The hip is a ball-and-socket joint that connects the thigh bone (femur) to the pelvis (hip bone). The hip joint is responsible for bearing the weight of the body and facilitating movement such as walking, running, and bending. Additionally, it allows for a wide range of motion, including flexion, extension, and rotation of the upper leg. But sometimes, hip pain can slow us down. This article will explore the common causes of hip pain and when it is time to seek medical attention.
What Are the Common Causes of Hip Pain?
Hip pain can be caused by various injuries or conditions, including:
- Arthritis: Different types of arthritis, such as osteoarthritis and rheumatoid arthritis, can affect the hip and cause pain and stiffness.
- Hip Bursitis: This condition occurs when the bursa, a fluid-filled sac that cushions the hip joint, becomes inflamed. This can result from overuse, trauma, or underlying medical conditions, such as rheumatoid arthritis.
- Muscle Strains: Overuse, improper form during physical activities, or sudden movements can strain the muscles around the hip, leading to localised pain and mobility issues. The most common strains are groin pulls and hamstring strains.
- Hip Fractures: A fall or accident can sometimes cause a break in the femur of the hip joint. This is more common in older adults and those with bone-weakening conditions, such as osteoporosis.
- Hip Tendonitis: Repetitive motions, sudden injuries, or posture issues can cause the hip tendons to become inflamed. One of the most common forms of hip tendonitis is iliotibial band (IT band) tendonitis.
- Hip Labral Tear: This hip injury occurs when the labrum, a ring of cartilage surrounding the hip joint socket, is damaged or torn. It commonly affects individuals who engage in repetitive twisting movements, such as athletes.
- Hip Impingement: Also known as femoroacetabular impingement (FAI), this condition is characterised by abnormal friction between the ball and socket of the hip joint. It can lead to pain and limited range of motion.
- Avascular Necrosis: Also referred to as osteonecrosis, this condition occurs when blood flow to the hip bone is restricted, resulting in the death of bone tissue. One of the common places for osteonecrosis to occur is in the hip joint.
Symptoms Commonly Associated with Hip Pain
The associated symptoms of hip pain can vary depending on the underlying cause. In general, one may experience:
- Limping when walking
- Decreased range of motion in the hip or legs
- Discomfort in the groin, outer hip, thigh, or buttocks
- A feeling of warmth around the hip joint
- Swelling and tenderness in the hip joint
- Snapping or clicking sounds in the hip, known as crepitus
- Pain accompanied by chills, fever, rashes, or other indications of infection
Complications of Hip Pain
Leaving hip pain untreated can result in worsening pain, loss of hip function, muscle weakness and joint stiffness. In some cases, untreated hip pain may also progress to chronic conditions, such as arthritis, bursitis, or other degenerative joint diseases, which can significantly impact one’s quality of life.
How Is Hip Pain Diagnosed?
Orthopaedic specialists often use various diagnostic techniques to detect the underlying cause of hip pain and develop an effective treatment plan. These include:
- Physical Examination: The doctor will examine the hip area for any signs of swelling, redness, or deformities. They will also evaluate the range of motion, muscle strength, and joint stability. Furthermore, they may perform specific manoeuvres to pinpoint the exact source of the pain.
- Medical History: Doctors will discuss your hip pain's onset, duration, and characteristics to understand the cause. They may also ask about risk factors, past injuries, and existing medical conditions to guide subsequent diagnostic tests.
- X-rays: This test provides detailed images of the bones within the hip joint to identify any structural abnormalities, such as fractures, arthritis, or bone spurs.
- Computed Tomography (CT) Scan: This test combines multiple X-ray images to generate cross-sectional images of bones, tissues, and blood vessels and diagnose conditions such as hip fractures, tumours, or complex joint deformities.
- Magnetic Resonance Imaging (MRI) Scan: This test utilises a powerful magnetic field and radio waves to produce detailed images of the hip joint. They can diagnose conditions such as labral tears, ligament or muscle injuries, or hip joint infections.
How Is Hip Pain Treated?
Depending on the cause and severity of the condition, hip pain treatments can be divided into non-surgical and surgical options.
Non-Surgical Treatment Options
Non-surgical treatments are typically the first line of treatment for low-level hip pain to help reduce inflammation and discomfort. Some commonly used non-surgical interventions for hip pain include:
- Rest: The initial approach to managing hip pain typically involves resting and avoiding activities that require bending the hip or placing excessive strain on the hip, such as heavy lifting and prolonged sitting or standing.
- Heat and Cold Therapy: Ice packs are used for acute injuries to decrease swelling, whereas heat pads are employed for chronic conditions to ease tension and stimulate blood circulation to the affected area.
- Physiotherapy: Targeted exercises and stretching techniques can relieve hip pain by strengthening the muscles around the hip and improving joint mobility, flexibility, and stability.
- Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help to manage mild to moderate hip pain and relieve accompanying symptoms.
- Injections: Corticosteroid injections can provide temporary pain relief and reduce inflammation in the hip joint.
Surgical Treatment Options
Surgery is typically considered when conservative methods fail to provide adequate relief or in cases of severe hip conditions. Surgical treatment options for hip pain include:
- Hip Arthroscopy: The orthopaedic surgeon to accesses the hip joint through small incisions and specialised instruments to address various issues such as labral tears, cartilage damage, and impingement. This minimally invasive outpatient procedure is typically recommended for younger patients with hip pain associated with sports injuries, overuse, or abnormalities in the hip bones.
- Hip Replacement: In severe arthritis or significant cartilage damage, an orthopaedic surgeon might recommend a hip replacement to replace the femoral head (ball) and acetabulum (socket) with an artificial joint (prosthesis), designed to restore pain-free mobility and function. The prosthesis can be implanted through traditional open surgery or minimally invasive techniques.
Can Hip Pain Be Prevented?
Hip pain may not be completely preventable due to factors such as ageing, genetics, age-related degeneration, or certain medical conditions that increase the risk of hip problems.
However, taking proactive measures to minimise risk and promptly addressing any hip pain or discomfort can help manage and reduce its impact. These include:
