Hip Pain

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Elderly woman suffering from hip pain at home.

If you are suffering from hip pain, it could be the result of many things. Hip pain can also be either temporary or long term in nature and the nature of the pain (what makes it worse) can vary from case to case.

Below, we will look at the most common causes of hip pain and briefly suggest possible treatments for each.

The hip is one of the largest joints in the body and plays a pivotal role in the forward and backward movement of your thigh while you walk or run. It also plays important roles when you are sitting down or changing direction while walking.

As a result of the role your hip plays in so many critical daily actions, hip pain can be a serious detriment to your quality of life. It should be taken seriously whenever it appears.

Anatomy

The hip joint is the intersection of the ball of the thigh bone (or femur) and the pelvis. It is a ball and socket joint with the socket located at the acetabulum of the pelvis. Both the pelvic and thigh bones are covered by cartilage within the socket in order to avoid direct contact between the bones.

In addition, a special tissue known as the synovium surrounds the joint and serves as a lubricator of joint movement. It also provides critical nutrients to the cartilage covering the thigh and pelvic bones.

The hip also contains ligaments that connect the thigh bone to the pelvis. In addition, there are several muscles and tendons in the joint. Small fluid filled sacs, known as bursa, help the muscles and tendons to glide smoothly and frictionlessly over joint surfaces.

The hip joint also lies in the neighbourhood of several critical blood vessels and nerves.Significantly, the largest nerve in the body, the sciatica, passes just behind the hip.

Symptoms Accompanying Hip Pain

Depending on the underlying cause, hip pain may be accompanied by several possible signs and symptoms. Some of these include:

  • Limping and general difficulty walking;
  • Groin or upper thigh  pain;
  • Loss of hip range of motion (so that hip flexion or rotation may be restricted)
  • Warmth & tenderness of the skin around the hip;
  • Swelling in the region of the hip;
  • Difficulty sleeping, particularly if you tend to sleep on the side of the injured hip.

The hip pain itself may be mild or severe, temporary or chronic, depending on the cause. In many cases, hip pain can be the result of a sports injury. You should therefore ideally consult with a health care professional with sports medicine expertise to understand the cause of the pain.

Diagnosing The Cause Of Hip Pain

To diagnose the cause of your hip pain, your doctor will probably start with a thorough physical examination and review of your medical history.

Your doctor will also try to identify what movements or actions make the pain worse, e.g. walking or sitting down. He or she may also ask you to perform  internal/external hip rotation.movements (twisting your thigh inward or outwards from your hip) and report whether the pain gets worse.

Further, the doctor may check for swelling or tenderness by palpating inflamed areas (i.e. examining them by touch).

In addition to the above procedures, your doctor may use imaging studies, such as X Rays or CT/ MRI scans, to further understand the reasons for your hip pain.

Some Common Causes Of Hip Pain

Some of the more common causes of hip pain are listed below. Be aware, however, that this list is not exhaustive. You should rely on the findings and recommendations of your doctor to understand the actual causes of your pain:

Hip Strains Or Sprains

As with so many other areas of the body where soft tissues are located, your hip pain can be the result of a hip muscle/tendon strain or a hip ligament sprain.

In most such cases, this injury (and the accompanying pain) can be easily treated by refraining from demanding physical activity so as to rest the hip joint. Compression shorts or other hip bracing devices can also be worn to reduce pressure on the joint and allow it to heal naturally. Ice and anti-inflammatory medications can also be used to reduce the pain as well as any swelling and inflammation that may be present.

Other Soft Tissue Injuries of The Hip

Other soft tissue hip injuries that can cause hip pain include hip tendonitis and hip bursitis, both of which are overuse injuries.

Hip tendonitis is a result of oversressing the muscles of the hip so that the tendons connected to these muscles become irritated and inflamed.

Hip bursitis is caused by irritation of the fluid filled bursa that allow these muscles and tendons of the joint to glide smoothly over the adjacent bones.

Both of these injuries are usually treatable by means of rest. The inflamed bursa and tendons will then recover naturally once given the opportunity to do so.

Hip Arthritis

The two most prevalent types of hip arthritis are osteoarthritis and rheumatoid arthritis. As is the case with other parts of the body, arthritis is an irreversible condition. Doctors will usually try to slow its progress and ease the patient’s pain and discomfort, but there is no actual cure.

Hip Osteoarthritis

Osteoarthritis is due to deterioration of the cartilage covering the bones in the joint, so that the bones eventually start to rub against each other. This condition can affect either the right of left hip and is sometimes the result of a previous hip injury that was not fully treated.

In its early stages, osteoarthritis is treated by lifestyle modifications such as losing weight to reduce pressure on weight bearing joints. Pain relief medication is also often recommended. However, as the disease reaches its advanced stages, doctors may suggest surgical treatments up to and including hip replacement.

Rheumatoid Arthritis

Rheumatoid arthritis, on the other hand, is an autoimmune condition. It results from your body’s immune system attacking and destroying the synovium lining of the hip joint.

As we have mentioned above, this lining is responsible for “lubricating” the joint. Consequently, its destruction causes pain when attempting to walk, run or perform any other activity that requires use of the joint. Unlike osteoarthritis, rheumatoid arthritis tends to attack both hips (left and right) simultaneously.

To treat this condition, your doctors can recommend medications that suppress your immune system.

Hip Fractures

Hip fractures can occur as a result of a condition known as osteoporosis in which the bones become progressively more brittle as you age. Falls or even minor accidents can cause them to crack or fracture.

The resulting hip pain can be a mild and persistent one, or very sharp and debilitating depending on the severity of the fracture.Contusions and swellings can also develop as the result of a hip fracture.

This type of injury will usually have to be treated by means of surgery.

Hip Labral Tear

This is an injury due to damage to the ring of cartilage lining the hip socket (called the labrum). If you are an athlete or physically active individual, you can sometimes tear the labrum as a result of repeated hip twisting.

In addition to the hip pain from a labrum tear, you may experience a catching or clicking sensation when walking, running or using your hip generally.

A doctor with sports medicine expertise will be able to advise on treatment of this injury.

Avascular Necrosis

This is a condition involving the death of boine tissue in the hip due to a lack of adequate blood supply to the area. A doctor can advise on the appropriate treatment

Cancer

A discussion of hip pain would not be complete without mentioning the possibility of tumours. Cancer of the hip can of course cause consistent, chronic pain in that area.  A doctor (preferably an oncologist) should be consulted urgently for treatment.

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