Hip Pain in Adults: Symptoms, Causes & Treatment

What are the early signs of hip problems?

Hip pain usually presents as discomfort or aching in or around the hip joint. The hip is basically a ball-and-socket joint composed of two bones: the upper end of the femur or the thigh bone (ball) and the acetabulum of the pelvis (socket). When you feel pain in this area, it suggests damage to the hip.

You might feel pain in the groin, outer hip, buttocks, or thigh. This pain can range from mild to severe. In some cases, there is extra-articular pain as well, meaning that it arises from surrounding structures like muscles, tendons, ligaments, or nerves.

What are the causes of hip pain?

While hip pain can stem from age-related factors or personal lifestyle choices, sometimes it may also signal a chronic health issue. Therefore, identifying the root cause is crucial before pursuing treatment options for the pain.

If you have any of the chronic conditions below and are undergoing any treatment for it, there's a chance you can still get pain flare-ups. Below are the most common conditions which can cause hip pain in adults.

• Osteoarthritis 

  • One of the most common causes, osteoarthritis occurs when the cartilage in the hip joint wears down over time. This can lead to stiffness, pain, and reduced range of motion.

• Bursitis

  • Inflammation of the bursa (small sacs of fluid that cushion the joints) is a painful condition that causes discomfort in hips, especially when moving or pressing on the affected area.

• Tendonitis 

  • Tendonitis refers to the inflammation of the tendons around the hip. This inflammation usually leads to joint dysfunction, often from an overuse injury or repetitive motions.

• Hip fracture

  • Hip fractures occur when the femoral head that connects to the hip socket breaks or slips off. They are more common in older adults due to osteoporosis.

• Labral tear 

  • The labrum is a ring of cartilage that surrounds the hip joint.  When a labral tear occurs due to injury or structural issues, it causes deep groin pain or pain in the buttocks.

• Muscle strain or injury

  • Hip flexor strain or flexor injury, which is caused by straining in the muscles of the hip, can lead up to severe pain. This happens often following a physical activity.

• Sciatica 

  • Irritation of the sciatic nerve can cause pain radiating from the lower back to the hip, buttock, and down the leg. Sciatica presents as both unilateral and bilateral. Learn more about sciatica here.

• Avascular necrosis

  • This condition occurs when blood supply to the hip joint is disrupted, leading to the death of bone tissue. This can result in pain and eventually joint collapse.

• Hip impingement

  • Also referred to as femoroacetabular impingement, this is a condition that occurs when there is abnormal contact between the bones of the femoroacetabular joint. This usually leads to pain and restricted movement.

• Infection 

  • Hip infections or infections in surrounding tissues (like septic arthritis or osteomyelitis) can cause pain, swelling, and fever.

For personalised advice regarding your underlying disease, you may consult with a specialist from Thomson Medical. Request for an appointment with our specialists today.

Symptoms of hip pain

Depending on the underlying condition, the pain can manifest in many different ways. Here are common symptoms associated with hip pain in adults:

• Pain characteristics

  • For some people pain causes joint dysfunction making it difficult to walk or stand. It sometimes also causes a noticeable limp. 

  • Can radiate to the outer thigh, groin, buttocks, or lower back. In cases of sciatica, pain may extend down the leg. 

  • Some conditions, like arthritis or bursitis, can cause posterior hip pain that persists even when resting or lying down. Pain at night is also commonly seen.

  • In the case of fractures or acute injuries, pain is often sharp, severe, and immediate.

• Weakness and inability to bear weight

  • Difficulty lifting the leg, weakness in the hip bone, or a feeling of instability in the joint.

  • In severe cases, individuals may be unable to stand or bear weight on the affected hip.

• Stiffness

  • Reduced range of motion in the hip joint, making it difficult to move or rotate the leg.

  • Your hip may feel stiff upon waking or after sitting for long periods.

• Clicking or popping sensation

  • Patients with hip pain also experience a clicking or popping sound in the hip joint when moving.

• Swelling and warmth

  • Swelling, tenderness, or warmth around the hip joint may indicate inflammation or infection.

Hip pain diagnosis 

1. Medical history assessment

   • Hip pain is often localised to one of three areas: anterior, lateral, or posterior, and understanding this localisation is crucial for diagnosis and treatment.

   • A thorough medical history is necessary for establishing differential diagnosis and evaluating the origin, degree, and specific circumstances of an individual's hip pain.

2. Physical examination

   • Your doctor's physical exam may include assessing whether the hips are level while the patient is standing to detect any discrepancies or abnormalities in hip alignment. The examination may involve testing the strength of the muscles around the hip to assess its function and identify any weakness.

   • During a physical examination for hip pain, the physician may also observe your joint in motion. To make a comparison between the two, they will also compare the range of motion. Palpation of the muscles surrounding the hip is a critical component to help localise the type of pain and evaluate disease process.

3. Imaging tests

   • Imaging tests such as X-rays, MRI, CT scans, or ultrasounds are commonly employed in diagnosing a patient with hip pain. It helps identify hip injury including fractures in the femoral head and soft tissue injuries.

4. Blood tests

   • Blood tests are essential in assessing the underlying causes of hip pain alongside imaging tests. Blood tests can help check for infections and autoimmune diseases, and help guide your doctor towards a definitive diagnosis of your condition.

