Hip Pain

The hip is a ball-and-socket joint that helps you move your legs during everyday activities such as walking and going up and down stairs. It has a good range of movement but it’s very stable and rarely dislocates, even after high-impact trauma.

The ball of the joint, which is at the top of the bone in your upper leg (the femur), is called the femoral head, and the socket created by the hollow of your pelvis is called the acetabulum.

The joint is surrounded by a tough, fibrous sleeve called the capsule, which helps to hold the bones together. The capsule is lined by the synovium, which produces a fluid (synovial fluid) that nourishes the cartilage and lubricates the joint. The hip joint is moved by a number of muscles that allow you to rotate your hip and walk.

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Symptoms of Hip Pain

Depending on the condition that's causing your hip pain, you might feel the discomfort in your:

  • Thigh
  • Inside of the hip joint
  • Groin
  • Outside of the hip joint
  • Buttocks

Sometimes pain from other areas of the body, such as the back or groin (from a hernia), can radiate to the hip.

You might notice that your pain gets worse with activity, especially if it's caused by arthritis. Along with the pain, you might have reduced range of motion. Some people develop a limp from persistent hip pain.

What causes hip pain?

Back to Hip pain

Most hip pain has a very simple explanation, for example if you’ve overdone it while exercising. The pain is usually caused by strained or inflamed soft tissues such as tendons, and it often clears up within a few days. Long-term hip pain can be caused by specific conditions.

Pain caused by a problem in the hip joint can be felt in the groin, down the front of the leg and in the knee. Sometimes knee pain is the only sign of a hip problem. This is called referred pain, and it’s fairly common. Hip pain can also be felt in the buttock (although pain in this area can also be caused by problems with the lower back) or on the outside of the hip.

Among the most common causes of hip pain are:

  1. Arthritis. The most common cause of chronic hip pain is arthritis, particularly osteoarthritis, the wear-and-tear kind that affects many people as they age. “
  1. Hip fractures. Hip fractures are common in older people, especially those with osteoporosis (decreased bone density).

Tendinitis and bursitis. Many tendons around the hip connect the muscles to the joint. These tendons can easily become inflamed if you overuse them or participate in strenuous activities.

Hernia. In the groin area, femoral and inguinal hernias can cause anterior (frontal) hip pain. Pregnant women can be susceptible to inguinal hernias because of the added pressure on the wall of their abdomen.

Gynecological and back issues. “Hip pain can have gynecological causes. “

Endometriosis (when the uterus lining grows somewhere else) can cause pelvic tenderness, which some women describe as hip pain. Pain from the back and spine also can be referred and felt around the buttocks and hip, Siegrist says. Sciatica, a pinched nerve, can cause pain in the back of the hip — the pain from sciatica can start in your lower back and travel down to your buttocks and legs.

How are hip problems diagnosed?

If your hip pain continues to get worse for more than two weeks, you should see a doctor. They’ll ask you about your pain and what movements make it worse.

Pain when bending the hip to get up and down stairs, and in particular when putting on socks, is often a sign of a hip problem. Your doctor will also ask how your symptoms started, how they affect your day-to-day activities and whether you’re getting pain at night.

They’ll examine your hip to find out how well it moves, and this will usually give them enough information to plan your treatment, although you may need other tests to diagnose some conditions.

Tests that your doctor may prescribe to examine your hip pain cause include: X-rays,CT scans,MRI scans,Blood tests

If your doctor thinks your pain is caused by an infection or rheumatoid arthritis, blood tests can often help.

treatments are there for hip pain?

If your hip pain doesn’t improve with simple medications such as paracetamol and ibuprofen, you should see your doctor for further advice. They may recommend the following treatments.

Drugs

Simple painkillers such as paracetamol (an analgesic) may help to ease pain. It’s best to take them before the pain becomes very bad, but you shouldn’t take them more often than every four hours or more than eight in 24 hours.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, which you can buy at chemists and supermarkets, can also help.

You can use painkillers and NSAIDs for a short course of treatment of about a week to 10 days. If they’ve not helped after this time then they’re unlikely to and you should see your doctor. However, if they do help but the pain returns when you stop taking them, you could try another short course. You can also try rubbing anti-inflammatory creams or gels onto affected areas.

If you’re pregnant, if you smoke, or if you have asthma, indigestion or an ulcer you should speak with your doctor or pharmacist before taking ibuprofen or aspirin.

If you have circulation problems, high blood pressure, high cholesterol or diabetes, you should check with your doctor or pharmacist whether over-the-counter NSAIDs are suitable for you, in case they could interact with any medication you’re taking.

Steroid injections

Steroid injections can help hip problems if they’re caused by inflammatory joint pain or inflamed bursae.

The injections are often given with a local anaesthetic, and they’re usually very helpful in treating trochanteric bursitis.

Iliopsoas tendinitis can also be treated with steroid injections, but the injection will need to be done by a radiologist because the ilipsoas tendon is so deep.

A snapping iliopsoas tendon can be treated with steroid injections which are done under videofluoroscopy (a type of x-ray) to make sure the injection is in the right place. Ultrasoundguided injections are also becoming more popular.

Physiotherapy and occupational therapy

Physiotherapy may help you to maintain your hip movements with gentle range of movement exercises and activities.

physiotherapist can also suggest specific exercises to maintain or improve the strength of the muscles around the hip joint. They may advise you about the best way to walk with your hip pain and may help you to use a stick or crutch.

You’ll need to use the stick in the opposite hand to your affected hip and make sure that it’s the correct height for you, so it’s important to see a physiotherapist before you start using one.

If you think your work or certain activities you do might be the main cause of your pain, it’s worth discussing this with an occupational therapist.

They’ll be able to advise on how to change your movements to help prevent pain continuing or returning. If your place of work has an occupational health department, they may also be able to help.

- See more at: http://www.arthritisresearchuk.org/arthritis-information/conditions/hip-pain/treatments.aspx#sthash.H66Solwa.dpuf

Exercise

We recommend that you don’t rest for more than a few days – start some gentle exercise as soon as the pain begins to ease. Simple exercises can help to restore your range of movement, promote strength, ease stiffness and get your hip back to normal.

Start by exercising very gently and build up gradually.

When the pain is gone and you’re feeling better, it’s important you continue to exercise on a regular basis otherwise the improvements you’ve made will disappear within a few weeks.

 Reducing the strain

It’s generally best to carry on doing your normal activities, but try not to overdo things. You might need to pace yourself to allow you to do a little bit more each day. Try the following tips:

  • Avoid sitting in low chairs as this bends the hip a lot and might give you more pain.
    • Don’t carry heavy weights. Use a trolley when you go shopping if carrying a basket is uncomfortable.
    • Find a comfortable sitting position at work to lessen the strain on your hip.
    • Use a walking stick to make walking easier. Use the stick on the opposite side to your painful hip. A therapist or doctor can advise on the correct length and the best way to use the stick.
    • Lose weight if you’re overweight.
    • Alter activities where you have to stand on one leg; for example, when you get into a car, sit on the side of the seat and swing both legs in rather than stepping in one leg at a time.