Hip Pain

The hip joint is one of the largest joints in the body, and one that is most constantly used. We can thank our hips for the ability to move, as well as support our weight and maintain our balance. So when hip pain is felt, it can affect everything we do. Regardless of your age, hip pain can be a major issue, especially if left untreated. If you have hip pain, the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas is here to help diagnose and treat the source of pain and get you back on your feet. 

What is Hip Pain? 

Hip pain is pain that you feel in or around the hip joint. The hip joint is where the femur (thigh bone) connects to the pelvis. While it is a very strong and durable joint, it can still be susceptible to both injury and medical conditions. Sports-related injuries (high impact or not), car accidents, slip and falls (especially for those who are elderly) are the most common incidence-related causes of hip pain. The most common reason a person might experience chronic hip pain is due to arthritis in the hip joint. 

Hip pain can be a short-term annoyance that can be remedied with rest and ice, or it can be a bigger issue that requires medical attention. The part of the hip that has been damaged or injured depends on where the pain is felt: 

• Above or around the hip: issues with muscles, ligaments or tendons
• Deeper inside the hip: bone or cartilage pain
• In the lower back: deeper pain that has spread to other parts of the body

Hip pain can also fluctuate in occurrence. You could experience worse pain first thing in the morning, or maybe even just late at night after you’ve been moving all day. Some patients experience pain after sitting or lying for long periods of time, or it could hurt most throughout the day. If at-home methods don’t help to resolve the pain in a short period of time, it’s a good idea to have a doctor take a look to make sure there isn’t a larger issue at hand.  

Anatomy of the Hip

The hip joint is a ball and socket joint that connects the femur to the pelvis. The top of the femur is a round ball that fits into the socket formed by the pelvic bone (acetabulum). The ball is able to glide and rotate within the pelvic bone with the help of ligaments and muscles that both support the joint and also keep the hip from overextending or rotating improperly. The synovial lining in the joint also helps to provide a lubricating fluid that helps to reduce friction, and the burse, a fluid-filled sac, helps with cushion and movement. All of these parts help a person to use his/her hip properly and without pain, so when pain is felt, it could be due to any number of issues within the hip joint. 

Additionally, the knee and ankle joints could be a source of hip pain. Because the upper thigh bone (femur) is connected to the hip at the top and the fibula and tibia at the bottom (lower leg), if a person is experiencing pain that in any part of the muscles of bones in the leg itself, this could create pain to be felt in the hip. 

Common locations for hip pain can include: 

• Outside of the hip
• Lower back
• Groin area
• In the buttock
• Down the back of the leg and into the thigh
• Down the side of the leg and into the knee

Due to the fact that the hip is a literal hub of movement, pain felt in the hip can be experienced elsewhere in the body, and pain originating in other parts of the body can also be felt in the hip. Not only do physical characteristics of a person’s body, including the natural shape of the hip joint, play a role in the possibility of hip pain, so do lifestyle habits and family history. While the anatomy of the hip is one main part of what could cause hip pain, it’s only part of the picture. 

What Causes Hip Pain? 

Hip pain can be systemic, relating to a particular system in the body, or can be related to the physical function and structure of the hips themselves. 

Two of the most common trauma-related reasons a person will experience hip pain include:

• Injuries and trauma: the two most common causes of hip pain, a person can unfortunately experience an injury from a single instance or repeated use of the hip joint, or from a one-time traumatic event. A person doesn’t have to be incredibly active, as even people who live a very sedentary life can succumb to hip pain. Hip dislocations, broken leg, car accidents, falls or car accidents, sports-related fractures, repetitive muscular strain injuries, hip flexor strains, and more. Pain that is left untreated can become chronic, so it’s important to utilize therapy and rehabilitative methods after a traumatic event. 
• Bursitis: when the bursa, the sac in the hip joint that provides cushion and movement, becomes irritated or inflamed, it causes a painful swelling and possibly burning sensation that increases with hip movement

Some of the most common disease-related reasons a person could experience hip pain include: 

