If hip pain has been bothering you for a while, you must be wondering whether it will go away on its own, or you need to consult your doctor. Pain in the hips can be due to a lot of reasons. These may be serious, or might go away simply by taking care of yourself at home.
Anatomy of the Hip Joint
The hip joint is also called a “ball and socket” joint. This is where the ball of the thigh bone (femur) is placed in the pelvis at a socket (acetabulum).
Cartilage covers the part of the femur and acetabulum of the hip bone.
Synovium, a tissue that lines the joint is present around it. The function of the synovium is to secrete fluid for lubrication of the joints and to provide nutrition to the joint cartilage.
A number of ligaments, tendons and muscles attach the femur to the pelvic bone. Bursae, tiny fluid-filled sacs are present between the muscles and tendons to reduce friction at the joint.
The sciatic nerve, the largest nerve of the body, passes behind the hip joint and the major arteries and veins of the legs pass in front of it.
The hip joint is one of the largest joints of the body, which allows complete circular movement (other than the shoulder joint). It is the main joint involved in walking, running, sitting and standing.
Causes of Hip Pain
Hip pain comes due to a number of reasons. Some of the common causes are:
- Arthritis (Osteoarthritis, Rheumatoid Arthritis, Septic Arthritis)
- Hip fractures (Due to injuries, trauma, accidents and fractures especially in old age due to decreased bone density)
- Trochanteric Bursitis (Bursae are fluid filled sac-like structures that are present between bones and tendons, which function to limit friction during movement. When they get inflamed, they cause pain.)
- Tendonitis (Tendons are bands of thick tissue which attach muscle to a bone. They cause pain when they are inflamed or irritated)
- Soft tissue damage such as muscle or tendon strain/ sprain
- Hip Labral tear (The labrum is a ring of cartilage present around the rim of the hip joint. Its main function is cushioning and holding the ball of the thigh bone firmly within the joint. A labral tear occurs when this rim is ruptured)
- Pinched Nerves (e.g. Sciatica)
- Cancers (especially of the bone)
- Others (e.g. Hernia or Avascular Necrosis: occurs when blood flow to the hip joint is compromised and bone tissue dies)
If the hip pain is not that severe, you can do the following at home to relieve it:
- Rest: Avoid unnecessary activities, lifting heavy objects, repeated bending, climbing the stairs and prolonged sitting.
- Using a walking assistive aid like a walker or a cane.
- Hot fomentation/ Ice: take a hot shower or apply warm towel to ease the pain. This can also be done using ice-packs.
- I.C.E. protocol: A series of steps performed if hip pain is felt while performing an activity until you see the doctor. This involves Rest, Ice, Compression and Elevation undertaken in the same progression.
Symptoms of Hip Pain That Warrant Attention
The cause of hip pain will be determined according to the underlying condition. Hip pain may be present in the following areas:
- Within the hip joint
- Outside the hip joint
- The thigh
- The groin
For some people the pain might be of high intensity. This means that in order to avoid the discomfort, they might stay off their legs and not be able to do the basic day-to-day activities. This leads to muscle weakness and does more harm in the long run.
On the other hand, the pain might be mild and chronic (or long-lasting) instead of being intense. This is a concern if it isn’t improving with rest or home remedies such as anti inflammatory medication.
Medical attention is needed if the pain is severe, getting worse, sudden, due to some injury or is associated with:
- Deformed appearance of the joint
- Tenderness (pain on touching)
- Fever or any other signs of infection like chills, redness
- Inability to move the leg, walk or bear weight
- Difficulty sleeping on the hip
- Foot or leg weakness
- Knee pain
- Unexplained weight loss
- Groin pain
- Abdominal pain
- Chest pain
- Shortness of breath
Hip Pain Diagnosis and Treatment Options
When you see a health care professional, he/she will diagnose the pain first by taking a history and performing a physical examination. They may further advice imaging studies including X-rays, CT, MRI or bone scans.
The treatment of hip problems will depend on the underlying cause.
For mild pain, the techniques mentioned above under the self-care section can be applied.
The doctor may advice steroid injections to reduce inflammation.
Antibiotics may be used if an infection is present.
Additionally, if the hip problems are related to a sports injury, seeking help from a sports medicine specialist may be beneficial, as is physical therapy.
Fractures may require surgery or hip replacement.