Stages of AVN: Understanding the Journey from Pain to Collapse

Imagine walking comfortably one day and limping the next, without a clear reason. The pain in your hip doesn’t go away it grows louder. You try to brush it off as a pulled muscle, maybe fatigue. But it persists. Then one day, an MRI tells you: “You have Avascular Necrosis.”

Now what?

Avascular Necrosis (AVN) isn’t just a medical condition it’s a journey. A journey that, if understood early, can change its outcome. In this blog, we’ll explore AVN stage by stage, from the first signs of pain to potential bone collapse. Whether you’re newly diagnosed or supporting someone through it, this guide will help you understand what’s really happening inside the body and what you can do about it.

But First, What Is AVN?

AVN, also known as osteonecrosis, is a condition where a lack of blood flow causes bone tissue to die. It usually affects weight-bearing joints like the hip, shoulder, or knee. When bone cells die, the structure weakens, and if left untreated, the bone can collapse leading to severe joint dysfunction.

Stage 1: The Silent Beginning (The “I’m Sure It’s Just a Sprain” Stage)

What’s happening inside:
In Stage 1, the blood supply to the bone has already started to decrease, but there’s no visible damage yet. X-rays often look normal, which makes early diagnosis tricky. Only an MRI can pick up these subtle changes.

What you might feel:

• Mild pain in the hip, groin, or thigh especially after walking or standing.

• Discomfort may come and go.

• You can still walk normally, but you feel “something’s off.”

Why this stage matters:
This is your window of opportunity. At this point, non-surgical treatments like PRP therapy, stem cells, Ayurvedic care, and physiotherapy can actually halt or reverse the damage. If caught early, you may avoid surgery altogether.

Stage 2: Damage Begins (The “Okay, This Isn’t Going Away” Stage)

What’s happening inside:
In Stage 2, the bone starts to harden (sclerosis) and weaken. Tiny cracks or cysts may appear. X-rays start to show subtle abnormalities, and MRIs reveal clear AVN lesions.

What you might feel:

• Persistent pain, even at rest.

• Pain while climbing stairs, jogging, or bending.

• You may begin limping slightly.

Treatment goals:
Prevent the bone from collapsing. This is when regenerative therapies (like stem cell injections), bisphosphonates, and targeted physiotherapy come into play. Lifestyle changes like reducing weight load on the joint, avoiding alcohol, and following a joint-friendly diet are crucial.

Stage 3: The Collapse Begins (The “Why Is It Getting Harder to Move?” Stage)

What’s happening inside:
Here’s where things get more serious. The top of the bone (like the femoral head in the hip) starts to flatten due to micro-fractures. The shape of the bone changes, which affects how the joint moves.

What you might feel:

• Increased stiffness.

• Pain becomes more constant and starts affecting your daily life.

• Difficulty standing for long periods, walking long distances, or even sitting cross-legged.

Treatment approach:
In some cases, core decompression surgery may be considered to relieve pressure and increase blood flow. But even now, some patients benefit from combination therapies (e.g., stem cells + Ayurveda + rehab).

Stage 4: Bone Collapse and Joint Damage (The “I Just Want My Life Back” Stage)

What’s happening inside:
The bone has collapsed significantly. The joint space narrows, cartilage wears out, and arthritis sets in. This is where permanent damage occurs, and unfortunately, function is severely limited.

What you might feel:

• Severe, constant pain.

• Restricted joint movement.

• Difficulty with everyday tasks like walking, dressing, or even sleeping comfortably.

Treatment options:
At this stage, joint replacement surgery (like hip replacement) may be the most effective solution. While the idea of surgery can be scary, modern techniques are safe, and recovery outcomes are improving every year. Many patients regain 90-100% function and live pain-free lives post-surgery.

A Real-Life Glimpse: Meet Rohit

Rohit, a 34-year-old software engineer from Delhi, was diagnosed with Stage 2 AVN after months of hip pain. Initially terrified by the word "necrosis," he thought surgery was his only option. But after visiting a multi-specialty non-surgical AVN clinic, he underwent stem cell therapy, PRP sessions, and lifestyle rehabilitation. Within 6 months, his pain was down by 80%, and his MRI showed halted progression.

“Knowing what stage I was in helped me take the right step. It saved my hip and my confidence,” Rohit says.

So, What Can You Do Right Now?

1. Don’t ignore hip pain especially if it’s persistent or unexplained.

2. Ask your doctor for an MRI if AVN is suspected. X-rays are not enough in early stages.

3. Get a second opinion especially from clinics experienced in non-surgical AVN care.

4. Educate yourself: Understanding which stage you're in is half the battle won.

5. Start treatment early: The sooner you act, the better your chances of recovery without surgery.

In Summary: From Pain to Empowerment

AVN is not a death sentence for your joints it’s a condition with a clear pathway. Each stage has its own signs, symptoms, and solutions. The earlier you detect it, the more control you have over your recovery.

The journey from pain to healing is possible. Whether you’re at the beginning or somewhere in between, there are choices, there is hope and there’s always a next step you can take.