Hip Pain

Pain in the hip joint can have a variety of causes.

• Pain in the hip joint can be temporary or chronic.
• There are many causes of hip pain.
• Treatment of hip pain depends on its underlying cause.

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 of 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.

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: 

• arthritis,
• 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.

Symptoms associated with hip pain depend on the cause. Symptoms include:

• limping,
• joint pain,
• groin pain,
• loss of motion of the hip,
• warmth,
• 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.

Healthcare 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.

Imaging studies, including X-rays, CT scans, and MRI scans, may be ordered to further define the causes of hip pain. Sometimes, nuclear medicine bone scans are used to image inflamed or fractured bone.

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 an infection is present, antibiotics are used. Fractures may require treatment with surgical repairs, including pinning, plates and screws, and total joint replacement. For severe arthritis, total joint replacement is performed when possible.

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.

Home remedies for hip pain include:

• rest,
• non-weight-bearing,
• cold application, 
• anti-inflammatory medications such as ibuprofen (Motrin and Advil), naproxen (Aleve), and
• pain medications such as acetaminophen (Tylenol).

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.

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.