Hip Pain – Causes and Treatment

The hip joint is an extremely durable joint which can take up a lot of wear and tear. It is a ball and socket joint with the rounded head of the thigh bone (femur) fixing into the socket of the hip bone. The joint has a thin layer of cartilage which allows for smooth, friction free movement.

However, in spite of its resilience, the hip joint too with time suffers damage which is felt as pain in the hip. There are many reasons for this ranging from muscle strain to arthritis. Given below is a brief overview of the various causes of hip pain.

Strains and Sprains:

• When hip muscles or ligaments are pushed beyond their capability, strains and sprains result.
• This will manifest as hip pain which will worsen with continued activity.
• Some inflammation and stiffness might also be present.
• While accidents can result in strains and sprains, other causes include not warming up properly before a work out and suddenly increasing the intensity of an activity.

Arthritis:

While there are many kinds of arthritis, osteoarthritis and rheumatoid arthritis are the two common ones that affect the hip.

• Osteoarthritis affects the cartilage in the joint.
• The cartilage which is usually rubbery and hence adaptable to strain becomes stiff when affected by osteoarthritis.
• When it becomes stiff, it suffers damage easily.
• Damage to the cartilage causes the bones to rub against each other and results in pain.
• While it can affect any joint, the hip and knee joints are most commonly affected as they take up a lot of weight.
• Elderly people over 60 years are often afflicted with this condition.
• Rheumatoid arthritis is an autoimmune condition with the body’s immune system affecting its own tissues.
• Here, the synovium, which is a covering surrounding the joints, gets inflamed and causes pain.
• RA is usually differentiated from other arthritis by the fact that it affects symmetrical joints, for e.g., both wrists, both knees, etc.

Bursitis:

• The hip has two bursae which are fluid filled sacs found between the bones and other soft tissues.
• Their function too is to facilitate smooth movement.
• When these fluid filled sacs or bursae suffer inflammation, it will result in hip pain and the condition is called bursitis.
• Bursitis is usually the result of overuse.
• Maintaining optimum weight, going about physical activity the right way and paying attention to posture can help prevent this condition.

Tendonitis:

• A tendon is a band of tissue that connects bones and muscles.
• When the tendon is hurt (usually by some kind of repetitive action), tendonitis results.
• It causes pain in the area around the affected tendon.
• The condition is more common in older adults as the tendons lose flexibility with age and suffer damage easily.
• Activities which result in tendinitis could vary from gardening and carpentry to sports that involve use of one particular part like golf.

Hip Fracture:

• A fracture or a break in the hip bones will result in severe hip pain.
• While here again older adults are more prone to hip fractures, an accident or similar trauma can result in a hip fracture in anyone.
• For the elderly though, due to osteoporosis, even a fall from standing height can result in a fracture. Since hip fractures usually need surgery, fall prevention and handling other conditions that contribute to falls gain a lot of importance.
• Hip fracture is identified by the following symptoms:
• Acute pain in the hip joint
• Getting up after a fall is not possible
• The injured side appears shorter
• The injured side is unable to take up weight

Hip Labral Tear:

• The labrum is a band of cartilage which lines the socket of the hip joint.
• The labrum serves to cushion the joint and also helps to fix the femur head into the hip socket. When the labrum gets damaged or suffers a tear, pain will result.
• While road traffic accidents and other similar occurrences can result in a labral tear, it can also happen due to repeated movement of the hip joint.
• Any sport that involves twisting the hip can result in a labral tear.
• However, labral tears in many cases develop over time due to general wear and tear.
• It is believed that osteoarthritis too can contribute to a hip labral tear. Woman are affected by this condition more than men.

Osteonecrosis:

• When the blood supply to the bones is cut off, the bone cells die. This condition is called osteonecrosis.
• A fracture can stop blood flow to the bones and result in this condition.
• Other causes include prolonged use of steroids, radiation therapy for cancer which can wear out bones and clot formation in the arteries which can stop blood flow.
• In its early stages, osteonecrosis is often symptomless and pain might be felt only when pressure is applied on the joint. Slowly this pain will increase and become persistent. When the joint suffers complete collapse, the condition will become extremely painful.

Treatment Options

The exact course of treatment is dependent on the condition.

• If the cause of pain is a strain or sprain, then pain medications will be given and rest will be advised. The same course of action is advised for bursitis.
• It is best to keep pressure off the hip joint till the pain reduces. Walking aids can be used for this.
• The doctor might also suggest icing the area to relieve pain.
• Shock wave therapy has also proven effective in alleviating pain.
• In the case of arthritis, low impact work outs and strength training can bring about pain relief.
• For rheumatoid arthritis, steroids and drugs which suppress the immune system will be prescribed to handle the inflammation.
• Surgery as a line of treatment is suggested only as a last option for all causes.

Staying on Guard

A consult with your orthopedic doctor is warranted in the following cases:

• The hip joint is swollen and warm to touch.
• The onset of pain was sudden without any known cause.
• Any fall that results in hip pain has to be checked.
• Obvious deformity in the hip joint.
• Inability to move the hip or put any weight on it.
• Hip pain persists even when at rest or while sleeping.