Hip Labral Treatment Options

Nonoperative treatment is usually the first line of approach for a hip labral tear for all patients. It is primarily indicated for patients with small tears, lower activity demands, or significant comorbidities that increase the risk of surgical complications. Nonoperative measures are also recommended for patients where the source of hip pain is uncertain, or the tear is incidental and not causing symptoms.

The main elements of nonoperative treatment include lifestyle modifications, physical therapy, and medications. These strategies aim to manage pain, reduce inflammation, restore hip joint function, and potentially slow the progression of joint damage.

Lifestyle Modification

One of the most critical aspects of managing a hip labral tear nonoperatively is through lifestyle modifications. This may involve reducing or modifying activities that aggravate the hip pain and focusing on lower-impact exercises, such as swimming or cycling. If the patient is overweight, losing weight can be beneficial because it reduces stress on the hip joint. Ergonomic adjustments at work or home may also be necessary to avoid positions that exacerbate hip pain.

Physical Therapy

Physical therapy is an integral part of nonoperative treatment for a hip labral tear. It focuses on exercises to strengthen the muscles around the hip, which can provide better support to the joint and limit stress to the labrum. Therapy also emphasizes improving flexibility and mobility of the hip joint to restore function and reduce pain. A physical therapist may also provide education on activity modifications and exercises to help patients avoid movements that might aggravate their symptoms.

Medications and Injections

Nonsteroidal anti-inflammatory drugs (NSAIDs) can be beneficial for managing pain and inflammation associated with a hip labral tear. They can be used on an as-needed basis for pain or as a regular regimen to manage chronic inflammation.

Corticosteroid injections, often done under ultrasound guidance, can provide significant temporary relief from pain and inflammation within the hip joint. In some cases, a hip joint injection with an anesthetic and a steroid can also serve a diagnostic purpose. If the injection significantly relieves hip pain, it confirms that the pain is indeed arising from the hip joint. However, it is essential to note that injections are typically not a long-term solution and are usually used in combination with other treatment modalities.

When nonoperative treatments fail to provide sufficient relief, or if the labral tear is severe and causing significant symptoms, surgical options may come into consideration. These surgical interventions are performed arthroscopically, a minimally invasive surgical technique. This involves making small incisions around the hip and inserting a small camera, called an arthroscope, to visualize and perform the surgery within the joint.