What is causing my hip pain?
The hip itself is a very stable ball and socket joint. The ligaments and muscles of the hip add extra support so that it can support your body weight. When you have a sore hip it is usual to think that the hip itself is the cause. Hip pain can also be referred from the low back, sacroiliac joint or abdomen. Pain from the hip joint can be felt at the side of the hip, groin, buttock or knee. Correct diagnosis of the cause of your hip pain is essential for effective treatment.
The actual ball and socket joint can become painful due to repeated wear or traumatic injury. Arthritis is the most common cause of a painful hip joint. Hip joint pain can be felt in the groin, buttock, outer thigh or knee. People with hip joint pain often have difficulty with sitting, squatting and sustained loading. Physiotherapy to improve muscle strength and flexibility around the hip joint is beneficial for hip arthritis. Hydrotherapy (exercise in water) can be a comfortable way for people to exercise with an arthritic hip. People with advanced hip arthritis can benefit from total hip replacement surgery. Physiotherapy and rehabilitation after this procedure is important for a full recovery.
The labrum of the hip is a cartilage structure that deepens the socket of the hip joint. With trauma or repeated wear this cartilage can become damaged. Labral injuries can cause the hip to have a painful click. Rehabilitation can help restore strength and co-ordination around the hip and benefit a labral injury. Rehabilitation also involves identifying and modifying any activities which cause the symptoms and rest from heavy loading. Severe labral injuries require surgical treatment.
Muscle and tendon problems
The gluteal muscles of the hip are very important for adequate support of the hip joint. Insufficient support from the muscles around the hip can not only lead to increased joint pain but strain on the muscles and tendons themselves. Tendinopathy is a technical term describing pathology in the tendons. Tendonopathy of the gluteal muscles supporting the hip is a relatively common condition which can be treated with physiotherapy. Gluteal tendinopathy is usually felt on or around the bony part of the hip bone (greater trochanter). The pain is brought on by sustained standing, walking, running and laying on the side. Treatment can include strengthening of the gluteal muscles and massage.
Trochanteric bursitis describes a painful condition at or near the greater trochanter of the hip. The diagnosis is used less and less as many people with a diagnosis of bursitis have been found to have other primary problems about the hip, such as tendinopathy. True bursitis often treated with a corticosteroid injection. Bursitis is often helped by the same stretching and strengthening treatment used for tendinopathy.
Low back referred pain
The hip and low back are parts of the body where we often find ourselves having the ‘chicken or egg’ debate. With a stiff hip, more load is transferred to the low back in activities such as sitting, bending and lifting. A painful low back can result in referred pain to the hip and weakness of the hip muscles. Weakness of the hip muscles can in turn result in reduced support for low back. And so it continues. For some people both the hip and low back need to be treated for a successful recovery.
Hip pain in young people
Children and adolescents with hip region pain need to be assessed thoroughly as there a number of hip pathologies which only occur in the growing body.
Slipped capital femoral epiphysis is a separation of the ball of the hip joint from the thigh bone (femur) at the upper growing end (growth plate) of the bone. It is most common in boys between 11 and 15 years old. The condition results in a painful hip or knee. The hip is often stiff and painful with walking. Surgical treatment is required for the problem.
Perthes’ disease is a pathology of the hip joint that affects children. The femoral head deteriorates due to poor blood supply. Perthes can affect children from 3-11 years of age and boys are more likely to be affected than girls. The problem causes difficulty with walking and pain in the thigh. Most children with Perthes’ disease eventually recover, but the bone can take between two and five years to re-grow.
Other causes of hip pain
Hip pain is usually increased by movements and activities. If the pain is not changed by physical activity it needs to be investigated by a medical practitioner as it may not originate from the hip joint or may be caused by a more serious pathology of the hip.
For a healthy hip you require strong muscles around the joint and adequate flexibility. Physiotherapy has been shown to help with pain in and around the hip joint. Correct diagnosis of the cause of your hip pain is essential for effective treatment and recovery.
APMA would like to thank the Fortus Health for permission to reprint this information.