What is hip impingement?
Hip impingement, or femoroacetabular impingement (FAI), happens when the ball of the thigh bone (femur) and the hip socket (acetabulum) have a shape that makes them press against each other during movement, especially deep bending and rotation. Over time this contact can damage the labrum and the joint cartilage.
An international consensus, the Warwick Agreement, defines FAI syndrome as a combination of symptoms, clinical signs and imaging findings. An FAI bone shape on its own, without symptoms, is common and does not need treatment.
Types of impingement
| Type | What is different | Who it often affects |
|---|---|---|
| Cam | Extra bone on the femoral head-neck junction, so the ball is less round | Young active men, athletes |
| Pincer | The socket rim over-covers the ball | More often women, middle age |
| Mixed | Both features together | Common |
Symptoms
- Groin or front-of-hip pain, often with sitting, squatting or getting out of a car
- Pain on twisting, pivoting or deep bending in sport
- Stiffness and reduced inward rotation of the hip
- Clicking or catching if the labrum is torn
How is FAI diagnosed?
A doctor examines the hip with movement tests and orders an X-ray to measure the bone shape. An MRI or MR arthrogram looks at the labrum and cartilage. A hip labral tear is a frequent companion of FAI, and the two are usually treated together.
Imaging also checks for early hip osteoarthritis, which changes the options. You can send your X-ray and MRI for a doctor review before making a decision.
Conventional hip impingement treatment
Conventional care should always come first.
- Education and activity changes. Understanding which positions provoke pain and modifying sport and sitting habits.
- Physiotherapy. A structured programme of hip and core strengthening and movement control, usually over at least three months.
- Pain relief. Anti-inflammatory medicines for short periods where safe.
- Steroid injection. An image-guided injection into the hip can reduce pain and help confirm the pain comes from inside the joint.
- Hip arthroscopy. Keyhole surgery to reshape the bone (osteoplasty) and repair or trim the labrum.
In the UK FASHIoN randomised trial, hip arthroscopy led to greater improvement in hip-related quality of life at 12 months than personalised physiotherapist-led care, although both groups improved (Lancet, 2018). Surgery is generally less effective once significant arthritis is present.
Regenerative options: what the evidence shows
No injection can change bone shape, so regenerative treatments cannot correct impingement itself. They are sometimes considered to address pain from joint irritation or an associated labral tear, usually when someone is not ready for surgery.
PRP
PRP therapy uses a concentrate of your own platelets injected under imaging guidance. Studies in FAI are few and small, and some have looked at PRP as an add-on during arthroscopy rather than on its own. Evidence quality is low.
Stem cells
Stem cell therapy with mesenchymal stromal cells has been studied mainly in knee osteoarthritis. For hip impingement there are no high-quality trials, so any use is experimental and aimed at symptoms, not structure.
Regulatory status
No stem cell product is approved for FAI by the US FDA, the TGA in Australia or the UK MHRA, and the FDA warns about unapproved stem cell treatments. Patients from Australia, the UK and Canada sometimes travel to Thailand, where licensed doctors may provide these treatments under Thai regulation.
Who may be a candidate, and who should not
May be considered for an injection-based program:
- Confirmed FAI syndrome with pain that persists after a proper physiotherapy programme
- Mild joint irritation or a labral tear without major mechanical symptoms
- People not ready for, or advised against, surgery for now
- Realistic goals: less pain, not a change in hip shape
Usually not suitable:
- Large cam or pincer deformity with clear surgical indications
- Significant hip dysplasia, which needs a different surgical approach
- Advanced arthritis or avascular necrosis
- Active infection, active cancer, pregnancy, or bleeding disorders
- Young athletes who have not tried structured rehab
Risks and side effects
- Post-injection pain and swelling for a few days (common)
- Bruising at the blood draw or harvest site
- Joint infection (rare but serious)
- Reactions to donor-derived products
- No meaningful improvement
Cells are prepared in ISO 9001:2015-certified partner laboratories.
What a Bangkok program looks like
- Send your reports. X-ray, MRI and physiotherapy history via WhatsApp.
- Doctor review. An honest opinion, including when surgical review is the better path.
- Assessment in Bangkok. Consultation, examination and blood tests.
- Treatment, if suitable. Image-guided hip injection as a day procedure.
- Rehab plan. A home exercise programme focused on hip control.
Read how it works for the full step-by-step journey.
Aftercare and recovery
- Relative rest for 24–48 hours after an injection, then gentle walking
- Avoid deep squats, low seats and long periods of sitting with the hips bent while the joint settles
- Avoid anti-inflammatory medicines for a period after PRP or cell injections if your doctor advises
- Return to strengthening exercises gradually, guided by a physiotherapist
- Move regularly on the flight home and stay under the care of your home doctor
- Report increasing pain, fever or redness promptly
Sources
- Griffin DR, et al. The Warwick Agreement on femoroacetabular impingement syndrome. Br J Sports Med, 2016.
- Griffin DR, et al. Hip arthroscopy versus best conservative care for FAI syndrome (UK FASHIoN). Lancet, 2018.
- NHS: Hip pain
- U.S. FDA: Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes
Frequently asked questions
Can hip impingement be fixed without surgery?
The bone shape does not change without surgery, but many people control symptoms well with physiotherapy, avoiding provoking positions and pain relief. A large UK trial found surgery gave somewhat better hip-related quality of life at 12 months, but physiotherapy-led care also helped.
What is the difference between cam and pincer impingement?
Cam impingement is extra bone on the ball of the femur, making it less round. Pincer impingement is a socket rim that covers too much of the ball. Many people have both, called mixed impingement.
Does hip impingement lead to arthritis?
FAI is linked to a higher risk of hip osteoarthritis, especially cam impingement, but not everyone with an FAI shape develops arthritis. Whether early surgery reduces that risk long term is not yet proven.
Can PRP or stem cells help hip impingement?
Injections cannot remove the bone that causes impingement. Some doctors use PRP to try to ease joint irritation or a related labral tear, but evidence in FAI is limited. A doctor reviewing your imaging can say whether this is reasonable.
How much does hip impingement treatment cost in Bangkok?
It depends on your diagnosis and the plan recommended, so we do not publish fixed prices. Send your hip X-ray and MRI on WhatsApp for a free doctor review and a personalised program.
What exercises should I avoid with hip impingement?
Deep squats, low seats, sitting with knees above hips, and movements that combine deep bending with inward rotation often provoke pain. A physiotherapist will guide what to modify rather than stopping activity completely.
This page is general information, not medical advice, and does not replace a consultation with your own doctor. Results vary and no treatment outcome can be guaranteed. We are a patient coordination service and may receive a referral fee from partner medical providers. See our medical disclaimer and referral disclosure.