Hip pain facts
- Pain in the hip joint can be temporary of chronic.
- There are many causes of hip pain.
- The treatment of hip pain depends on its particular cause.
What is the anatomy of the hip?
The hip joint is where the ball of the thigh bone (femur) joins the pelvis at a socket called the acetabulum. There is cartilage covering both the bone of the femur and the acetabulum of the pelvis in the hip joint. A joint lining tissue, called synovium, surrounds the hip joint. The synovium tissue produces fluid that lubricates the joint and provides nutrients to the cartilage of the joint. The ligaments around the hip joint attach the femur bone to the bony pelvis. There are a number of muscles and tendons that glide around the hip joint. Tiny fluid-filled sacs, called bursae, provide gliding surfaces for muscles and tendons around the hip joint. Major arteries and veins pass the front of the hip joint. The largest nerve of the body, the sciatic nerve, passes behind the hip joint.
The hip joint is one the large joints of the body and serves in locomotion as the thigh moves forward and backward. The hip joint also rotates when sitting and with changes of direction when walking.
What are causes and risk factors for hip pain?
There are many causes of hip joint pain. Some hip pain is temporary, while other hip pain can be long-standing or chronic. Causes of hip pain include bursitis, inflammatory and noninflammatory arthritis, fracture, sprain, infectious arthritis (septic arthritis), avascular necrosis, Gaucher's disease, sciatica, muscle strain, iliotibial band syndrome (IT band syndrome), and hematoma.
Hip Pain Symptoms and Signs
Pain in the hip can result from a number of factors. Sometimes diseases that affect other joints in the body, such as the inflammation resulting from arthritis, can be the cause of pain in the hip. Depending upon the cause of hip pain, the pain may occur when walking, running, or engaging in activity. Trochanteric bursitis is the most common type of hip bursitis and causes pain at the point of the hip.
What symptoms and signs may be associated with hip pain?
Symptoms associated with hip pain depend on the cause. Symptoms include
- joint pain,
- groin pain,
- loss of motion of the hip,
- swelling over the hip,
- tenderness of the hip,
- difficulty sleeping on the hip.
Symptoms vary in intensity from mild to severe. Hip pain can be a cause of disability.
How do health-care professionals diagnose hip pain?
Health-care professionals diagnose hip pain with a history and physical examination. Physical examination maneuvers, such as internally and externally rotating the hip, can be used to detect pain-aggravating positions. Tenderness can be elicited by palpating over inflamed areas. Straight leg raising can detect signs of sciatica. A health-care professional may use imaging studies, including X-rays, CT scans, and MRI scans, to further define the causes of hip pain. Sometimes, nuclear medicine bone scans are used to image inflamed or fractured bone.
What are treatments and medications for hip pain?
The treatment of hip pain depends on the precise cause of the pain. Treatments can include rest, non-weight-bearing, cold application, and anti-inflammatory medications. For local inflammation, sometimes injection of cortisone medication (steroids) is used to quiet the inflammation. If infection is present, antibiotics are used. Fractures can require treatment with surgical repairs, including pinning, plates and screws, and total joint replacement. For severe arthritis, total joint replacement is performed when possible.
What types of specialists treat hip pain?
General medicine physicians, including general practitioners, family medicine doctors, and internists, as well as orthopedic surgeons, rheumatologists, and sports medicine specialists treat hip pain. Often physical therapists and rehabilitation physicians are involved in the care of hip pain.
What is the prognosis of hip pain?
The prognosis of hip pain depends on the cause and the response to treatment. Most mild strain injuries have a good outlook and resolve rapidly in response to home remedies.
Is it possible to prevent hip pain?
Hip pain can be prevented by avoiding injury to the hip joint. This includes sports injury. Sometimes proper conditioning prior to a sports event can prevent injury.
Firestein, G.S. Kelley's Textbook of Rheumatology, Ninth Edition. China: Elsevier Saunders, 2012.