Are you experiencing deep hip pain that does not seem to improve, even when resting? Have you been diagnosed with avascular necrosis (AVN) or osteonecrosis of the hip and want to avoid or delay surgery? Avascular necrosis is a serious condition that requires careful management, and physical therapy can play an important role in maintaining mobility and reducing discomfort.
At Rose Physical Therapy, with clinics in Navy Yard, Friendship Heights, and Farragut North in Washington, DC, physical therapists provide individualized care to help people manage hip pain related to AVN and maintain function as safely as possible.
Understanding Avascular Necrosis
Avascular necrosis (AVN), also called osteonecrosis, occurs when the blood supply to a portion of bone becomes reduced or interrupted. Without adequate blood flow, the bone tissue may begin to weaken and deteriorate.
The femoral head, the ball shaped portion of the hip joint, is particularly vulnerable because it has a relatively limited blood supply. As the bone weakens, the smooth shape of the joint can become disrupted, leading to pain, stiffness, and progressive joint dysfunction.
In the early stages, avascular necrosis may cause few or no symptoms. Over time, however, the condition can progress and affect the structure and function of the hip joint.
Common Causes and Risk Factors
Several factors can contribute to reduced blood supply to the hip.
Trauma or Injury
Hip fractures or dislocations may damage the blood vessels that supply the femoral head.
Long Term Corticosteroid Use
Extended use of corticosteroid medications for certain medical conditions has been associated with AVN.
Excessive Alcohol Consumption
Heavy alcohol use may affect blood flow and bone health.
Blood Disorders
Conditions such as sickle cell anemia may increase the risk of developing AVN.
Medical Conditions
Certain systemic conditions, including lupus and Gaucher’s disease, may contribute to impaired blood supply to the bone.
Idiopathic Causes
In some cases, avascular necrosis develops without a clearly identifiable cause.
Signs and Symptoms of Hip Avascular Necrosis
Symptoms often develop gradually and may resemble other hip conditions in the early stages.
Common signs and symptoms include:
• Deep aching pain in the groin, buttock, or outer hip
• Pain that worsens with weight bearing or activity
• Stiffness or reduced hip range of motion
• Limping or changes in walking mechanics
• Pain at night or during rest as the condition progresses
• Difficulty climbing stairs, standing for long periods, or getting in and out of chairs
In advanced stages, weakening of the bone may lead to collapse of the femoral head, which can cause severe pain and may require surgical intervention such as hip replacement.
How Avascular Necrosis Is Evaluated
At Rose Physical Therapy, evaluation focuses on understanding your symptoms, movement limitations, and functional goals. Physical therapists often work closely with your physician or orthopedic specialist during care.
Your assessment may include:
• A review of symptom history and previous imaging results
• Hip mobility and range of motion testing
• Strength testing of the gluteal muscles and other hip stabilizers
• Analysis of walking and weight bearing mechanics
• Functional testing such as stair climbing, balance, or sit to stand movements
• Assessment of pain during specific movements or loading patterns
This evaluation helps guide a treatment plan that supports mobility while protecting the joint.
Physical Therapy for Avascular Necrosis of the Hip
Although physical therapy cannot reverse the underlying bone changes caused by AVN, it can help preserve mobility, reduce pain, and maintain strength that supports daily function.
Treatment plans at Rose Physical Therapy are individualized based on the stage of AVN and each patient's goals.
Activity Modification
Patients receive guidance on reducing stress on the hip joint and adjusting daily activities to limit excessive loading.
Manual Therapy
Hands on treatment techniques may help maintain joint mobility and reduce surrounding muscle tension.
Strengthening Exercises
Exercise programs focus on strengthening the gluteal muscles, core, and surrounding hip stabilizers to improve support for the joint.
Gait Training
Physical therapists may address walking mechanics to reduce compensatory movement patterns and improve efficiency.
Balance and Stability Training
Exercises may be used to improve coordination and stability during daily activities.
Assistive Device Education
When appropriate, guidance may be provided on the safe use of assistive devices such as canes or crutches to reduce joint stress.
Pre and Post Surgical Rehabilitation
If hip replacement becomes necessary, physical therapy can help prepare the joint before surgery and support recovery afterward.
Avascular Necrosis Treatment in Washington, DC
Avascular necrosis of the hip can affect mobility, independence, and daily activities. With appropriate care and guidance, many individuals can maintain function and manage symptoms effectively.
At Rose Physical Therapy, treatment programs focus on preserving joint mobility, improving strength, and supporting long term movement.
If you have been diagnosed with AVN or are experiencing persistent hip pain, schedule an evaluation at one of the Washington, DC clinic locations:
Farragut North
Friendship Heights
Navy Yard
Rose Physical Therapy provides comprehensive care designed to support mobility, reduce discomfort, and help patients maintain their quality of life.