Hip pain has a variety of possible causes. Read on to learn more about treating the types of hip conditions that exist.
The human hip joint is a complex ball and socket joint, crucial for healthy everyday activities such as standing and walking. So when hip pain occurs, it can cause strong discomfort.
What Causes Hip Pain?
There are many hip pain causes, and it is quite a common problem. It is important to make an accurate diagnosis of the cause of your symptoms, so that appropriate treatment can help tackle the underlying problem.
Common Causes of Hip Pain
Arthritis, characterised by progressive wearing away of the cartilage of the joint, is among the most frequent causes of hip pain. While hip arthritis usually affects patients over 50 years of age, it is also common in people who are overweight.
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Trochanteric bursitis is an extremely common problem that causes inflammation over the outside of the hip joint.
Tendonitis is inflammation of the tendons and can occur in any of the tendons that surround the hip joint. The most frequently encountered tendonitis around the hip is iliotibial band (IT band) tendonitis.
Osteonecrosis is a condition that occurs when blood flow to an area of bone is restricted. If an inadequate amount of blood flow reaches the bone, the cells will die and the bone may collapse. One of the most common places for osteonecrosis to occur is in the hip joint.
Many back and spine problems can cause symptoms around the buttocks and hip. The most common problems that transmit pain to the hip region are herniated discs and sciatica, both of which involve lumbar pain.
Snapping hip syndrome is a term used to describe three distinct hip problems:
• The first is when the IT band snaps over the outside of the thigh
• The second occurs when the deep hip flexor snaps over the front of the hip joint
• Finally, tears of the cartilage, or labrum, around the hip socket can cause a snapping sensation
Strains of the muscles around the hip and pelvis can cause pain and spasm. The most common strains are groin pulls and hamstring strains.
Hip fractures are most common in elderly patients with osteoporosis. Treatment of broken hips requires surgery to either replace the broken portion or repair it with a metal plate and screws.
Stress fractures of the hip are most common in athletes who participate in high-impact sports, such as long-distance runners. Treatment usually involves avoiding the impact activities.
Hip Pain in Children
Developmental Dysplasia
When the hips are dislocated or out of position in infancy, the joint may not develop properly. While this is not usually painful as a child, it may lead to early arthritis and problems with walking.
Legg-Calve-Perthes Disease
Also called Perthes disease, this is a problem similar to osteonecrosis (see above) but happens during childhood. If severe, it can lead to permanent damage to this hip joint and early arthritis.
When Should You Call Your Doctor About Hip Pain?
If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of hip pain must be directed at the specific cause of your problem. You should see your doctor when:
• You are unable to walk comfortably on the affected side
• You have an injury that causes deformity around the joint
• Your hip pain occurs at night, or while you are resting
• You have hip pain that persists beyond a few days
• You are unable to bend the hip
• There is swelling of the hip or thigh area
• There are signs of an infection, including fever, redness, warmth
• You experience any other unusual symptoms
Treatment Options
The treatment depends entirely on the cause of the problem. Therefore, it is important that you understand the cause of your symptoms before embarking on a treatment programme. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.
Not all of the treatment options listed are appropriate for every condition.
Rest
The first treatment for most conditions that cause hip pain is to rest the joint, and allow the acute inflammation to subside. Often this is the only step needed to relieve hip pain. If the symptoms are severe, crutches or a cane may be helpful as well.
Ice and Heat Application
Ice packs and heat pads are among the most commonly used treatments for inflammation. Ice packs are mostly used for acute injuries to help minimise swelling while heat pads are used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area.
Stretching
Stretching the muscles and tendons that surround the joint can help with some causes of hip pain. Talk to your doctor about the best way to establish a safe, effective and regular routine.
Physiotherapy
This is an important aspect of treatment for almost all orthopaedic conditions. Physiotherapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity.
Anti-inflammatory Medication
Nonsteroidal anti-inflammatory medications, commonly referred to as NSAIDs, are some of the most frequently prescribed medications, especially for patients with hip pain caused by problems such as arthritis, bursitis and tendonitis.
Total Hip Replacement
Hip replacement surgery may be considered when arthritis limits your everyday activities such as walking and bending, when pain continues while resting, or stiffness in your hip limits your ability to move or lift your leg. Hip replacement may be recommended only after careful diagnosis of your joint problem. If you find you are still not getting enough pain relief from anti-inflammatory drugs, or other treatments like physical therapy aren’t working, it may be time to consider surgery.
Hip Replacement
Hip replacement surgery involves replacing the femur (head of the thighbone) and the acetabulum (hip socket). Typically, the artificial ball and stem is made of a strong metal or ceramic, and the artificial socket is made of polyethylene (a durable, wear-resistant plastic) or metal backed with a plastic liner. The artificial joint may be cemented in position or held securely in the bone without cement. The ball and insert are designed to glide together to replicate the hip joint.
For the vast majority of patients, joint replacement can be successful in providing relief from pain and improved mobility for many years. According to the American Academy of Orthopaedic Surgeons, hip replacement procedures have been found to result in significant restoration of function and pain reduction in over 90 percent of patients.
Hip replacement surgery is common all over the world. In the US, 200,000 patients undergo hip surgery each year to relieve their hip pain, and get back to enjoying normal, everyday activities. Most patients need to stay in hospital for only four to five days.
Hip Resurfacing
In this process, the end of the thigh bone (femur) is capped with a metal covering — a strong cobalt chromium metal — much like the capping of a tooth. This fits neatly into a metal cup that sits in the hip socket. The head swivels within the cup, gliding together to replicate the hip joint. The surfaces that rub against each other are both made from highly polished metal. This type of hip device is called a metal-on-metal hip resurfacing device.
The first benefit of hip resurfacing is that it is bone conserving, meaning that more of your healthy bone is kept intact. The damaged area is simply resurfaced, not fully removed.
In addition, there is more natural motion and less chance of dislocation than total hip replacement — as large amounts of bone are not removed, the surgeon can resurface the hip closer to the size and shape of your natural hip. In fact, your resurfaced femur is similar to the size of your natural bone so you get a better fit inside your hip socket. This may result in greater stability and the potential for an increased range of motion, so you can return to the activities you love, whether it’s going to the gym or dancing.
Another advantage is that you are better prepared for a potential hip treatment later on. Hip resurfacing removes less of your own bone, which may be important should you ever require a total hip replacement in the future.
Hip resurfacing may be appropriate for younger, more active patients, patients with good bone quality, osteoarthritis and rheumatoid arthritis.
Hip resurfacing is not recommended for patients with the following conditions:
• Active or suspected infection in or about the hip joint
• Poor bone quality which your surgeon feels could not support the implant
• Multiple cysts
• Any known allergy to metal
• Extreme overweight (this can cause overload on the device that would lead to failure)
• Skeletal immaturity
• Women in child-bearing years
• Weak immune system due to disease or certain medications (e.g., corticosteroids)
• Kidney failure
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