The hip is a complex structure consisting of two bones, the joint between them, and the muscles that generate its strength and motion. Everything from getting out of a chair to running requires the use of the hip. It requires many large muscle groups to work in coordination to provide motion. Oftentimes, these muscles also affect the back or knee joint. Because of this, hip pain can often be difficult to diagnose and very debilitating. Hip problems can be caused by overuse, traumatic injury, and/or changes that occur naturally in your body.
Suffering from hip pain? Contact us to learn about treatment options.
How Your Hip Works
The hip consists of two bones: the thighbone (femur) and the hip (pelvis). The femur and the pelvis come together to form the hip joint (iliofemoral). The thighbone is a long bone running from the knee up to the hip with a head shaped like a ball to fit neatly into a socket on the hip (acetabulum). Inside the socket is a flexible rim of soft tissue called the labrum, which helps increase the stability of the hip. Surrounding the hip joint is a joint capsule and multiple ligaments that help strengthen the hip joint.
Surrounding the hip joint are many different small muscles that work together to either turn the leg in (internally or medially rotate) or turn the leg out (externally or laterally rotate). The major muscles that extend or allow the leg to move backward are the group of gluteal muscles. The hip flexors in the front of the leg help to flex the hip, bringing your leg up as if you were climbing stairs. In order for the hip to function properly, the bones, joints, and muscles must all work in unison.
Evaluating Hip Pain
Evaluation for hip pain starts with you giving us a history of your problem: when and how it started, how it currently feels, and which treatments you have tried so far. We also ask you about other medical conditions that may contribute to your hip pain. We conduct a physical exam to test the structures of your hip. We check your hip’s range of motion and strength and do special tests that can uncover specific problems.
Hip pain can sometimes be the result of an issue in your lower back, as they are within close proximity of each other and many muscles overlap. This makes it particularly difficult to determine the true cause of the pain. If a nerve is pinched in your back, the pain can often manifest in your hip or groin region.
Based on the findings of your physical exam, we may recommend a cortisone injection as both a clinical test and treatment for your pain. The numbing medicine mixed in the injection helps us determine the source of your pain, whereas the cortisone medication of the injection can provide pain relief. Sometimes we order tests such as x-rays or MRIs to visualize your bones and soft tissues. X-rays can show us things like fractures, spurs, and changes from arthritis. MRIs can show us more detail of the bones, as well as soft tissue damage like tears of a muscle or labrum.
Causes of Hip Pain
- Bone Spurs/Impingement
- Soft tissue damage
- Less common causes include dislocation, infection, tumors, or nerve problems.
Treating Hip Pain
Treatment of hip pain is very specific to the diagnosis and severity of your symptoms.
Lifestyle modifications include: resting your hip, changing your daily activities to avoid painful situations, and doing exercises to strengthen weak muscles.
Medications can help with some hip conditions. Non-steroidal medications (NSAIDs) such as ibuprofen or naproxen can relieve inflammation. If the inflammation is severe, then a short burst of a steroid medication may be an option. Medications like acetaminophen (Tylenol) can help to control your pain.
Cortisone injections are used to target a specific location in your hip using a powerful anti-inflammatory medication. Numbing medications mixed in the injection help us know if the spot injected is the source of your pain.
Physical therapy is a form of treatment that focuses on getting your hip muscles and joints to properly work together to move your arm. Even if you are very strong and active, you may have muscle imbalances which are causing you hip pain. Physical Therapists can identify and address these muscle imbalances through corrective exercises. They may give you a series of take-home exercises to help return you to regular activities pain-free.
Surgery may be the next option for certain hip conditions if all other treatment options have been exhausted. Some surgeries can be done through small incisions using a special camera to see inside the body (arthroscopy), whereas others like a hip replacement require a traditional open surgery.