If your hips are healthy, you probably don't think about them very often. If you're having hip pain, though, it may be the only thing on your mind. The hip is a large joint that helps support your body and all of its supporting structures, so this means there are plenty of causes of hip pain. Here’s what you need to know, and whether you should consider seeking treatment.
What are the First Signs of Hip Problems?
Because the hip joint is a connecting point for bones, muscles, ligaments, and other connective tissues, it may be difficult to tell whether your pain is stemming from your hip itself. Generally speaking, however, a problem that’s stemming from the hip will cause pain in the groin area or the inside of the hip.
Conversely, pain that affects the upper thigh, outer buttock muscles or the outside of the hip is more than likely a problem with a tendon, ligament, muscle, or other soft tissue that surrounds the hip rather than the joint itself. And, sometimes pain that feels like it’s due to hip issues is actually caused by injuries, diseases, or conditions in other parts of your body, including your lower back.
How Do I Know if My Hip Pain is Serious?
Hip pain can be uncomfortable, but how do you know whether it’s a “weekend warrior” injury that will subside in a few days or something more serious? One of the first signs that your hip problem might require medical attention is how long it lasts. If it’s longer than a few days without signs of improvement, it may be wise to see a doctor.
Signs that you should seek immediate medical help for a hip injury include:
- Exposed bone or muscle
- An area that’s warm to the touch
- A popping sound
- Inability to bear weight
It’s also important to seek help right away if you experience swelling, redness, warmth, tenderness, or soreness in the area of your hip joint because these could be signs of more serious conditions. Septic arthritis, for example, is a joint infection that can lead to deformities or osteoarthritis if not treated.
Common Causes of Hip Pain
If your hips are bothering you, here’s a list of some of the most common causes of hip pain, along with some less common causes.
Several different types of arthritis can affect the hip joint, but the most common is osteoarthritis. Osteoarthritis, also known as "wear-and-tear" arthritis, indicates that the protective cartilage in the joint has degenerated to the point where bone rubs on bone. This type mainly affects those over 50, although those younger can experience it as well. Arthritis hip pain can keep someone from being as active as they would like, and can seriously impact well-being. Hip replacement may be recommended for osteoarthritis if other treatments don’t work.
2. Labral Tears
A labral tear is damage to the cartilage that surrounds the hip socket. Repetitive motions, a fall, or an accident can lead to labral tears, and they can also appear in early osteoarthritis. Often, sports like ice hockey, football, ballet, golf, and soccer can lead to hip labral tears. However, they can also be caused by abnormalities in the structure of the hip joint itself. Symptoms can include a locking or clicking sensation in your hip joint, stiffness, and pain that’s made worse by long periods of inactivity.
3. Femoroacetabular Impingement (FAI)
This condition occurs when one or both of the bones that form the hip joint grow an irregular shape. There are three types of impingements:
- Pincer: When the bone growth extends over the edge of the acetabulum.
- Cam: A bone growth on the edge of the femur that restricts movement of the ball joint.
- Combined: When both pincer and cam growths are present.
When the labrum and femur do not fit correctly around the hip joint, it causes damage to the joint, pain, and limited mobility.
Fluid-filled sacs called bursae cushion and lubricate your joints. There is one that resides between the hard bone on the outside of each hip and the connecting tendon. If these bursae become inflamed and swollen, it's known as trochanteric bursitis, and can be exquisitely painful, particularly when lying on the affected side, moving around a lot, or even simply walking around.
This hip condition is a bit lesser-known, and occurs when cells of the hip bone start to die due to insufficient blood supply. Most often, osteonecrosis (also called avascular necrosis) happens as a result of excessive use of alcohol or corticosteroids. However, it can also be the result of hip dislocation or fracture.
Symptoms of osteonecrosis include pain in the thighs, buttocks, or knees, as well as hip and groin pain that gets worse with walking. It’s most common in the hip, although it can occur in other joints as well.
6. Hip Fractures
Hip fractures are significant injuries. They can vary in severity, but all hip fractures need immediate attention from an orthopedic specialist. These are often caused by severe trauma, but older people can experience a hip fracture with just a fall. They are severely painful and result in an immediate loss of mobility.
While it usually takes direct trauma to fracture a hip, factors such as cancer, osteoporosis, or stress injuries can weaken the joint and make it more susceptible to injury.
Tendons attach muscles to bones and are found throughout the body. They are thick and strong because of the work they do every day, but can become irritated or inflamed. When tendons are injured or overused, the resulting pain is called tendinitis.
The tendons around the hips are especially strong, but they’re also especially subject to stress and strain due to the hip’s weight-bearing responsibilities. Especially with sports, repeated, stress-inducing activities can wear on your hip tendons. What might start as a mild strain due to overuse can eventually progress into an injury without treatment.
Tendonitis is often marked by pain in your hip flexor muscles, which are the muscles that allow you to raise your knee toward your body, and are connected to movement or even touch. It can be common in athletes, such as soccer or tennis players, and runners.
