Hip pain is a widespread issue, affecting individuals across various age groups and lifestyles, from young adults to seniors. Pinpointing the exact reason for your hip discomfort can be challenging, but understanding the type and location of the pain offers crucial clues for diagnosis.
Dr. Shane Nho, a hip preservation specialist at Rush University Medical Center, identifies seven frequent culprits behind hip pain, some of which might be unexpected. Understanding these potential causes can empower you to seek appropriate care and relief.
1. Core Muscle Injury (Sports Hernia or Athletic Pubalgia)
If your pain is centered in the groin area, it could indicate a core muscle injury, often referred to as a sports hernia or athletic pubalgia. This involves strains or tears in the muscles or soft tissues of your lower abdomen.
This type of injury is particularly common among weekend athletes who engage in sports with frequent twisting and turning movements but may lack the necessary conditioning. Activities like tennis, golf, or even intense fitness classes can put you at risk.
Treatment: Rest is paramount for recovery. Allowing the affected muscles to heal for several weeks is crucial. In some cases, surgical intervention by a general surgeon may be needed to repair the torn muscle and restore full function.
2. Bursitis
Pain located on the outer hip, thigh, and/or buttocks might point towards bursitis. This condition involves the inflammation of bursae, small, fluid-filled sacs that cushion tendons and muscles, preventing them from rubbing directly against bones.
“While prolonged walking or stair climbing can exacerbate bursitis pain, it’s often not solely activity-related. The discomfort can be persistent daily,” explains Dr. Nho. “Even sleeping on the affected side can trigger pain.”
Bursitis becomes more prevalent with age, especially affecting individuals over 60. Factors like repetitive movements, injury, or underlying conditions can increase the risk.
Treatment: Home care is often effective for managing bursitis. Rest the hip, apply ice compresses to reduce inflammation, and consider over-the-counter anti-inflammatory medications like ibuprofen or naproxen. In some cases, your doctor might administer a cortisone injection to alleviate inflammation more directly.
3. Tendonitis
For active individuals experiencing tenderness in the hip flexor (the muscles that lift your knee and leg towards your body) or groin area when touched or moved, tendonitis could be the cause.
“Overusing or straining tendons—the tough cords connecting muscles to bones—results in minor, repeated injuries. This can lead to muscle imbalances in the hip,” Dr. Nho clarifies. “People who perform highly repetitive activities, such as soccer players kicking a ball repeatedly, are susceptible to this intense pain.”
Tendonitis in the hip can be triggered by activities like running, jumping, cycling, or any motion that excessively strains the hip tendons.
Treatment: Treatment approaches for tendonitis are similar to those for bursitis. Rest, ice, compression, and elevation (RICE) are initial steps. Pain relievers and physical therapy to strengthen the surrounding muscles can also aid recovery.
4. Labral Tears
The labrum is a crucial ring of cartilage surrounding the hip socket. It ensures the femoral head (the “ball” of the thigh bone) remains securely in place. Tears in the labrum, frequently seen in athletes and dancers, can cause pain in the hip or groin and restrict movement. You might experience sensations of locking, catching, or clicking in the hip joint.
“The pain from a labral tear tends to be persistent and doesn’t readily subside,” notes Dr. Nho. These tears are more common in individuals with pre-existing hip abnormalities, such as shallow hip sockets or hip impingement (discussed below), or those with a history of hip injuries.
Treatment: Surgical repair is often necessary for labral tears. Minimally invasive arthroscopic surgery can repair the labrum and address any underlying bone shape issues. This procedure aims to restore proper hip alignment, reduce pain, and protect the joint from further damage.
5. Gynecological or Pelvic Floor Issues: Pain Beyond the Hip Joint
It’s important to consider that hip pain may not always originate directly from the hip joint itself. Pain in the hip area can sometimes be referred pain from other structures in the pelvis.
“The pelvis is a compact area housing multiple systems in close proximity. This proximity can sometimes lead to confusion about the precise source of pain,” Dr. Nho explains.
For women, pain limited to the groin area that coincides with ovulation or menstruation could be related to conditions like endometriosis or uterine fibroids rather than a hip problem. Similarly, urological and gastrointestinal issues, such as gastroenteritis or prostate issues in men, can also manifest as pain that is easily mistaken for hip injury.
Treatment: A comprehensive evaluation by your primary care physician is crucial to determine the root cause of pain in this region. Depending on the diagnosis, you may be referred to a specialist, such as a gynecologist or gastroenterologist, for targeted treatment.
6. Hip Impingement (Femoroacetabular Impingement – FAI)
Dr. Nho frequently treats hip pain in younger individuals who participate in high-intensity activities like obstacle course races, CrossFit, or barre classes.
“These vigorous activities can, surprisingly, cause the hip bones to fuse in an irregular shape, limiting hip movement,” Dr. Nho points out. This condition is known as hip impingement or femoroacetabular impingement (FAI). Besides causing pain, FAI also elevates the risk of premature osteoarthritis.
Hip impingement occurs when the femoral head and acetabulum (hip socket) rub abnormally, leading to cartilage damage and pain.
Treatment: Physical therapy is often the initial approach to manage hip impingement. Exercises can help improve hip mobility and strengthen surrounding muscles. However, surgery to reshape the hip bones and restore proper joint mechanics may be necessary in some cases to alleviate pain and prevent long-term joint damage.
7. Osteoarthritis
Osteoarthritis stands as a very common cause of chronic, dull hip pain. This condition involves the breakdown of cartilage within the hip joint, leading to inflammation, stiffness, swelling, pain, and joint deformity.
Recent research suggests that osteoarthritis can develop when the hip bones don’t form perfectly, resulting in an imperfect fit within the joint. This misalignment leads to increased friction and wear and tear over time, Dr. Nho indicates.
Factors like high-impact activities (marathon running, basketball), aging, obesity, and previous traumatic injuries can increase your susceptibility to osteoarthritis. The resulting pain can become debilitating and significantly impact daily life.
Treatment: Management of osteoarthritis typically involves a multi-faceted approach. Rest, ice application, steroid injections, and over-the-counter pain relievers and anti-inflammatory medications are common initial strategies. More advanced treatments include stem cell therapy and surgical options, ranging from hip resurfacing to total hip replacement, depending on the severity of the condition.
Maintaining Healthy Hips
To help prevent hip pain and maintain joint health, Dr. Nho recommends incorporating these practices into your lifestyle:
- Maintain a healthy weight: Excess weight puts extra stress on your hip joints.
- Regular stretching and yoga: Improve flexibility and range of motion in your hips.
- Strengthen your core muscles: A strong core supports your hips and pelvis.
- Annual check-ups: Regular medical evaluations can help detect and address potential issues early.
- Appropriate exercise: Engage in regular physical activity, choosing exercises that are suitable for your age and fitness level.
If you experience persistent or severe hip pain, it’s essential to consult your primary care physician. They can assess your condition and refer you to a specialist, like an orthopedist or sports medicine physician, for further evaluation and targeted treatment. Early diagnosis and intervention are key to managing hip pain effectively and maintaining an active, pain-free life.
