Hip replacement surgery is meant to relieve pain and restore mobility, but up to 30% of patients continue to experience chronic pain after surgery.

One major cause is nerve irritation or damage. Small nerves around the hip may become stretched, compressed, or injured during surgery, leading to persistent pain, numbness, or burning sensations. Scar tissue buildup can also trap nerves, making movement painful.

Another issue is implant-related problems. If the artificial hip doesn’t fit properly, becomes loose, or wears down over time, it can cause stiffness, instability, and discomfort. Some patients may also develop inflammation or sensitivity to the implant materials.

Muscle imbalances and joint stiffness can also contribute to pain, especially if the surrounding muscles—such as the hip flexors and gluteal muscles—become weak or tight after surgery. Some patients may also experience referred pain from the lower back or SI joint, which can mimic hip pain.

Certain factors increase the risk of chronic pain. Younger patients, women, and those with pre-existing nerve conditions or severe arthritis are more likely to experience persistent discomfort. Obesity, surgical complications, and inadequate rehabilitation can also play a role.

If pain continues after surgery, there are options beyond medication. Nerve blocks, radiofrequency ablation (RFA), and regenerative medicine can help manage symptoms. For more severe cases, spinal cord stimulation (SCS), dorsal root ganglion (DRG) stimulation, or peripheral nerve stimulation (PNS) may provide long-term relief.

These treatments block pain signals before they reach the brain and are reversible and adjustable, making them safer alternatives to additional surgery.

Hip replacement can improve quality of life, but it’s not a guaranteed fix for pain. If you’re considering surgery or struggling with pain after a hip replacement, exploring all treatment options and getting multiple opinions can help you find the best path to lasting relief.