8. Hip Flexor Strain
A strain happens when a muscle or tendon — or both at the same time — gets stretched or torn. In the hip, the at-risk muscles are the hip flexors (the iliopsoas and rectus femoris muscles), which allow you to move your legs up and down. A hip strain refers to a stretching or tearing of a muscle or its associated tendon (or both).
Hip flexor strains commonly happen when the muscles are overused due to sports with repetitive motion, such as cycling or tennis, or from trauma, such as a direct hit. A hip flexor strain can cause swelling, weakness in the muscle, or restricted movement.
9. Snapping Hip Syndrome
The main symptom for this type of hip injury is exactly what it sounds like — a snapping sound or popping sensation in the hip joint. It can also be accompanied by side hip pain with walking, getting up from a chair, or other similar movements. The snap happens when soft tissue, such as tendons or muscles, move over a bony part of the hip joint.
One of the most commonly affected tissues in snapping hip syndrome is the iliotibial band, more commonly referred to as the IT band, which runs from the hip along the outside of the thigh. When the IT band passes over the upper thigh bone, it creates the snapping sound.
Like other hip injuries, snapping hip syndrome is common in athletes or others who engage in repetitive, stressful motion that causes them to bend at the hip. In fact, it’s also referred to as “dancer’s hip.”
Sciatica hip pain can be significant. The sciatic nerve runs from your lower back, through your hips and buttocks and down each leg, and generally affects only one side of your body. It's caused by compression of the sciatic nerve from many potential factors, such as a bone spur on your spine, a herniated disk, or narrowing of the spine.
11. Inguinal Hernia
An inguinal hernia can cause pain in the front of the hip joint and happens when tissue (part of the intestine, for example) protrudes through a weak spot in the abdominal wall. It can happen as the result of a sports injury, or because of the extra pressure that women experience on their abdomens as the result of pregnancy.
Regardless of how they occur, hernias can be quite painful, especially if aggravated by a cough or lifting something heavy. One symptom is a bulge on either side of your pubic bone that’s easier to see when standing up. It can burn or ache at the site, or cause a heavy or dragging sensation in the groin.
Sometimes, hernias resolve on their own and are not dangerous. Others, however, can cause persistent pain, get larger, or cause severe complications. In these cases, surgery is often recommended.
12. Gynecological and Back Issues for Women
Especially for women, what feels like hip pain might actually stem from a problem with the pelvis. Gynecological issues, such as fibroids or endometriosis, can cause significant pain in the groin area during either ovulation or menstruation. Likewise, issues with the urinary or digestive systems — prostate cancer or gastroenteritis, for example — might also feel like an issue with the hip.
Finally, women might also feel issues stemming from the back or spine down around the hip and buttocks area. Sciatica is one common issue that usually causes pain on one side of the body, including the back side of the hip and even down the leg.
How is Hip Pain Diagnosed?
Doctors determine the source of hip pain using a number of different diagnostic techniques, from medical history to medical imaging. During a physical exam, your doctor may ask you to walk around to observe joint movement, measure it compared to your normal hip, or manipulate the hip joint using various range-of-motion techniques.
If sciatica is suspected, for example, a straight-leg raise might cause aggravation. If an infection is present, touching the affected area might cause pain. You may also encounter questions about your pain, including whether it’s affected by the time of day, position, activity, and when it first started to bother you.
Further diagnostics can include imaging tests, such as ultrasounds, MRI scans, CT scans or X-rays, blood bests, or examinations of joint fluid. Any combination of these tests can create a more thorough picture of your issue.
What are the Treatments for Hip Pain?
Unless there’s an obvious fracture, dislocation, deformity, or other injury that requires surgery, doctors usually begin with conservative treatments. These can include suggestions about lifestyle changes, such as controlling your weight, getting regular exercise, and doing yoga or other stretching exercises. They may also advise at-home remedies, like ice, over-the-counter anti-inflammatories, elevation, or rest.
If your hip pain increases with certain activities or positions, your doctor may recommend modifying the activity or stopping it altogether to manage and limit the pain. However, the course of treatment depends on the source of the pain.
In some cases, especially when inflammation is determined to be the cause of your pain, your doctor may be able to offer you a cortisone steroid injection. If an infection is present, you may be prescribed antibiotics.
Treatment for hip pain depends on what's causing it. At Alexander Orthopaedics, we offer several hip pain treatments that can help you feel better. One common procedure we offer is hip arthroscopy, which allows doctors to visualize your hip joint and make repairs without using a large incision. Fractures may necessitate surgical repair such pinning, plates, and screws. Both fractures and severe arthritis can require total joint replacement. Total hip replacement surgery removes an arthritic joint and replaces it with a hip prosthesis in order to regain motion and reduce pain.
We can also work with you to develop hip pain exercises and other treatment plans that will get you back on your feet. Schedule an appointment today and get started on the path back to a pain-free life.