Hip pain treatment

Conservative management & home remedies

When it comes to hip pain, there are a wide range of regular therapies and modifications you can do to help alleviate your symptoms. These include: 

• Ice and heat therapy

  • Ice: Applying ice packs to the painful area for 15-20 minutes several times a day can reduce inflammation, especially if the pain is due to an injury or inflammation like bursitis.

  • Heat: For chronic pain or stiffness (like in rheumatoid arthritis or pain in athletes), applying a warm compress or taking a warm bath may help relax the muscles and ease stiffness.

• Physical therapy and exercise routine

  • Strengthening exercises: Targeting the muscles around the hip (glutes, hip flexors, quadriceps) with the help of a physical therapist can help support the joint and reduce pain.

  • Stretching exercises: Gentle stretching can improve flexibility and reduce stiffness in the hip joint.

  • Range of motion exercises: These repetitive motion exercises can help maintain or improve the joint's mobility and reduce chronic hip pain associated with stiffness.

  • Aquatic therapy: Exercises in water are a low-impact way to strengthen muscles and improve mobility without putting pressure on the hip joint.

•  Lifestyle modifications

  • Weight management: For those with hip osteoarthritis or chronic conditions, maintaining a healthy weight can reduce hip strain.

  • Posture and ergonomics: Using supportive chairs, improving posture, and adjusting the way you sit, stand, or sleep may reduce posterior hip pain and improve flow of blood.

• Assistive devices

  • Walking aids: Canes or walkers can reduce the weight load on the affected hip and help prevent limping or further injury.

  • Orthotic shoe inserts: Custom inserts can help correct imbalances and reduce stress on the hip joint.

• Alternative therapies

  • Acupuncture: May help relieve chronic hip pain for some individuals.

  • Chiropractic care or osteopathic manipulation: Help in improving hip alignment and reduce pain.

  • Massage therapy: Can be useful in relieving muscle tension during daily activities.

Medications for hip pain

• Over-the-counter medications

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) can reduce acute hip pain and inflammation.

  • Acetaminophen (Tylenol): For mild pain without significant inflammation.

• Prescription medications

  • Corticosteroid injections: Steroid injections into the hip joint or surrounding bursa can provide relief from inflammation in conditions like arthritis or bursitis.

  • Hyaluronic acid injections: Sometimes used to lubricate the hip joint, especially in cases of osteoarthritis.

  • Muscle relaxants: May be prescribed for muscle spasms associated with hip pain.

The above options can help with the management of hip pain. However, if the pain persists for two weeks or worsens, do get in touch with your healthcare provider for professional advice. Request an appointment with our specialists at Thomson Medical today.

Surgical interventions

If the therapeutic approach does not alleviate the pain, or if there is significant damage, hip surgery may be necessary:

• Hip arthroscopy

  • A minimally invasive surgery used to treat labral tears, hip impingement, or cartilage damage. Small instruments are inserted into the joint to repair or remove damaged tissue.

• Hip replacement (total hip arthroplasty) 

  • For hip pain such as arthritis or significant joint damage, hip replacement surgery may be recommended. The damaged hip joint is replaced with an artificial joint.

• Hip resurfacing 

  • An alternative to hip replacement where only the damaged surfaces of the bones are replaced rather than the entire joint.

When to seek medical help

While mild hip pain can often be managed with home care, there are times it becomes crucial to see an expert opinion for accurate diagnosis.

• Severe pain or pain that is persistent despite rest and home treatments.

• Inability to move the hip or walk comfortably.

• Swelling, warmth, or redness around the hip joint, which may indicate infection.

• Sudden hip pain following trauma, such as a fall.

• Sciatica-like pain radiating down the leg or associated with tingling, numbness, or weakness (which could be sciatica or a nerve issue).

• Hip deformity or abnormal positioning of the hip or leg.

• Pain that worsens at night or while resting.

An early diagnosis can help prevent further damage to the hip joint and help devise a more effective treatment plan for hip pain, helping to manage the underlying causes more effectively. Request an appointment with our hip specialists at Thomson Medical today for an accurate diagnosis and a personalised treatment plan.

FAQ

What can I do to relieve hip pain at home?

You can try resting, applying ice, and taking over-the-counter anti-inflammatory medications to alleviate mild hip pain. Gentle stretching and strengthening exercises, especially for the muscles around the hip, can also be beneficial. If symptoms persist, it’s important to consult a doctor.

Can hip pain be a sign of something serious?

Yes, severe hip pain can sometimes indicate serious conditions such as fractures, infections, or avascular necrosis. Persistent or severe pain should always be assessed by a healthcare professional.

How is hip arthritis diagnosed?

Doctors diagnose hip arthritis using a combination of medical history, physical examinations, and imaging studies, such as X-rays or MRIs.

Can hip pain be related to back problems?

Yes, conditions like sciatica or herniated discs can cause pain that radiates from the lower back to the hip and down the leg. It can also cause problems in the lumbar spine.

When is surgery necessary for hip pain?

Surgery is typically considered when conservative treatments fail to provide relief, or if there is significant joint damage. Common procedures include hip replacement and arthroscopy for labral tears or for femoroacetabular impingement

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request for an appointment with Thomson Medical today.