Where is hip pain felt?

Hip pain can be felt deep into the hip joint but can also refer into your buttock, groin and sometimes down the front of your thigh. These pain referrals are similiar to lower back pain it is therefore important to gain a diagnosis to establish the cause of your symptoms.

What causes hip pain?

The most common causes of hip pain are osteoarthritis especially in older adults. Osteoarthritis leads to inflammation of the hip joint and the breakdown of cartilage that cushions of your hip bones. Hip bursitis, bursae are fluid filled sacs which can become inflammed and cause pain. Tendinitis is where the tendons that attach your bones to muscles become inflammed again. Both bursitis and tendinitis are generally associated with repetitive overuse movements. Muscular strains (especially your hip flexor muscle) can become inflammed and be painful on hip movements.

Less common causes of hip pain

Hip fractures are more common with age where the bones can become weaker and can break with falls.  Avascular necrosis of the hip is where the blood flow to the hip slows and the tissue dies. This is more likely to happen following a fracture or a dislocation. Kidney or digestion referral, inflammatory and vascular conditions and potentially cancer are other hip pain differentials. It is therefore important to gain a specific diagnosis in order to know how best to treat your condition. Hip labral tear, where the ring of cartilage within the hip joint (labrum) has torn. Athletes who have experienced a fall or a trauma with fast twisting movements are at higher risk of experiencing this problem.

What does bursitis in the hip feel like?

Joint pain and tenderness, there may also be swelling and feel warmth around the affected area. It will feel like a sharp pain for the first few days and then be dull and achy in nature afterwards. You will notice it more when going from a seated to a standing position. After prolonged sitting and when sleeping on the affected side. A bursitis can resolve relatively quickly (hours or days) or it can take longer (weeks and sometimes months). A bursitis can going away and then returning again with particular positions or movements. It would be best to see an Osteopath to gain a plan to optimise your healing process.

How do I know if hip pain is osteoarthritis?   

A pain that feels deep inside the hip joint and can refer to your groin, buttock and thigh. You will feel joint stiffness worse in the morning or after prolonged sitting. You will experience a reduced hip range of motion typically when you spread the legs apart. Extend the leg straight back, or to point toes inward and move the entire leg in that direction. Your hip pain will be feel better with short rest but you will feel stiff after longer periods of rest.  Typically hip osteoarthritis is more common for older people (60+ years old) and being overweight. In addition, female more than males, past history of hip trauma and with a family history of osteoarthritis.          

How is your hip pain diagnosed?

It’s not necessary to see your GP to gain a hip pain diagnosis for the majority of cases. Manual therapists (Osteopaths, physiotherapists or chiropractors) are able to diagnose hip pain. They will take a full case history and perform a physical examination with testing. Give you a diagnosis so you understand the cause of your pains. If the manual therapist then feel you require extra information a scan or GP referral will be made.

Treatment Options

Osteopath in Central London

An Osteopath will address the whole posture to get other areas moving more freely (typically knees, upper and lower back and other hip). This will reduce pressure onto your hip by distributing the forces more evenly. Osteopaths will use a combination of muscular stretching, joint articulations and joint manipulations (only when appropriate) techniques to increase the functionality of movement and reduce pain. You will be advised on how best to self manage your tensions. Be given both muscular stretching and strengthening exercises. Lifestyle and basic nutrition and hydration advice to optimise healing times to support you back into activity.

GP 

Considering how your hip pain started your GP will either refer to a physiotherapist for exercises. Orthopaedic consultant to discuss surgical options or accident and emergency if the hip pain is considered to need urgent attention. Medications will be prescribed for hip complaints.

Pilates in Central London

If the pain is not too severe then light exercise has shown to be beneficial for people with hip OA for reduced knee pain and physical function (Cochrane 2018). At Wellthy Clinic we big advocates for meaningful movement and Pilates exercises are a great for hip pain. The combination of stretching and strengthening exercises help increase blood flow to optimise inflammatory processes. In addition, increase functionality of joints, strengthens muscles and self empowers you to feel a little bit better. Exercises will be graded depending on the severity of your symptoms, regularly reviewed and changed to ensure progression.

Psychology

Chronic hip pain affects all domains of people’s lives. People’s beliefs about chronic pain shape their attitudes and behaviours about how to manage their pain. Without adequate information and advice from healthcare professionals, people do not know what they should and should not do. Therefore they avoid activity for fear of causing harm. Participation in exercise programmes may slightly improve physical function, depression and pain. Gaining reassurance and clear advice about the value of exercise in controlling symptoms will encourage greater exercise participation, which brings a range of health benefits (Cochrane Library 2018).

How long should hip pain last?

From an osteopath’s perspective typically an acute (experienced for less than 6 weeks) mechanical hip pain lasts 3-4 weeks. Longer lasting hip pains, depending on the cause and the individual will either take longer to recover. In both cases having a structured plan will enable you to take control of your tensions would be worthwhile.

References

Cochrane Library (2019) Paracetamol versus placebo for knee and hip osteoarthritis https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013273/full?highlightAbstract=knee%7Cpain

Cochrane Library (2018) Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010842.pub2/full?highlightAbstract=knee%7Cpain