“My hip is affecting my relationship." The hip pain she was too embarrassed to talk about.
Topic: hip osteoarthritis, groin pain, pain during sex
This story is inspired by the many people we've cared for over the years. Names and details have been changed and combined to protect privacy. If you recognise yourself in this story, you're certainly not alone.
Michelle’s story
For as long as she could remember, walking had been one of her favourite things to do. She loved getting outdoors, exploring new places and catching up with friends at her weekly walking group. It was her time to clear her head, get some fresh air and enjoy herself.
But over the last few years, things had slowly started to change. At first, it was little things. Getting out of the car took a little longer than it used to. Walking for extended periods left her hip aching, and climbing the stairs was becoming increasingly uncomfortable. The pain was deep in her groin and sometimes travelled down her thigh. She tried to ignore it, hoping it would eventually settle, but instead, it seemed to become a little worse with each passing year. Gradually, the things she once did without thinking started to feel like a challenge.
Eventually, she made the difficult decision to stop attending her walking group. She simply couldn't manage the distances anymore without paying for it afterwards. Losing that part of her life hit her harder than she expected. She felt frustrated, miserable and increasingly unlike herself. The constant pain was wearing her down, and her sleep was suffering too.
She had less energy, less patience and less enthusiasm for the things she used to enjoy. The strain was beginning to affect her relationship with her husband, too. When you're uncomfortable every day and struggling to get a decent night's sleep, it's difficult not to let that frustration spill over into other parts of your life.
But there was something else. Something she hadn't told her friends. Something she felt too embarrassed to bring up with a healthcare professional. Her hip pain was affecting her relationship in a way she hadn't expected.
The real reason she came to see us
Intimacy with her husband had become uncomfortable. Certain movements caused pain, and sometimes she felt so worried about triggering another painful episode that she didn't want to have sex at all. She worried about what this meant for their relationship. She didn't want her husband to think she wasn't interested in him anymore, but she also didn't want to put herself through something that hurt.
She felt stuck between the two, and she didn't know who she could talk to about it. Then, one day, she went for coffee with a friend from her walking group.
Coffee with a friend
During their conversation, her friend mentioned that they had been experiencing hip pain too, and had visited us at Evolv Health so that she could continue in the walking group.
For the first time in a long while, she felt a little spark of hope. Perhaps she didn't have to keep putting up with this. Perhaps there was something that could help.
She wanted to walk again, climb the stairs more comfortably and feel like herself. She wanted to stop thinking about her hip every time she moved. And, although she hadn't yet found the words to explain it to anyone, she wanted to feel comfortable and confident in her relationship again, too.
So, she booked an appointment.
At Evolv Health
We began, as we always do, with a thorough assessment.
We talked through her current symptoms, her medical history and her previous health concerns. I wanted to understand not just where she hurt, but how the pain had developed, what made it worse, and how it was affecting her life.
During the physical assessment, I found that the movement in her hip was restricted. Bringing her knee up towards her chest reproduced a sharp pain in her groin, and rotating her hip was also more limited than expected.
These findings, alongside her history and the pattern of her symptoms, suggested that hip osteoarthritis could be contributing to her pain.
I explained this to her. Her immediate reaction was worry. Her mum had needed a hip replacement, and she was frightened that she would inevitably end up needing the same operation.
I reassured her that osteoarthritis does not automatically mean you need a hip replacement. There are conservative approaches that may help manage symptoms, maintain movement and strength, and make everyday activities more comfortable.
For some people, these approaches are enough to manage their symptoms for a long time. Others may eventually need surgery, particularly when pain and disability remain significant despite other treatments.
We discussed what we could work on together and agreed to start by seeing whether we could improve her comfort and movement.
We started with some hands-on treatment, including gentle hip traction, joint mobilisation and work to the surrounding hip flexor muscles. After treatment, we reassessed her movement.
She was surprised to find that her hip moved more freely and that the sharp discomfort she had experienced during the movement was reduced.
It was an encouraging start. I explained that this immediate change was a positive response, but it didn't mean the arthritis had disappeared or that the improvement would necessarily last. Osteoarthritis is a long-term joint condition, and symptoms can fluctuate.
Telling us what has really been upsetting her
“I haven't been able to enjoy intimacy with my husband.”
She explained that she had been struggling with intimacy for some time because of her hip pain. Certain positions were uncomfortable, and sometimes she avoided sex altogether because she was worried about triggering another painful episode.
It had become something she felt embarrassed about, even though it was having a real impact on her life. When she finally said it out loud, she seemed relieved. She had been carrying that worry around alongside everything else.
I was glad she felt comfortable enough to tell me. It meant we could consider the whole picture rather than focusing solely on whether she could walk or climb the stairs. Hip pain can affect many different movements, including those involved in sexual activity. When the hip is painful or stiff, bending it deeply, rotating it or moving it into certain positions may aggravate symptoms.
For some people, the impact goes beyond the physical discomfort. They may start anticipating pain, avoiding intimacy or worrying about how their partner feels. This can create stress and misunderstandings in a relationship, even when both people care deeply about one another.
It is an important part of someone's quality of life, and it deserves to be taken seriously. You shouldn't have to feel embarrassed about discussing how pain affects your relationship. It's a legitimate concern, and a healthcare professional can help you explore possible causes and appropriate ways to manage it.
What is hip osteoarthritis?
Osteoarthritis is a condition that affects the whole joint. Changes can occur in the cartilage, the bone beneath it and the surrounding joint tissues.
The hip is a ball-and-socket joint. The rounded top of the thigh bone sits inside a socket in the pelvis, allowing the leg to move in several directions. In hip osteoarthritis, changes to the joint can lead to pain, stiffness and reduced movement. Symptoms vary considerably between individuals. Some people experience relatively mild symptoms, while others find that pain interferes with walking, sleep and everyday activities.
Common symptoms include:
Pain in the groin, which may spread into the thigh or buttock.
Stiffness, particularly after resting or first thing in the morning.
Difficulty getting in and out of a car.
Discomfort when walking for longer distances or climbing stairs.
Difficulty putting on socks and shoes.
Pain when bending or rotating the hip.
Discomfort at rest or during the night in more persistent cases.
