending on the procedure, your overall health, and how strong and active you were before surgery. Your care team will give you a plan tailored to you, but these are common themes:
Early phase (first days to weeks)
- Pain, swelling, and stiffness are common.
- Walking aids (like crutches or a walker) may be needed, especially after arthroscopy, fracture fixation, or joint replacement.
- You usually start gentle movement and strengthening early to protect function and reduce complications.⁶
Rehab phase (weeks to months)
- Most people do a structured strengthening and walking progression.
- You may work on hip and core strength, balance, and safe return to work or sport, with guidance based on your procedure.³ ⁶
Common challenges
- Fatigue, sleep disruption, and “good days and bad days” can be part of recovery.
- It can take time to rebuild confidence in the joint, especially if pain has been present for months or years.
Potential risks to discuss with your surgeon
- Infection, blood clots, stiffness, nerve irritation, or persistent pain.
- For arthroscopy, some people improve a lot, but others may have smaller gains depending on factors like cartilage health and symptom drivers.³
- For total hip replacement, many people improve, but outcomes still vary and recovery is not instant.⁶
If you are considering surgery, ask your clinician: “What changes the odds of a good result for me?” That question often leads to the most useful, personalized plan.
Can hip surgery be avoided?
Often, yes. Many people with hip pain can reduce symptoms and improve function through:
- Education and pacing (learning how to adjust loads without stopping life)
- Progressive strengthening (especially hip and leg muscles)
- Movement retraining and gradual return to activity
- Weight management support when relevant for osteoarthritis⁵ ⁶ ⁹ ¹³
For femoroacetabular impingement syndrome, research shows that both structured conservative care and arthroscopy can help, and not everyone needs surgery.³ ⁴ A well-designed rehab plan can also clarify whether surgery is likely to add meaningful benefit for your goals.
Sword's AI Care can help you recover from home: in randomized trials, fully remote digital physical therapy programs produced improvements similar to in-person physical therapy for chronic musculoskeletal pain conditions (including shoulder and low back pain), suggesting that high-quality conservative care can be delivered effectively in a remote format when needed.¹⁴ ¹⁵
Did you know?
A hip scan alone does not decide if you need surgery. Bone shape changes linked to femoroacetabular impingement are common in people without pain, so the diagnosis requires symptoms and exam findings that match imaging.⁴
Can surgery be avoided?
Often, yes. For many people with groin pain, especially adductor related or pubic related pain, a structured exercise program and smart load management are the main treatments and can match or outperform passive care.¹ ⁵ ¹⁵
- The classic Hölmich trial showed that athletes with long standing adductor related groin pain did better with an active strengthening program than with passive treatments alone⁵
- Team based adductor strengthening programs, such as the Copenhagen adduction exercise, have been shown to reduce groin problem rates in football when used regularly in warm ups⁶
- For hip related groin pain from femoroacetabular impingement, both physiotherapist led care and arthroscopic surgery improved symptoms. Surgery gave greater short term gains in selected patients, but not everyone needed an operation⁷ ⁸ ⁹
Surgery is hardest to avoid when:
- There is a high risk femoral neck stress fracture on the tension side or a displaced fracture¹¹ ¹²
- There is an incarcerated hernia that will not reduce or return to the abdomen¹⁴
- Conservative care has been properly tried and is still not enough to let you walk, work, or play sport
For most other groin pain, it is reasonable, and often wise, to do a full course of good rehabilitation before considering surgery.
How Sword can support you before and after surgery
Physical therapy can play an important role in preparing for surgery, supporting recovery, and, in some cases, helping people manage symptoms without surgery. Sword offers physical therapy programs designed to support you at different points along that journey.
Sword supports recovery before and after surgery, with care designed to fit into your life. You receive high-quality physical therapy at home, guided by licensed clinicians and supported by smart technology.
- Care that adapts as your body and recovery needs change
- Licensed physical therapists guiding your care at every stage
- Non-invasive, evidence-based physical therapy programs
Support for preparation, recovery, and long-term movement health
Clinical insight
