Hip Pain: Causes Symptoms, and Treatment

The hip joint is arguably one of the most important in the body, being involved in mobility, and tasks such as sitting or even changing direction. However, many people are unsure of the exact location of this joint, often confusing it with the pelvis.

The hip, is the name of actual joint where the bottom of the pelvis meets the top of the femurs (thigh bones). Being a joint, the hip is subject to many conditions that can cause pain and discomfort, in some cases requiring joint replacement in order to achieve some degree of mobility when significant deterioration has occurred.

Causes of Hip Pain

There are a few causes of hip pain, differing in their intensity and relative duration (whether short-term or chronic). These causes include:

Arthritic Disease

One of the primary causes of hip pain, especially in persons over the age of 40, osteoarthritis occurs when the protective synovium tissue around the joints become worn down, leading to bone rubbing upon bone. This results in pain, sensitivity and inflammation, all characteristic traits of arthritis.

Rheumatoid arthritis tends to first manifest in younger individuals, and may even necessitate complete hip replacements in juvenile patients.

Strain/Sprain

In addition to bone and synovium tissue, the hip joint, like most other joints, also have ligaments and tendons that help to connect bone to muscle in order to facilitate movement. Sprains occur when ligaments have been stretched beyond the limit, resulting in acute pain upon movement.

Strains on the other hand, are more likely to involve muscles directly, and tendons to a lesser extent.

Sciatica

Sciatica occurs when the sciatic nerve, the largest nerve in the human body, becomes compressed, resulting in consistent pain. The sciatic nerve is found to the back of the hip joint, and is more likely to become compressed during pregnancy, or in overweight individuals.

Fractures

Pelvic bone fractures are very common in the elderly, especially those with pre-existing arthritic disease or osteoporosis who are prone to falls. Pelvic fractures are more difficult to completely heal based on anatomical position, and may result in chronic low-grade pain subsequently.

Hematomas

A hematoma is a collection of blood outside of a blood vessel that usually occurs following damage to the blood vessel such as frequently occurs with fractures. In some instances, the body is able to heal damage to blood vessels, but other times the damage is too great and what results is a large pooling of blood at the area outside of the blood vessel, leading to localized inflammation and pain at the site.

Symptoms of Hip Pain

Hip pain does not usually occur as an isolated symptom, unless it occurs and resolves without intervention. Other commonly associated symptoms along with hip pain include:

Groin Pain

Usually occurs following strain or falls.

Limping/Difficulty Walking

Since the hip joint is critically involved in movement, it makes sense that pain of a certain intensity will impair your mobility.

Tingling/Numbness

This is most likely to affect areas directly around the hip joint, and the groin region. Numbness usually indicates nerve impingement, with sciatica being a probable accompaniment.

Loss of Motion

The hip joint provides a great degree of motion, with any hindrance that occurs along with hip pain indicating a more serious underlying condition.

Tenderness

Tenderness, swelling or warmth around the region of the hip joint or groin usually indicates inflammatory processes, or rarely bacterial infection of the joint. Bacterial infections are a possible complication from hip replacements.

Weakness

Though the hip joint itself is not a common source of weakness, groin pain that radiates to the area of the hip can make it feel like standing on your feet places your pelvis under high pressure. Weakness originating in this region can indicate an underlying fracture or even osteonecrosis of bone tissue.

Treatment of Hip Pain

Treatment approaches commonly employed to address hip pain very based on the underlying condition, and the relative intensity of the pain felt. Common modalities include:

Rest

Acute hip pain with no obvious trigger can usually be resolved with rest. Such types of pain may indicate a mild sprain or strain of some sort, which requires time for healing and not much else. If your pain subsides with a few days of rest, count yourself lucky that it wasn’t a more serious condition.

Application of Ice

Ice is best employed to treat inflammation that occurs following a fall or a known type of trauma. Keep in mind, excessive application of ice can mask more serious symptoms and slow down overall recovery, so let good sense prevail when choosing to ice the hip joint.

Topical Analgesics

We have all heard of Bengay before, as it seems that every one of us had a grandparent or elderly relative that had this in their medicine cabinet. Local analgesics offer mild short-term relief from pain, being most commonly employed to help reduce painful symptoms of arthritis.

They are also effective at treating muscle pain in this region, though they are likely to be of no benefit to more intense hip pain.

Prescription Medication

Your doctor may prescribe various medications that can help to manage pain, inflammation, reduce nerve over excitability (for sciatica), antibiotics to treat infections, or may administer a localized corticosteroid injection for sustained release action over a longer term.

Physical Therapy

Physical therapy is most effective when used in persons that suffered falls or accidents that resulted in some degree of mobility reduction. The goal of physical therapy is to make anatomical motion as painless as possible, and as close to normal as achievable.

Surgery

Surgery may be needed in the event that a fracture of the pelvis has occurred, or to perform hip replacements. While the hip replacement can be considered an elective surgery, those done on fractures are based on necessity, being deemed a medical emergency.

It is important to note the associated risk of surgery to the hip joint or pelvis beforehand, as there have been instances where mobility loss has resulted from complications.

Hip Pain – Summary

Hip pain remains a major source of incapacitation for adults all over the world, being especially prevalent in persons over the age of 50. Healthy lifestyle changes such as maintaining a normal BMI, regularly exercising, and managing comorbidities as they occur can reduce the necessity for a total hip replacement later in life, or going under the knife for other procedures.

Sources

https://www.healthline.com/symptom/hip-pain
https://www.medicinenet.com/g00/hip_pain/article.htm?i10c.encReferrer=&i10c.ua=1&i10c.dv=2
https://www.mayoclinic.org/symptoms/hip-pain/basics/definition/sym-20050684