Hip dislocation: symptoms, causes, treatment and what to do next

The hip is a ball-and-socket joint. Arthritis UK explains that the top of the thigh bone is shaped like a ball and sits inside a hollow socket in the pelvis, and that the joint is held together by a covering of muscles secured to the bones by strong tendons, forming a capsule around the joint. Because of this support, Arthritis UK says it is unusual for the hip to become dislocated, even after a high-impact injury.

When a hip does dislocate, University Hospitals Plymouth NHS Trust describes the femoral head coming out of its socket (the acetabulum). It is a different problem from a broken hip (a fracture of the bone), although a fall that dislocates a hip can also break bones.

The most reliable features come from trust leaflets written for people with a hip replacement, which describe what a dislocation feels like. Dorset County Hospital lists acute groin or thigh pain and reduced ability, or inability, to put weight on the operated leg, which may follow a trauma or a bending or twisting movement. Plymouth lists unusual hip movement or deformity, which could indicate that the hip has dislocated again.

The NHS general advice on hip pain is relevant for any hip: severe hip pain after a fall or injury, being unable to walk or put weight on your leg, and tingling or loss of feeling in the hip or leg after an injury all need an emergency response.

Treat a suspected dislocated hip as an emergency. Dorset County Hospital says to call 999 if you have dislocated your hip, because you will need medical input to relocate it. The NHS says to call 999 or go to A&E for severe hip pain after a fall or injury, being unable to walk or put weight on your leg, or any tingling or loss of feeling in the hip or leg after an injury. Do not drive to A&E; call 999 and ask for an ambulance, and bring any medicines you take.

Do not try to put the hip back yourself. Plymouth explains that relocation is a procedure performed by clinicians with pain relief.

Plymouth says hip dislocations can occur due to congenital deformities, trauma and following hip replacements. Dorset County Hospital notes that a joint dislocation after a hip replacement may result from a trauma or from a bending or twisting movement.

Plymouth adds that it is possible for a new hip or a re-located hip to dislocate. Dorset gives the typical soft tissue healing time after a hip replacement as six to 12 weeks, so precautions matter most in the early weeks.

The NHS notes that a hip fracture and other serious hip problems can cause similar emergency symptoms, which is why anyone with severe pain after a fall needs urgent assessment rather than self-diagnosis.

Plymouth says the initial treatment is a procedure called a reduction, where the top of the thigh bone is manually moved back into the socket with pain relief. The doctor may want to X-ray your hip after the reduction. Pain medication may also help relieve pain while you recover, and you may need ongoing physiotherapy to aid recovery.

The sources used for this page do not describe the surgical options used when a hip keeps dislocating or when the bones are also broken, and they do not give timing windows or complication rates. Your orthopaedic team can explain what applies in your case, including whether a brace, a revision operation or other treatment is needed.

• Reduction: the hip is put back in the socket by clinicians, with pain relief.

• X-ray after reduction to check the position of the joint.

• Pain relief while you recover.

• Physiotherapy to rebuild strength and confidence.

• Equipment such as crutches or a frame, taught by the physiotherapist (Plymouth).

Plymouth gives advice to significantly reduce the risk of a new or re-located hip dislocating, for the next 3 months:

• Do not sit on low furniture.

• Do not cross your legs.

• Do not bring your knee higher than your hip (more than 90 degrees).

• Do not bend over from standing.

• Do not twist your hip or swivel on your feet.

There is no single recovery time because it depends on whether the hip was replaced or native, whether other bones were broken, and the person's fitness. The Plymouth leaflet gives the three-month precaution period, and the Dorset leaflet describes the broad recovery pattern after a hip replacement shown above. Expect to use crutches or a frame at first, with physiotherapy to guide how quickly you progress.

Do not drive, return to sport or resume heavy activity until your orthopaedic or physiotherapy team agrees.

Plymouth lists reasons to seek immediate medical attention. They apply after any reduction or surgery:

• Increased or severe pain that is not relieved with prescribed medication.

• Signs of infection at a surgical site: redness, swelling, warmth or discharge.

• Pins and needles, numbness or weakness in the leg, knee or foot, which may indicate nerve or vascular injury.

• Cold, pale or blue toes, a possible circulation problem.

• Sudden difficulty breathing, chest pain or swelling in the calf, signs of a blood clot or pulmonary embolism. Call 999.

• Unusual hip movement or deformity, which could mean the hip has dislocated again.

Plymouth says hip dislocation can occur due to congenital deformities. This is usually discussed under developmental hip problems in babies and children. The UK sources used for this page focus on adults, so if you are worried about a baby's or child's hip, ask your GP, health visitor or NHS 111. Any child with severe pain, who is unable to bear weight after an injury, needs emergency assessment.

None of the UK sources used here gives specific advice for hip dislocation in pregnancy. A suspected dislocation is an emergency at any time, so call 999 and tell the ambulance crew that you are pregnant.

A suspected hip dislocation is dealt with by an NHS ambulance and emergency department, because the hip has to be put back with pain relief and checked by X-ray. After reduction, follow-up is usually through orthopaedics and physiotherapy; Plymouth says you will be assessed and given equipment to take home if necessary.

If you have had a hip replacement privately, tell the hospital and ask whom to contact if the hip dislocates; Dorset County Hospital's leaflet directs patients to its elective orthopaedic unit for other concerns and to 999 for a dislocation. Keep your discharge paperwork where you can find it.