Hip Pain Overview
Pain in the hip is a common complaint that can be caused by a wide range of problems. Symptoms are frequently worse with prolonged walking and going from a sitting to standing position. The first issue is to determine if the hip comes from the hip joint (the ball and socket joint) or referred pain from the ‘lateral hip’ including muscles, ligaments, tendons and other soft tissues. Some patients even have lumbar or buttock pain that can refer pain to the hip or groin. Injuries including chronic bursitis involving the greater trochanter (the bony region on the side of your hip that causes pain if you lay on one side) or the ischial bursa (the ‘butt bone’). Labral tears, hip dislocations, and prior fractures are also possible causes.
In many patients, the pain is referred from the upper nerves from the lower back due to a pinched or inflamed nerve, bad disc, or joint inflammation. There are some nerves that can be compressed in the pelvis or the top of the thigh. An xray, MRI, ultrasound, NCS/EMG, or CT may be necessary to further evaluate the true source of pain.
If the pain is referred from the back, nonsurgical treatment options include trigger point injections, epidurals, selective nerve blocks, joint injections, and physical therapy. If the discomfort is secondary to a problem with the hip joint itself, nonsurgical treatment options include non-steroidal anti-inflammatories, compound transdermal medications, bracing, neuomodulation treatments, custom bracing, vitamin supplementation, cold therapy, initial corticosteroid injections, growth factor injections, cryopreserved stem cell injections, botox therapy, and platelet rich plasma injections.
Sometimes called "wear-and-tear" arthritis, osteoarthritis is a common condition that many people develop during middle age or older. In 2011, more than 28 million people in the United States were estimated to have osteoarthritis. It can occur in any joint in the body, but most often develops in weight-bearing joints, such as the hip.
Osteoarthritis of the hip causes pain and stiffness. It can make it hard to do everyday activities like bending over to tie a shoe, rising from a chair, or taking a short walk.
Because osteoarthritis gradually worsens over time, the sooner you start treatment, the more likely it is that you can lessen its impact on your life. Although there is no cure for osteoarthritis, there are many treatment options to help you manage pain and stay active.
Bursae, are small, jelly-like sacs that are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They contain a small amount of fluid, and are positioned between bones and soft tissues, acting as cushions to help reduce friction.
Bursitis is inflammation of the bursa. There are two major bursae in the hip that typically become irritated and inflamed. One bursa covers the bony point of the hip bone called the greater trochanter. Inflammation of this bursa is called trochanteric bursitis.
Another bursa — the iliopsoas bursa — is located on the inside (groin side) of the hip. When this bursa becomes inflamed, the condition is also sometimes referred to as hip bursitis, but the pain is located in the groin area. This condition is not as common as trochanteric bursitis, but is treated in a similar manner.