Hip Pain

The Hip

The hip is the largest ball-and-socket joint in the body and is responsible for supporting body weight and providing stability. Held together by various bones, muscles, tendons, and ligaments, our hip allows us a vast range of mobility, letting us walk, run, and play sports. Some of the main structures in our hip include:

  • Femur: the thigh bone, one of the longest bones in our body
  • Pelvis: made of the ilium, ischium, and pubis bones
  • Iliofemoral ligament
  • Pubofemoral ligament
  • Ischiofemoral ligament
  • Ligamentum teres
  • Acetabular labrum
  • Gluteal: gluteus minimus, gluteus maximus, and gluteus medius
  • Adductors
  • Iliopsoas
  • Hip flexors
  • Hamstring

Common Hip Conditions

Due to the intricate structures in our hip and how much it is used for everyday movement, the joint is susceptible to a number of conditions that can affect a person’s quality of life.

Hip bursitis is when there is inflammation of the bursa, which are small, fluid-filled sacs in the joint that serve as a cushion and reduce friction in the hip. There are two major bursae in the hip that can become inflamed:

  • Trochanteric bursa: located on the side of the hip, covers the bony part of the tip
  • Iliopsoas bursa: located on the inside or the groin side of the hip

Bursitis can cause pain, localized tenderness, decreased mobility, and swelling. Pain caused by this condition usually becomes worse when lying down or with prolonged exercise, and can be caused due to repetitive stress, arthritis, sudden injury, or bone spurs. Surgery is rarely used to treat bursitis, as it can often be treated with strengthening exercises, NSAIDs, or corticosteroid shots.

Similar to the joint in your shoulder, the hip also contains a labrum that provides stability and keeps the ball and socket together. A labral tear in the hip may cause:

  • Pain in your hip or groin
  • A locking or clicking sensation in the joint
  • Stiffness
  • Feeling of unsteadiness
  • Limited mobility

You may tear your labrum from sudden trauma, osteoarthritis, structural abnormalities, or overuse. Typically, the first line of treatment for a labral tear is a nonsurgical treatment, but your orthopedic specialist at Comprehensive Medical Care may suggest surgery depending on how active your lifestyle is or the extent of the tear.

Hip impingement, or femoroacetabular impingement (FAI), is a condition that occurs when the ball of the hip pinches against the hip. This condition typically happens when one or more of the bones in the hip has an irregular shape, which creates friction upon movement. There are three types of hip impingements:

  • Cam impingement: head of the femur is irregularly shaped
  • Pincer impingement: socket is too deep and fits over the head of the femur
  • Combined impingement: when both the head and the socket are abnormally shaped

FAI is present at birth for many individuals, but it is also fairly common in athletes who compete in sports with frequent twisting or squatting. This condition can cause considerable pain and stiffness, and to alleviate this discomfort your physician may recommend rest, activity modification, physical therapy, or NSAIDs. If your pain does not improve with conservative treatment, you may need surgery to address the damaged tissues in the hip, as well as correct the abnormal shape of the bone structures.

Sciatica is a condition pertaining to inflammation or pinching of the sciatic nerve. This nerve originates in the lower back and extends down through the hips and buttocks into each leg. Most frequently, a herniated disc irritates the nerve, which results in pain in the lower back and hip region. You may even experience pain radiating into your legs when affected by this condition. Fortunately, most people are able to make a full recovery from sciatica with non-operative treatments.


Treatment for Hip Conditions

  • There are several nonsurgical treatment options for the above hip conditions. Among the most effective conservative treatment techniques are:

    • Physical therapy
    • Rest
    • Ice or heat therapy
    • NSAIDs
    • Injections: intra-articular, psoas, or trochanteric bursa injections
    • Over-the-counter pain relievers
  • If hip pain does not respond to conservative treatment, your orthopedic specialist at Comprehensive Medical Care may suggest having surgery. Some surgical options that are effective at treating issues with the hip include:

    • Hip arthroscopy: minimally-invasive procedure using fiber-optic technology
    • Synovectomy: removal of inflamed synovial lining
    • Labral tear repairs: labral debridement, labral refixation, and partial psoas release
    • Impingement procedures: acetabuloplasty and osteochondroplasty
    • Hip replacement: when diseased parts of the joints are replaced with artificial components