Patients can experience “hip” pain in a variety of areas around the hip joint, including the upper thigh, inner leg (groin), outer buttock, or outside (“lateral” side) of the hip. Pain in these areas can occur for many reasons, some of which are related to the hip joint itself and some which are related to structures other than the hip, such as the lower back, tendons, ligaments, or nerves. Since the hip is located deep inside the body and surrounded by numerous muscles and nerves, it can be difficult for a patient to tell exactly where the pain is coming from. Patients with true hip joint pain usually have pain in the groin area, but hip joint pain can present anywhere around the hip. Sometimes hip pain may even radiate to the knee below.
If you are experiencing pain around the hip, it is important to consult a hip specialist to get an accurate diagnosis and the appropriate treatment.
What do I need to know about hip anatomy?
The hips are the body’s largest ball-and-socket joints. The ball, or “femoral head”, is the uppermost part of the thigh bone, or “femur”. The socket, or “acetabulum”, is formed from three fused bones that create half of the pelvis. Both the femoral head and the acetabulum are covered with cartilage surfaces that provide cushion within the joint and low friction motion. The hip is nourished and lubricated from a soft tissue lining around the hip called the “synovium”, which produces a lubricating “synovial fluid”.
Most people have a ball and socket that conform to each other well, meaning that the hip joint has high stability just from the shapes of the bones and how well they fit together. Additional soft tissues around the hip enhance the function and stability of the hip joint.
The “labrum” is a ring of cartilage attached to the edge of the acetabulum. This ring deepens the hip and creates a “suction seal” to improve hip stability. Ligaments crossing from the pelvis, outside of the socket, to the top of the femur create the “hip capsule” that further stabilizes the hip. Finally, numerous muscles cross the hip joint, and their tendons insert on various surfaces of the thigh bone to stabilize the hip joint and provide hip motion.
Nerves exit the spinal cord in the lower back and run both within the pelvis and outside of the pelvis to the bone, cartilages, muscles, and skin around the hip and down the leg. They give feedback to the brain about pain and also position of the joint (“proprioception”), and control and coordinate muscles to balance the body and power limb motion.
What causes hip pain?
When you walk, each hip joint experiences 2 to 3 times your body weight. Over time, repetitive use, particularly with excess load (for example, elevated body weight) can lead to cartilage breakdown and eventual damage to the underlying bone. Additionally, there are other predisposing factors that can accelerate hip joint damage and cause pain. Some of these are systemic (body-wide) conditions, like rheumatoid arthritis, while others are related to abnormal shape(s) of one or more bones contributing to the hip joint, as seen in hip impingement.
Some common causes of hip pain include:
- Hip arthritis, including osteoarthritis, inflammatory arthritis and secondary arthritis
- Hip impingement
- Labral tear
- Childhood hip disorders, including hip dysplasia, Legg–Calvé–Perthes disease (LCPD), and slipped capital femoral epiphysis (SCFE)
- Hip fracture, including femoral neck fracture and stress fractures
- Hip dislocation or hip instability
- Hip tendinitis, snapping hip, or tendon tear
- Hip bursitis
- Pinched nerve around the hip
- Hip infection
When should I see a doctor for hip pain?
If the hip pain is minor, nonsurgical treatments may be successful at relieving your symptoms. These include rest, and icing or heating the painful area to reduce discomfort. However, if hip pain persists or becomes more severe, patients should make an appointment with an orthopedic hip specialist. In particular, if hip pain interferes with your daily life, work or recreational activities, wakes you from sleep, or requires prescription pain medication, you should not delay seeing a hip surgeon.
In some situations, medical assistance may be required immediately. You should seek help right away if you have any of the following symptoms:
- Inability to move the hip joint or leg
- Inability to stand or put pressure on the hip
- Signs of infection, such as fever along with pain in the hip
- Extreme swelling around the hip or leg
How will Dr. McLawhorn diagnose my hip condition?
Dr. McLawhorn prefers to begin your evaluation by taking a detailed history, including your description of your hip pain along with your general health history. Next, he performs a physical exam, during which he will assess your walking, range of motion, and strength around the hip. X-rays are an important part of your evaluation to look at the status of your hip joint. X-rays of other relevant areas, such as the lumbar spine, may be ordered if necessary for an accurate diagnosis. MRI is useful when there are further questions about the health of the bone, cartilage, labrum, or muscles around the hip. CT is ordered selectively for patients requiring certain types of hip surgery. Blood work or injections into the hip or spine may be necessary for diagnosis in rare circumstances.
After Dr. McLawhorn makes the diagnosis, he will recommend the best hip and knee treatment option to suit your needs and expectations.
FAQ
What Is Hip Pain?
