Hip Pain - Causes, Symptoms, Diagnosis, and Treatment

What Is Hip Joint?

The joint where the tip of the femur (thigh bone) articulates with the pelvis socket (acetabulum) is called the hip joint. Cartilage covers both the femur bone and socket in this joint. Synovium, the tissue lining the joint, also surrounds the hip joint. This synovium produces synovial fluid that lubricates and provides nutrients to the joint. The femur is attached to the hip joint with the help of ligaments, muscles, and tendons. Many fluid-filled sacs (bursae) in the joint provide gliding surfaces in the hip joint. The muscles and tendons move around these gliding surfaces. The sciatic nerve (longest nerve) and other major arteries, nerves, and veins pass behind the hip joint.

What Is Hip Pain?

Hip pain can be mild to severe and cause aching, sharp, or burning pain. Various causes can lead to hip pain, some of which are serious and need immediate medical treatment. Some causes, such as a hip fracture, arthritis, or infection, can lead to permanent hip damage or can be debilitating. The doctor will first try to identify the cause of the hip pain and suggest a treatment plan, which can include surgery, home remedies, rest and ice, painkillers, and physical therapy, depending on the cause.

What Are the Possible Causes of Hip Pain?

Some of the possible conditions that can cause hip pain are:

1. Arthritis - Osteoarthritis and rheumatoid arthritis are the most common causes of hip pain in older adults. Arthritis causes inflammation of the hip joint, which breaks down the cartilage and destroys the cushioning effect. This results in hip pain, stiffness, and reduced range of motion.

2. Tendinitis - Tendons are bands of tissue that attach the head of the femur to the muscles in the hip joint. Repetitive stress due to overuse can result in the inflammation of these tendons (tendinitis).

3. Hip Fractures - The bones become weak and brittle with age, which is more common in women. This weakening makes the bones more prone to fracture during a fall. A hip fracture can also lead to life-threatening complications. The symptoms include severe hip and groin pain, inability to put weight on the injured side, stiffness, and swelling.

4. Bursitis - The fluid-filled sacs (bursae) found in the hip joint help ease the friction of the bones, muscles, tendons, and ligaments rubbing together. In case when these bursae get inflamed, they result in hip pain. It can be caused due to overuse or repetitive actions that overwork the hip joint.

5. Muscle Strain - Overworking the joint without proper stretching exercises can put unwanted strain on the muscles and ligaments. This causes hip pain and a limited range of motion.

6. Hip Labral Tear - The labrum is the rim of the cartilage that lines the hip socket, which provides cushioning to the hip joint and securely holds the ball of the femur in the joint. When this labrum gets ripped, it results in severe hip pain. It is commonly seen in athletes and people who repetitively twist their bodies.

7. Cancer - Hip pain can also be caused by bone tumors originating in the hip bones.

8. Osteonecrosis - Otherwise called avascular necrosis, osteonecrosis occurs when the bone tissue dies because of reduced blood flow. It can affect any bone, including the hip. The causes include a hip fracture or hip dislocation and prolonged steroid use.

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9. Snapping Hip Syndrome - It commonly affects dancers and athletes. It is a condition that results in a snapping feeling or sound in the hip while walking and getting up from a sitting position. In rare cases, it can cause hip pain, but mostly it is painless.

10. Femoroacetabular Impingement - Here, hip pain is caused when abnormally shaped bones in the hip rub together.

11. Hip Dysplasia - This is a condition where the hip socket does not completely cover the head of the femur.

12. Osteomyelitis - Infection in the bone or hip joint.

13. Sickle Cell Anemia - People with sickle cell anemia (a type of anemia where the red blood cell becomes sickle-shaped or curved) often complain of hip pain. This is because of bone death caused by permanent or temporary loss of blood supply to the bone.

What Are the Symptoms Associated With Hip Pain?

Based on the cause, the symptoms associated with hip pain are:

• Groin pain.

• Pain while walking.

• Joint pain.

• Loss of motion of the hip joint.

• Swelling.

• Tenderness.

When to Consult a Doctor for Hip Pain?

Most causes of hip pain get better with rest and over-the-counter painkillers. But always consult a doctor before taking any medicines. In the following situation, go to the emergency room immediately:

• If pain persists even after resting for a week.

• If an individual has a fever or rash.

• If an individual has sickle cell anemia and they are experiencing hip pain.

• If more than one joint is painful.

How Does a Doctor Diagnose the Cause of Hip Pain?

The doctor will try to diagnose the cause of the hip pain by conducting a physical examination, taking a complete medical history, and asking questions about the pain. An individual should be ready to answer questions like when the pain is severe, what aggravates or relieves pain, when the symptom began, and whether it has affected his or her ability to walk. The patient may be instructed to walk so the doctor may assess their range of motion. Then the doctor might suggest getting the following tests:

• Blood tests.

• Urine tests.

• Fluid in the joint is tested.

• X-rays.

• CT (computed tomography) and MRI (magnetic resonance imaging) scans.

• Ultrasounds.

Based on the findings of the above tests, the doctor will attempt to determine the cause and will decide on the treatment plan.

What Are the Different Treatment Options for Hip Pain?

Based on what is causing the hip pain, the different treatment options include:

1) Home Remedies:

• Avoid activities that aggravate the pain.

• A cake or a walker will help the person to walk and improve mobility.

• In case of hip pain and swelling, an individual should follow the R.I.C.E protocol, which stands for rest, ice, compression, and elevation.

2) Medications:

• Various NSAIDs (nonsteroidal anti-inflammatory drugs), such as Diclofenac, Ibuprofen, Naproxen, or Paracetamol, are used to ease hip pain.

• In severe cases, stronger painkillers like opioids are used.

• Other medications include disease-modifying anti-rheumatic drugs (DMARD) for rheumatoid arthritis and antibiotics for joint infection.

3) Physical Therapy:

Along with medication, physical therapy plays an important role in treating most kinds of hip pain. It helps improve the hip's strength, flexibility, and mobility. It also includes massage, ultrasound therapy, ice, and heat therapy.

4) Surgery:

Surgery is indicated for hip fractures, osteonecrosis, and some types of cancer.

Conclusion:

Hip pain is a painful condition that can decrease the quality of life of an individual. It is treatable; however, if ignored, it could develop into a significant problem. To prevent such illnesses, individuals should lead a healthy lifestyle that includes frequent exercise and a well-balanced diet.

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