Hip Pain

November 14, 2018 | Jane Grainger

Hip pain is very common in the older generation.

The hip is a ball and socket joint, designed to carry the weight of the body whilst also allowing a large amount of movement. The hip is designed to withstand a fair amount of wear and tear as it is involved in constant large range weight bearing activity.

A layer of cartilage cushions the joint, preventing friction, and improves the congruency of the joint. The joints stability is increased by the surrounding ligaments and muscles that do an excellent job at stabilising and mobilising the joint.

Unfortunately with time and use the cartilage can degenerate or become damaged, the joint surfaces can suffer and the hip can subsequently suffer from arthritis. Trauma, overuse and biomechanics can also affect the muscles and ligament. Fractures can be common after falls.

A few conditions that cause hip pain are:

• Arthritis – commonly Osteoarthritis (Rheumatoid arthritis is a systemic inflammatory condition diagnosed usually by blood tests and x-rays, and is controlled by medication through your doctor). Osteoarthritis causes degeneration of the cartilage and joint surfaces, leading to pain and progressive stiffness of the joint. The pain from an arthritic hip can travel in to the groin or even down to the knee. Diagnosis is through examination by your Physiotherapist or GP and confirmation by X -ray. Physiotherapy is usually the first line of treatment and can increase range of motion and reduce pain. In the long term hip replacements may be required if the degeneration is bad.
• Femoroacetabular impingement – this is when the hip and socket rub together due to abnormal shaping
• Labral tear – occurs often due to trauma. A tear occurs in the cartiledge surrounding the hip socket
• Fractures – usually following a fall, but occasionally the trauma can be minimal if osteoporosis is present. If you suspect a fracture you need an x ray for diagnosis. These require treatment at hospital followed by Physiotherapy rehabilitation.
• Bursitis – the fluid filled sacs called bursae are present to protect muscles and joints from rubbing and over use. They can become inflamed and swollen. These may be treated by Physiotherapy or cortico steroid injections
• Pain referral – it is common to have pain referred from the back in to the hip region. You need assessment and treatment by Physiotherapist.
• Septic arthritis, or Osteomyelitis – an infection in the bone or join. If you have hip pain and a fever see your GP immediately.
• Tendonitis – tendons are the thick bands of tissue that attach bones to muscles. Tendonitis is inflammation or irritation of the tendons. Sometimes inflammation of a tendon around the hip can occur. Usually caused by overuse, trauma or poor biomechanics. Treatment is usually from the Physiotherapist and a biomechanical assessment sometimes required.
• Muscle or tendon strain -repeated activities can put strain on the muscles, tendons and ligaments that support the hips. When these structures become inflamed from overuse or an injury they can cause pain and prevent the hip from functioning normally. Physiotherapy treatment is required if they don’t settle quickly on their own.
• Cancers – (uncommon) tumours that start in the bone (bone cancer) or that spread to the bone can cause pain in the hips, as well as in other bones of the body. Relatively uncommon your GP or health professional will screen for anything they feel needs further investigation.
• Osteonecrosis – (uncommon) this condition occurs when blood flow to the hip bone is lost and the bone tissue dies as a result. Although it can affect other bones, osteonecrosis most often occurs in the hip. It can be caused by a hip fracture or dislocation, or from the long-term use of high-dose steroids (such as prednisolone), amongst other causes. If it is suspected it requires further investigation to confirm, and a referral to a specialist at the hospital.

 

Old injuries can cause weakness and pain, and so if you have ongoing problems you may want to see your GP or Physiotherapist for an assessment.

 

Some ways to manage hip pain initially at home:

• Lose weight- if you’re over weight it will increase the pressure on your hip
• Wear supportive flat shoes and avoid prolonged standing
• Do some hip and gluteal stretches
• Avoid activities that make the pain worse
• Consider seeing a Physiotherapist for investigation, treatment and exercise
• See your GP if you have fever with the hip pain, if your hip pain occurred after a bad fall, if you are unable to weight bear or move your leg, or if you leg is deformed or badly bruised /bleeding.
• If you would like more information on Hip pain http://www.hipproblem.co.uk is a resource website launched by the company Smith and Nephew and offers some information to those under 50 suffering with hip pain.