Hip Pain

Pain in the hip joint can have a variety of causes.

Pain in the hip joint can have a variety of causes. The most common causes are strains, injury, arthritis, and bursitis. Hip pain can be either temporary or chronic. Treatment of hip pain depends on the underlying cause.

The hip joint is where the ball of the thigh bone (femur) joins the pelvis at a socket called the acetabulum. There is cartilage covering both the bone of the femur and the acetabulum of the pelvis in the hip joint.

A joint lining tissue, called synovium, surrounds the hip joint. The synovium tissue produces fluid that lubricates the joint and provides nutrients to the cartilage of the joint. The ligaments around the hip joint attach the femur bone to the bony pelvis. There are a number of muscles and tendons that glide around the hip joint. Tiny fluid-filled sacs, called bursae, provide gliding surfaces for muscles and tendons around the hip joint. Major arteries and veins pass the front of the hip joint. The largest nerve of the body, the sciatic nerve, passes behind the hip joint.

The hip joint is one of the large joints of the body and serves in locomotion as the thigh moves forward and backward. The hip joint also rotates when sitting and with changes of direction when walking.

There are many causes of hip joint pain. Some hip pain is temporary, while other hip pain can be long-standing or chronic. Causes of hip pain include:

• arthritis (inflammatory and noninflammatory),
• bursitis,
• strains and sprains,
• hip flexor problems,
• subluxation or dislocation,
• fracture,
• sciatica,
• infectious arthritis (septic arthritis),
• avascular necrosis,
• Gaucher's disease,
• iliotibial band syndrome (IT band syndrome), and
• hematoma.

Symptoms associated with hip pain depend on the cause. Symptoms include:

• limping,
• joint pain,
• groin pain,
• loss of motion of the hip,
• warmth,
• swelling over the hip,
• tenderness of the hip,
• difficulty sleeping on the hip.

Symptoms vary in intensity from mild to severe. Hip pain can be a cause of disability.

What does hip flexor pain feel like?

Hip flexor pain is usually caused by a muscle strain. This usually happens when you put a lot of stress on them or when you keep them stiff for long periods.

You will feel sudden hip pain as soon as you get a hip flexor strain or tear. Other symptoms of a hip flexor tear or strain include:

• Stiffness and pain in the groin region in the morning (while you get up from your bed)
• Pain when you try lifting your knee toward your chest
• Pain while doing exercises that stretch the hip muscles
• Swelling, redness, or tenderness in the hip or thigh area
• Limping gait (if the pain is severe)

What does hip subluxation pain feel like?

A hip subluxation occurs when the hip joint is partially out of position. This can cause pain, spasm, and difficulty bearing weight on the affected side.

Subluxation is not the same as dislocation, which occurs when the bones in a joint get split or knocked out of their normal locations. Subluxation usually happens gradually over time due to decreased muscle tone, spasticity, or motor vehicle collisions.

Common symptoms of hip subluxation include:

• Joint swelling
• Pain in the joint
• Visible deformity
• Spasms over the thigh and buttocks
• Bruising
• Difficulty moving the leg
• Tingling
• Numbness
• Muscle weakness
• Difficulty walking
• Difficulty bearing weight or standing on the affected hip
• Leg on the side of the affected hip may appear shorter and may be turned inward or outward

Healthcare professionals diagnose hip pain with a history and physical examination. Physical examination maneuvers, such as internally and externally rotating the hip, can be used to detect pain-aggravating positions. Tenderness can be elicited by palpating over inflamed areas. Straight leg raising can detect signs of sciatica.

Imaging studies, including X-rays, CT scans, and MRI scans, may be ordered to further define the causes of hip pain. Sometimes, nuclear medicine bone scans are used to image inflamed or fractured bone.

The treatment of hip pain depends on the precise cause of the pain. Treatments can include rest, non-weight-bearing, cold application, and anti-inflammatory medications.

For local inflammation, sometimes injection of cortisone medication (steroids) is used to quiet the inflammation. If an infection is present, antibiotics are used. Fractures may require treatment with surgical repairs, including pinning, plates and screws, and total joint replacement. For severe arthritis, total joint replacement is performed when possible.

General medicine physicians, including general practitioners, family medicine doctors, and internists, as well as orthopedic surgeons, rheumatologists, and sports medicine specialists treat hip pain. Often physical therapists and rehabilitation physicians are involved in the care of hip pain.

Home remedies for hip pain include:

• rest,
• non-weight-bearing,
• cold application, 
• anti-inflammatory medications such as ibuprofen (Motrin and Advil), naproxen (Aleve), and
• pain medications such as acetaminophen (Tylenol).

The prognosis of hip pain depends on the cause and the response to treatment. Most mild strain injuries have a good outlook and resolve rapidly in response to home remedies. More severe problems such as subluxations, fractures, ligament tears, or infections may require surgery. In these cases, the prognosis is more variable and guarded. Severe hip problems may also require extended rest periods followed by intensive physical therapy.

Hip pain can be prevented by avoiding injury to the hip joint. This includes sports injury. Sometimes proper conditioning prior to a sports event can prevent injury.