The hip joint is a ball and socket joint formed from the femur (thigh bone) and the acetabulum of the pelvis (hip socket). The anatomy of the hip best allows weight-bearing and stability as opposed to large ranges of movement.
Below are several conditions that can cause hip pain:
Osteoarthritis. Hip osteoarthritis is one of the most common locations of osteoarthritis in the body. It is caused by the cartilage thinning resulting in the underlying bony surface to rub. This in turn causes inflammation of the tissues surrounding the joint, further cartilage damage and osteophytes (bony growths) to develop within the joint leading to the common symptoms of pain and stiffness. Osteoarthritis is a common degenerative joint disorder that can occur with advancing age. People are more prone to develop OA if they’ve had previous trauma to the hip or an abnormality in the structure of the hip (such as hip dysplasia).
Trochanteric Bursitis. This is the inflammation of a fluid filled sac (bursa) on the outside of the hip. This causes pain on the outside of the thigh that can be aggravated by lying on the affected side, walking up stairs and getting up from a low chair or car. The main goals with treating this condition are to reduce any pain and inflammation whilst preserving the joint mobility. In many cases the cause is unknown but is often due to injury, overuse or stress on the joint tissues due to arthritis or poor posture.
Femoroacetabular impingement (FAI). FAI is a condition caused by abnormal bone growth and can occur in any age. With this condition, many patients experience reduced movement and pain. There are 2 types of deformities: ‘cam’ and ‘pincer’. Both can present as a deep ache in the groin during or after repetitive hip flexion – meaning exacerbating activities include things such as climbing, running (particularly up hills) and prolonged sitting. Pincer deformities can also cause pain in the upper buttock area, aggravated by repetitive hip hyperextension such as downhill walking and speed walking.
Iliotibial band (ITB) syndrome. This condition refers to a specific strain of a ligament in the thigh, often caused by overload in running. This causes a sharp pain on the outside of the knee but occasionally towards the hip, people may also experience swelling and the area may be tender to touch. This pain will become aggravated by running downhill, or increase with activity , if the issue gets worse, it may start to affect you when you complete everyday activities such as walking up and down stairs and sitting with knees bent. Treatment for this is rest. However if it is a common occurrence then it’s best to get this investigated by an Osteopath or Physiotherapist to see if your biomechanics predispose you to getting this recurrently.
Labral Tear. Many labral tears have no symptoms however some people get stiffness and pain in the hip or groin aggravated by sitting, standing or walking for long periods of time and a locking/catching sensation in the joint. This injury normally occurs from trauma, people with structural abnormalities in the joint and in sports with repetitive twisting/pivoting such as golf, football or dancing.
Hip fracture. A break in the bone within the hip joint. This is most commonly seen in older people particularly those with osteoporosis after a fall. Hip fractures will cause sudden acute pain, swelling and an inability to weight bear through the affected leg.
Meralgia Paresthetica. This condition is due to the entrapment of a single nerve called the ‘lateral femoral cutaneous nerve’ which supplies sensation to the outside of the thigh. Symptoms mimic numerous other conditions so it often goes misdiagnosed. Symptoms include pain (stabbing, burning and aching) and numbness in the outside portion of the thigh. There are a number of causes of meralgia paresthetica such as being overweight, pregnancy, wearing tight clothing. It can also be as a result of some medical conditions including diabetes, hypothyroidism and alcoholism.
Septic arthritis/Osteomyelitis. Is an infection within the bones of the hip joint or within the joint. This causes sudden severe joint pain, usually accompanied by swelling, fever and a general feeling of being unwell. Symptoms tend to develop quickly and can progress over a few days. Septic arthritis/osteomyelitis occurs when bacteria gets into the joint, this is most likely after complicated joint surgery, injuries to a joint (including a bad skin injury) and if there is infection elsewhere in the body that can get into the joint via the bloodstream. It needs treating as soon as possible, usually by hospital care, otherwise complications can occur.
Muscle strains. Hip muscle strains are most commonly an acute injury when a muscle or tendon is stretched beyond its limit or torn. These can also happen over time from deterioration of these structures. Most strains resolve with at home treatment but some may require help from manual therapy or even surgery. These can cause pain and tenderness in the area and increased pain while using the injured muscle/tendon. Other symptoms can include swelling, reduced range of movement and weakness. You are at increased risk of a strain if you’ve had a prior injury in the same area, muscle tightness and neglecting to warm up properly prior to exercise.
Hip Dysplasia. Hip dysplasia is a condition in which the hip joint is in the wrong shape or the hip socket is not in the correct position to completely cover and support the top of the leg bone (hip dysplasia). This is often congenital (present at birth) and with an early diagnosis, children are able to walk properly with full movement, but, there are a few cases that go undiagnosed until later in life. This will present later in life with a limp and/or hip pain in the groin area or outside of the hip often with a catching/popping sensation that will tend to increase with activity and relieve with rest.
Hip Pain can also be referred from the lumbar spine (low back), kidneys, reproductive system and cardiovascular system so its important to seek attention from a trained professional if you’re unsure why an issue has occurred or its not resolving as expected. .