The hip area is the largest supporting structure in the human body as it is what holds up the entire torso. The hips are located near the femur and pelvic socket, which is surrounded by cartilage. If this protective cartilage sustains any damage or is worn down, it can cause pain to occur in the hip area.
What Are The Symptoms of Hip Pain?
Pain from the hip joint usually manifests as groin pain. There are other symptoms aside from experiencing pain in the hip area.
These symptoms can include the following:
- You cannot bear weight on the affected leg.
- Your hip makes popping or grinding sounds ("crepitus").
- There is a noticeable deformity of the leg, including progressive shortening and rotation.
- Your hip pain worsens over time.
Pain around the hip area can also be a symptom of other conditions, such as bursitis and tendinitis.
How Is Hip Pain Diagnosed?
Hip pain can be diagnosed through a variety of methods. First, the Dr. McLawhorn will go over your medical history and perform a physical examination to get a basic understanding of the problem. If the symptoms you have are severe enough, you may require a more extensive examination.
These examinations can include the following:
- Radiography
- Ultrasonography
- Magnetic resonance imaging (MRI)
- Computed Tomography (CT)
Radiographs are usually sufficient to diagnosis hip conditions that are severe enough to warrant hip replacement surgery. Other imaging modalities are necessary for selective issues for which plain X-rays are insufficient.
Can Hip Pain Point to a Worse Condition?
Yes, hip pain can sometimes signify a more serious condition. It is often due to common issues such as arthritis, bursitis, or muscle strain. However, hip pain can also point to more severe problems, such as:
- Hip fracture
- Osteonecrosis (avascular necrosis)
- Infections such as septic arthritis or osteomyelitis
In some cases, hip pain may also be a sign of systemic conditions. Examples include inflammatory bowel disease, certain types of cancer, or neurological issues such as sciatica.
What Is Anterior Total Hip Replacement?
Anterior total hip replacement is a minimally invasive surgical technique for replacing the hip joint.
Traditional hip replacement approaches access the hip from the side or back. The anterior method involves making an incision at the front of the hip.
This approach lets the surgeon work between the muscles without detaching them from the hip or thigh bones. It can lead to a quicker recovery, less pain, and improved mobility post-surgery. The technique often results in a shorter hospital stay and allows for a faster return to normal activities.
How Effective Is Hip Replacement Surgery for Relieving Hip Pain?
Hip replacement surgery is very effective in relieving hip pain. It’s particularly beneficial for those suffering from severe arthritis or other debilitating hip conditions.
Most patients experience:
- Significant pain reduction
- Improved joint function
- Enhanced quality of life following the procedure
Studies also show that over 90% of hip replacements last at least 15 to 20 years.
How Do I Prepare for Hip Surgery?
Preparing for hip surgery generally involves the following steps:
- Medical Evaluation: Undergo a thorough medical examination. This may include blood tests and X-rays to confirm you are fit for surgery.
- Medication Assessment: Discuss any medications you are currently taking with your doctor. A few days before surgery, you may need to stop certain medications, especially blood thinners.
- Pre-Surgery Instructions: Follow any specific instructions provided by your surgeon. For example, you will likely need to fast before the procedure.
- Home Preparation: Prepare your home for easy movement after surgery. Consider installing safety bars, getting a raised toilet seat, and creating a comfortable recovery area.
- Transportation and Support: Arrange for someone to drive you to and from the hospital. Ensure you have someone to help you at home during the initial recovery period.
- Rehabilitation Plan: Discuss your post-surgery rehabilitation plan with your doctor or physical therapist. Understanding the exercises and activities you must do can help you prepare.
Why Choose Alexander McLawhorn, MD?
Dr. Alexander McLawhorn is a top choice for hip pain treatment, especially for active adults considering joint replacement.
With over 600 procedures performed each year, he tailors individualized care plans using the latest techniques, technologies, and implants. His extensive experience ensures that each patient receives high-quality, personalized care to restore mobility and improve quality of life.
In 2022, Dr. McLawhorn was acknowledged as the top surgeon for joint replacement at the Hospital for Special Surgery in New York State. He has also been named the “best value” for joint replacement in New York City. He and his team are proud to offer exceptional care in Manhattan and Stamford, CT.
How Will Dr. McLawhorn Diagnose My Hip Condition?
There are many possible causes for hip pain, which can lead to more serious medical problems if left untreated. It is important to seek advice from an orthopedic hip specialist to accurately diagnose and treat your hip pain. Dr. McLawhorn is an orthopedic surgeon at Hospital for Special Surgery, specializing in hip and knee reconstruction and replacement. He sees patients at locations in New York City, and Stamford, Connecticut. To learn more, call 212-606-1065 (NYC) or 203-705-2113 (CT) today or schedule an appointment by using the form on this page.
Learn more about hip pain, conditions, and treatments at hss.edu
