Hip pain is one of the commonest reasons for which patients come to see me. Usually patients with true hip joint pain suffer from pain located in the groin, but they can also have buttock pain, pain on the side of the hip, and pain in the knee below. Pain traveling down the back of the leg from the buttock to below the knee usually indicates a problem in the lower back (for example, sciatica), and not the hip joint.
The hip joint is one of your largest weight-bearing joints, and, while it’s quite durable, it is prone to developing several disorders that can result in pain. The hip is a ball-and-socket joint made up of the femoral head (the ball), which is the top of the femur (thighbone), and the acetabulum (the socket), which is part of the pelvis. The ball and the socket are each lined with several millimeters of cartilage, which cushions the joint. Primary stability of the hip joint is provided by the congruence between the ball and the socket. A cartilage ring called the “labrum” is fixed around the mouth of the socket, deepening the hip and creating a “suction seal” between the socket and the ball. This structure contributes secondarily to hip stability. Ligaments and the “hip capsule” are dense connective tissues attaching the ball to the socket. These also contribute to stability of the joint. The lining of the joint is called the “synovium”, and it produces lubricating joint fluid that also nourishes the joint. Large muscles and their tendons cross the hip joint and provide further support to the joint and enable movement. The most important of these muscles are the hip flexors, hip abductors and the large gluteus maximus. Fluid-filled sacs (bursae) provide cushioning between bones, muscles, and tendons.
When a disease, inflammation, wear and tear, or other issue affects one of these parts, you may experience pain.
What causes hip pain?
Hip pain is extremely common and can be difficult for most people to determine exactly where it is coming from. Sometimes the pain is related to the hip joint itself, but it can also be related to conditions in other parts of your body.
Common causes of this type of hip pain include the following:
- Arthritis – including osteoarthritis and rheumatoid arthritis
- Injuries – including bursitis (inflammation of a bursa), tendonitis (inflammation of a tendon connecting muscles to the bone in the hip joint), dislocations, fractures, and labral tears
- Pinched nerves – including sciatica (irritation of the sciatic nerve, which runs from your lower back into your legs)
- Other issues – impingement (motion conflict between the thighbone and pelvis) and avascular necrosis (death of bone tissue due to inadequate blood supply)
What symptoms warrant seeing a doctor for hip pain?
If you have minor hip pain that hasn’t been going on for a long time, you can try the following at home:
- Over-the-counter pain relievers
- Applying ice or heat
- Resting your hip by avoiding direct pressure, repeated bending, and prolonged sitting
If these remedies do not offer adequate relief and you find that your pain is interfering with your life, you should see an orthopedic hip specialist.
You should also seek immediate medical attention if the pain is intense, you can’t move your leg or hip, you have sudden swelling, or you have fever, chills, or redness around your hip.
How is hip pain diagnosed?
After reviewing your medical history with you, including specific information about the severity of your hip pain, where it hurts, and how long the pain has lasted. I will also ask about any self-care remedies you’ve tried and if they provided any relief.
Next, I will examine you in order to assess the range of motion and strength around your hip as well as your walking. Tests, such as an X-ray or MRI, may also be warranted if more information is needed about your hip joint, cartilage, muscles, or other supporting structure, as well as nearby areas of your body that could be causing the pain in your hip. CT scans and blood work may be necessary in some, but not all, cases.
Where can I find the best treatment for my hip pain?
If you’re experiencing hip pain, make an appointment today. I will gather the information needed to diagnose the cause of your pain and recommend the best available treatments to help alleviate your pain and let you return to your active lifestyle.