Problems with our hips can be caused by diseases such as osteoarthritis or avascular necrosis. Other hip problems are attributed to injuries such as sprains, bursitis, dislocations and fractures. Treatments for hip problems range from basic pain management techniques to sophisticated medical treatments to cure disease and repair injuries.
Hip pain is a common complaint that can be brought on for a variety of reasons. The location of your hip pain can provide clues about the cause. Problems within the hip joint tend to result in pain on the inside of your hip or your groin. Hip pain on the outside of your hip, upper thigh or buttock is usually caused by problems with muscles, ligaments, tendons and other soft tissues that surround your hip joint.1
Your hip is a ball-and-socket joint that allows you to move and provides the stability needed to bear the weight of your body. The “ball” part part of your hip is located at the top of your femur or thighbone, and the “socket” is the cup in your pelvis called the acetabulum.
Many people experience hip pain caused by osteoarthritis, the gradual wearing down of the cushioning surfaces in the hip. Hip pain can also be the result of disease or injury to the components of the hip or surrounding nerves. Additionally, hip pain can sometimes be caused by diseases and conditions in other areas of the body, such as the lower back or knees. This type of pain is called referred pain. Some types of hip pain can be controlled with self-care at home, while others may require medical or surgical treatment.
Hip Problems Due to Arthritis
Arthritis is the most common cause of hip tissue degeneration and joint pain.2 There are three types of arthritis that commonly affect hips:
Osteoarthritis: often called “wear and tear arthritis” it is the most common type of arthritis and can occur in one or both hips after years of use and bearing the weight of the body.2 It results in deterioration of the cartilage that normally acts as a cushion between the bones that come together within a joint. In your hip it would be where the top of the femur (ball) comes together with the acetabulum (socket). When the cartilage at this juncture wears, it allows the bones to come into direct contact causing varying degrees of pain depending upon the amount of deterioration that has occurred. Arthritis in its early and mid stages can be treated with pain relievers and light exercise, while more advanced cases may require surgery such as total hip replacement.
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Rheumatoid arthritis: is a systemic or body wide disease that causes the immune system to attack the synovial membrane. This attack causes the production of too much fluid resulting in damage and inflammation to this important structure and to the cartilage within the joint, leading to pain, stiffness, and disability. There is no cure for this disease, and treatments focus on administering inflammation reducing medication to relieve pain and prevent or slow joint damage.
Traumatic arthritis: is largely the same as osteoarthritis, but this time caused by some source of trauma such as an old injury, sporting injury, or previous joint surgery. These incidents can damage the cartilage and/or the bone, changing the mechanics of the joint and making it wear out more quickly.4 Treatments are similar to osteoarthritis and range from non-invasive conservative methods, to surgical options such as hip arthroscopy or total hip replacement.
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Other Hip Injuries and Disorders
Some of the most common hip injuries and disorders include:3
Sprains and strains: involve a stretched or torn ligament, which are tissues that connect two bones at the hip. Symptoms include soreness, bruising, burning, stabbing, throbbing, aching, swelling and stiffness, and being unable to move your hip. You might feel a pop or tear when the injury happens. Treatment usually involves rest, ice packs, wearing a bandage to compress the area, and medications.
Dislocations: are joint injuries that cause the bones of a joint to go out of position. In the case of a hip dislocation, it’s when the “ball” is forced out of the “socket” resulting in a great deal of pain and immobility. If this happens it is important to get immediate medical attention. When properly repositioned, your hip will usually function normally within a few weeks but you must take extra care to not cause another dislocation.
Fractures: are a physical break in the bone usually caused by accident, fall, or sports injury. Other causes can be due to low bone density or osteoporosis, both of which cause weakening of the bones. Fractures in the hip area include femur shaft fractures and pelvic fractures. These injuries need immediate medical attention so the bones may be realigned by a plaster cast, splint, or surgical procedure to use pins, plates or screws to secure the fracture thus allowing the bones to heal and grow back together.
Hip pointer: is an extremely painful injury to the muscle that connects at the top of the pelvis just below the waist. It most commonly is the result of a blow, fall or a quick turn of the body and most often occurs in contact sports such as football and soccer. Given time, most hip pointers will heal on their own with conservative treatment and rest.
Snapping hip: is a snapping sensation or popping sound experienced in your hip when you walk, get up from sitting, or swing your leg around. It occurs when a muscle or tendon moves over a bony protrusion in your hip. It’s usually painless and harmless, but can be annoying. In some cases the snapping can lead to bursitis (see below) however.
Bursitis: occurs when one of the natural small fluid-filled sacs around the hip area becomes inflamed and painful. This is usually caused by overuse of a joint muscle but can also be caused by injury. Treatment involves rest, ice packs, and medication to reduce inflammation.
Avascular necrosis: occurs in the head of the femur when the blood supply is interrupted by a fracture or other injury. It can also be caused by developmental disorders such as dysplasia and from use of certain drugs, in particular prednisolone (cortisone or prednisone) which has been used to treat conditions like asthma, skin complaints and other ailments. The course of treatment may only have been a short one and symptoms may surface from weeks to years later. It can also (rarely) occur as an aftermath of certain bone tumours such as bone cysts. Treatment focuses on prevention of further bone loss through medications and therapy. In advanced cases, surgical procedures are often indicated and include core decompression, bone transplant, bone reshaping, and hip replacement.
Burning thigh pain: can be experienced on the outer side of the thigh on one side of the body. It can be caused by compression of or damage to one of the large sensory nerves to your legs. The goal in treatment is to remove the source of pressure on the nerve. This may include avoidance of an activity that aggravates the condition, weight loss, medication to reduce inflammation, and in rare cases surgery.5
- The Mayo Clinic, “Hip pain” http://www.mayoclinic.com/health/hip-pain/MY00257
- New York Presbyterian Hospital, “Hip Problems” http://nyp.org/health/spine-hip.html
- Medline Plus, a service of the U.S. National Library of Medicine and the National Institutes of Health, “Hip Injuries and Disorders” http://www.nlm.nih.gov/medlineplus/hipinjuriesanddisorders.html
- The Cleveland Clinic, “Diseases & Conditions: Post-Traumatic Arthritis” http://my.clevelandclinic.org/disorders/arthritis/hic-post-traumatic-arthritis.aspx
- AAOS The American Academy of Orthopaedic Surgeons, “Hip & Thigh: Injuries, Diseases & Conditions” http://orthoinfo.aaos.org/menus/hip.cfm
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