What is Normal Pain After Hip Replacement Surgery?
After hip replacement surgery, many patients find themselves asking the same difficult question: Is this pain normal? The line between expected recovery discomfort and a possible complication isn’t always easy to see. Could the pain you’re feeling be a sign of something wrong—or just part of healing? This article explores the subtle difference between typical and concerning pain after hip replacement.
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What Pain Levels Are Normal After Hip Replacement Surgery?
After hip replacement surgery, it’s common to feel mild to moderate pain during the first two weeks. This discomfort is tied to surgical trauma and natural healing, but it’s usually manageable with pain medication. In the first week, most patients take regular medication to manage the discomfort. By the second week, pain typically starts to ease, and the need for medication tends to decrease.
As the weeks go by, pain continues to lessen. By the fourth week, many patients no longer need pain relief. Some stiffness in the morning or after long periods of rest is normal and expected as part of recovery. These sensations improve with time and proper rehabilitation.
While most hip replacements work well and improve daily function, there are cases where pain is not part of normal healing. A full medical evaluation is needed to determine the exact cause and set the right treatment plan. Early detection helps ensure better outcomes.
Immediate Post-Surgery Pain
This type of pain is generally manageable with medication and typically gets better in the days following surgery. Although pain levels vary between patients, the key is that symptoms should gradually improve rather than worsen.
Several factors can affect postoperative pain levels. The most common include:
| Surgical procedure | Pain caused by the incision and manipulation of tissues. |
| Anesthesia effects | Dizziness or other lingering effects can make pain feel worse. |
| Inflammation or injury | Conditions like bursitis or trochanteritis can add to discomfort. |
| Infection | May cause persistent pain and needs immediate medical care. |
| Loosening of the prosthesis | If the implant isn’t securely fixed, it can cause pain and walking difficulties. |
Pain is typically most noticeable during the first 24 to 72 hours, but it should steadily improve. If the pain doesn’t ease, gets worse, or is joined by other symptoms such as fever, redness, or discharge from the surgical site, medical evaluation is needed. Identifying complications like infection or implant loosening early supports better recovery.
Discomfort from Surgical Site and Swelling
After hip replacement, it’s common to feel discomfort around the surgical area along with moderate to severe swelling in the first few weeks. These symptoms are a normal part of healing, as the body adjusts to the new joint.
Some patients may continue to experience mild to moderate swelling for several months, especially after physical activity or at the end of the day.
While some swelling and discomfort are expected, signs of potential complications should not be ignored. Seek medical advice if the discomfort is severe, constant, or appears alongside redness, warmth, or fever. Possible causes of abnormal pain or swelling include:
| Infection | Can cause ongoing pain, swelling, warmth, or discharge. |
| Loosening of the prosthesis | May result in deep pain and difficulty walking. |
| Soft tissue problems | Inflammation or irritation in nearby muscles, tendons, or bursae. |
| Reaction to prosthetic materials | Some people may be sensitive to the materials used in the implant. |
Getting timely medical evaluation ensures that any problems are identified and managed properly.
Pain During Movement and Physical Therapy
Pain during movement and early physical therapy sessions is a normal part of recovering from hip replacement surgery. It reflects the body’s healing process and the effort to adapt to the new joint and secure it to the bone.
Though uncomfortable, this type of pain is a sign the body is actively recovering. If pain continues for several months without improvement, it may be linked to issues in or beyond the hip, such as spinal problems, and should be evaluated.
Certain movements should be avoided early on to prevent added pain and setbacks in healing. These include:
- Crossing the operated leg: Avoid crossing your legs when standing, sitting, or lying down.
- Bending the hip into a “V” shape: Avoid postures where the torso and thigh form a tight angle. Aim to keep the hip at a 90-degree “L” shape.
- Turning the operated leg inward: Make sure the toes on the operated leg point forward when moving or turning your body.
Initial pain is part of the recovery journey, but if it worsens or blocks progress in physical therapy, a professional should assess it.
Pain Management and Adjusting Medications
Pain management is a key part of recovering from hip replacement surgery. A range of medications is used and adjusted over time to match the patient’s needs and progress.
During the first hours or days, intravenous painkillers or epidural medications are used. In some cases, a patient-controlled analgesia (PCA) system allows the person to administer preset doses through a button, giving better personal control.
As recovery advances, patients usually shift to oral medications like acetaminophen or ibuprofen. Muscle relaxants like methocarbamol or cyclobenzaprine may be prescribed to ease muscle spasms. In some cases, local anesthetics are applied to reduce sensitivity near the incision.
Pain management plans are flexible. The medical team monitors the patient and adjusts medications based on:
- Pain levels
- How well the patient responds to the drugs
- Presence of side effects
Patients should report any unmanaged pain or adverse effects so medication can be adjusted promptly.
Ongoing pain control and medication adjustments help patients move more freely, take part in physical therapy, and recover more effectively.
Long-Term Pain During Recovery
Most patients see major improvements in mobility and quality of life after hip replacement. Still, long-term pain can signal an underlying issue. If pain continues or worsens over time, it should be reviewed by a healthcare provider to find the cause.
Common sources of prolonged pain include loosening of the implant, which can make certain movements uncomfortable. Infections at the surgical site or around the prosthesis can also cause persistent pain and require medical treatment. Other possible causes include sciatic nerve irritation or damage, which may lead to pain, numbness, or tingling in the buttocks or legs, as well as soft tissue problems like bursitis or tendon inflammation.
Less often, the pain is related to mechanical issues with the implant, such as wear or part failure. That is why follow-up care should continue beyond the initial recovery. Addressing these issues early can prevent them from getting worse and lead to better long-term results. Ongoing communication with the medical team and attention to warning signs play a vital role in full recovery.
Sources:
- Ursavaş, F. E., & Yaradılmış, Y. U. (2021). Relationship between pain beliefs and postoperative pain outcomes after total knee and hip replacement surgery. Journal of PeriAnesthesia Nursing, 36(2), 187-193.
- Hulin, K., Fearon, A., & Newman, P. (2025). What are the diagnoses attributed to persistent hip pain after hip arthroplasty? A systematic review. Journal of Clinical Orthopaedics and Trauma, 103036.