top of page



Hip pain can be caused by a wide 

range of injuries and conditions.

Our orthopedic specialists can quickly diagnose your source of pain and work with you to develop a treatment plan.

The Team

Most people with hip pain won’t need surgery, but those who do will be glad to know our highly-skilled

orthopedic doctors can dramatically reduce postoperative discomfort and recovery time with minimally-invasive surgical techniques.


James Ramser, MD

Total Joint Replacement

Hip and Knee


Scott Koenig, MD

Total Joint Replacement

Hip and Knee


Miguel Pelton, MD

Arthroscopic Surgery

Hip, Knee, Shoulder, and Elbow

Treatment for hip Pain

In most cases, patients can expect our hip specialists to suggest non-operative treatment — such as lifestyle changes, physical therapy, or pain management — before considering surgery. 


Physical therapy

Hip pain can often be treated with physical therapy, a non-invasive approach that is focused on strengthening muscles, increasing flexibility, and maintaining your joint’s fullest possible range of motion. Physical therapists are advanced practitioners (many of whom have earned doctorates and/or additional certifications) who thoroughly assess your physical condition and create an individualized program that addresses the underlying hip condition.

Pain Management


Depending on the source of the pain, therapeutic intra-articular injections may also be an effective non-operative approach to treat hip pain. Our highly-skilled pain management team here at Blue Ridge Orthopaedic uses real-time x-ray imaging to guide injections to exactly the right spot within the hip joint.

Lifestyle Modifications

Another viable non-operative treatment for some patients is to make modifications to their activities and/or lifestyle. Switching to low-impact (or non-weight-bearing) exercises, quitting smoking, and making dietary changes are all common modification that can help reduce hip pain. Your orthopedic specialist can help you determine which changes will be most helpful.

Total joint replacement​


Good news! Total hip replacements almost always reduce joint pain and, as a result, patients are able to enjoy an improved quality of life for many years.

Even better news is that both Dr. Ramser and Dr. Koenig use an innovative surgical technique that offers additional benefits. The Anterior Supine Intermuscular Hip Replacement Approach is a minimally-invasive hip replacement procedure that results in reduced postoperative pain and a quicker recovery. It is especially well suited for elderly patients.


Younger patients see amazing results as well. “Many of my younger patients are staying only one day in the hospital and don’t require physical therapy,” says Dr. Ramser.


Dr. Ramser and Dr. Koenig are among only a few orthopedic surgeons in Virginia that routinely perform Anterior Supine Intermuscular Hip Replacement surgery.

Hip Arthroscopy

Arthroscopic surgery is an effective, minimally-invasive treatment used by orthopedic surgeons to treat certain types of hip conditions. Labral tears, for example, are a fairly common hip injury that can be treated with arthroscopy. 

Arthroscopic hip surgery is performed with two or three small (2-½ centimeter) incisions which allow the surgeon to put a small a camera inside the hip joint along with other instruments needed to fix things inside the joint. The small incisions result in a relatively quick result from surgery. 


Patients generally undergo a period of time where they’re not putting a lot of weight on the leg and we call that basically toe touch weight bearing so they’re on crutches and a hip brace as well. And that’s anywhere from a period of two to six weeks.”

commom causes of hip pain


Osteoarthritis is the most common form of hip arthritis. It’s a degenerative type of arthritis where the cartilage in the joint wears away over time, resulting in a gradual increase in pain and stiffness. It is sometimes referred to as “wear-and-tear arthritis,” and occurs most often in people 50 years old and older.


Inflammatory arthritis is another common cause of arthritic hip pain. This type of arthritis also destroys cartilage in the hip joint, but in a different way. The damage is caused by an overactive immune system which mistakenly attacks healthy tissue. Inflammatory arthritis tends to affect joints on both sides of the body equally and in people of all ages



Bursae are fluid-filled sacs that cushion the bones and tissues around your joints (similar to bubble wrap). There are about 160 of them in your body, with several located in the hip joint area. The bursa located on the bony point of the hip bone is the one that most commonly becomes inflamed, causing pain. Common causes include repetitive stress, a fall or injury, rheumatoid arthritis, and bone spurs. Bursitis typically gets better on its own, using R.I.C.E. to relieve pain. 



For most people, the hip joint is extremely stable, held together by tough ligaments and strong muscles. Dislocation of this joint requires considerable force and, as you might imagine, it is an extremely painful injury. This type of injury is considered a medical emergency due to the risk of secondary injuries and the amount of force needed to put your joint back into place. Surgery is sometimes necessary.


Hip fractures occur more frequently in older people with osteoporosis but they can also occur in younger people as the result of a traumatic injury or overuse. Treatment depends on the type of fracture and the patient’s condition.​

Labral tear


Your hip has a ring of cartilage called the labrum that stabilizes the ball-and-socket joint. Overuse and injuries can tear this cartilage, resulting in loss of mobility, pain, a clicking sound, and other symptoms. Many patients respond well to non-operative treatment, such as physical therapy. In some cases, arthroscopic surgery may be indicated.


Strains and Sprains


A torn muscle (strain) or ligament (sprain) can usually be treated with R.I.C.E., except in extreme cases where physical therapy may be necessary. 



A tendon is connective tissue that connects muscle to bone. Hip tendonitis, sometimes called hip flexor tendonitis, is a condition that happens when a tendon becomes inflamed, typically due to overuse.

bottom of page