• Osteoarthritis: one of the most common causes of arthritis in the United States, osteoarthritis (OA) is a degenerative joint disease that most often affects women, people older than 55, obese people and those who have experienced previous joint trauma or disease. Osteoarthritis is typically one sided and can occur in any joint and is a direct result from repeated wear and tear. Some patients also experience crepitus, which is a cracking or popping noise due to the breakdown of cartilage creating rough edges to rub together. This can create limited mobility and pain that generally improves with rest and worsens with activity. 
• Rheumatoid arthritis: a chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility, rheumatoid arthritis (RA) happens when the body’s immune system attacks its own tissue, including joints. This is a chronic inflammatory disorder that mostly affects women aged 35-50, but can affect anyone. It’s characterized by symmetric involvement of the large and small joints, and is thought to be triggered by viruses and bacteria infections, as well as genetic factors. 
• Avascular Femoral Head Necrosis: Avascular necrosis is the death of bone tissue due to a lack of blood supply, which has either been interrupted or reduced. Also called osteonecrosis, it can lead to tiny breaks in the bone and cause the bone to collapse. Reduced blood supply can be caused by injury or trauma, fatty deposits in blood vessels, arthritis, or other diseases. Pain associated with avascular necrosis of the hip might center on the groin, thigh or buttock. If left untreated, avascular necrosis worsens and eventually the femur bone can collapse and fracture, which can lead to additional complications.
• Labral tears: the hip socket is lined with labrum, or cartilage, which allows for smooth movement in the hip socket. If the labrum is torn, generally due to wear and tear, it can result in painful movements and generally a catching or locking sensation within the hip. 
• Lumbar radiculitis: radiculitis is a term used to describe the symptoms felt when a nerve or nerve root is pinched, irritated or inflamed, which can happen for various reasons. It can affect any part of the spine, but it most commonly occurs in the lower back (lumbar region) or in the neck. This pain is known as referred pain because while it is caused in the low back area, it is felt in the hip. 

How is Hip Pain Diagnosed? 

The best way to begin feeling relief from your hip pain is to make an appointment with a pain management specialist. Since the cause of hip pain is not always straightforward, a medical professional will have to perform a comprehensive physical exam as well as review the patient’s medical, health and family history. To get more information into each patient’s particular hip pain, the provider could ask: 

• What were you doing when you first noticed hip pain? 
• When do you feel the pain, i.e. time of day, activity level, etc.?
• Where do you feel the pain?
• Have you tried any at-home methods that have provided any pain relief?
• Does hip pain run in your family? 
• Do you suffer from any other medical conditions?

In addition to a physical exam, your provider will most often utilize imaging devices, such as X-rays (to look at solid structures), MRIs (to see a detailed look into the body) or CT scans (to see cross sectional views of the body’s structures) that help to provide greater insight into the hip joint and the surrounding muscles and connective tissues. Blood work can also help to rule out certain causes, and testing the fluid in the joint itself, including amount and consistency, helps to provide answers as well. 

The most important tool your pain management specialist will have is you, as the patient. Learning about each patient’s particular feeling of hip pain working together to create a customized treatment plan is the best way to ensure a successful – immediate and long-term – pain relief outcome. 

What Treatment is There for Hip Pain? 

There are several treatment options for hip pain, all dependent upon the cause or causes of the pain. Pain management specialists will most often begin with the least invasive options, which include RICE (rest, ice, compression and elevation), as well as over-the-counter medications, staying as active as possible and physical therapy. 

If these methods fail to provide the patient with pain relief, the next step could be joint injections. Not only are joint injections a minimally-invasive and low-risk treatment option that are comfortably performed in a doctor’s office, they also provide immediate relief, help to reduce inflammation, and can also be used as a diagnostic tool. Because pain relief is felt immediately, this provides patients with the ability to get back to an active lifestyle as well as comfortably take advantage of physical therapy, which will help for healing on a long-term basis. 

There are surgical options for patients who are unable to find relief, such as hip arthroscopy and hip replacement surgery, but these are often used as a last resort. 

Can I Prevent Hip Pain?

Sometimes! Due to the fact that hip pain can be caused by medical conditions beyond a patient’s control, the ways you can try and prevent hip pain are more along the lines of lifestyle and health changes. But, it’s always important to see your medical provider regularly so if there is anything that has changed, or is changing, with the physical makeup of the body, treatment can begin as soon as possible. 

In regard to personal prevention, patients can focus on exercising safely. This includes wearing the correct protective equipment, stopping exercising if pain is felt or if a clicking or popping noise is heard, stretching and warming up before beginning exercise, cooling down properly, and giving your body time to rest properly in between workout sessions. 

It’s also helpful to ensure a safe at-home space that is free of clutter (avoiding chances of tripping/slipping/falling), using the proper tools and equipment when reaching for objects, and using a cane or walking stick if you feel you need support for long walks or traveling. 

If you have hip pain and aren’t sure what to do, please reach out to the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas today. Regardless if you experienced a traumatic injury, believe the pain is a result of an underlying medical condition, or the pain has become unbearable and you’re not sure why, our team of dedicated pain management specialists can accurately diagnose and efficiently treat all causes of hip pain with a goal to get our family of patients out of pain and back to enjoying an active lifestyle.