Hip pain is a widespread phenomenon that can affect both young and old people. Also the causes of hip pain can be manifold. Nevertheless, it can be observed in clinical everyday life that different causes of hip pain can often be assigned to specific age groups.
In general, the causes of hip pain are divided into congenital and acquired diseases. Furthermore, acquired causes of hip pain can be divided into a traumatic (caused by an accident) and an atraumatic (not caused by an accident) group. In this context, hip pain can be caused by disorders of the muscle-ligament apparatus and by changes in the bony hip.
Degenerative causes for the development of hip pain are often found, especially in older patients. Due to the variety of possible illnesses that can make themselves felt through hip pain, those affected should observe exactly where the complaints are localized and in what context the pain develops. In general, if hip pain occurs frequently and/or lasts for a long period of time, a specialist should be consulted promptly and the exact cause clarified. The most common causes that lead to the development of hip pain can be treated quite well, especially in the early stages. Advanced processes, on the other hand, usually require more extensive therapy and have a much worse prognosis.
Causes for unilateral hip pain
In most cases, unilateral hip pain is related to an incorrect posture of the body axis. Many of the patients affected tend to shift a large part of their body weight to one leg, for example while standing. This results in an imbalance of the entire body, which over a longer period of time leads to an increased increase in the musculature on the load side.
After all, the patients concerned tend to assume an unbalanced position not only when standing but also when sitting or walking. In many cases, the cause of hip pain in women in particular is that they put small children on their hips while carrying them. Typical causes for the occurrence of unilateral hip pain in childhood are insufficient hip joint maturation, impairment of the individual hip joint components (for example in Perthes disease) and traumatic injuries to the bony structures or the muscle-ligament apparatus.
Patients suffering from unilateral hip pain should observe, if possible, where the pain occurs and whether it radiates to other parts of the body. In addition, the quality of the hip pain (stabbing, burning, dull) also plays a decisive role in the search for the underlying causes. Hip pain, the causes of which are to be found in the area of the muscle-ligament apparatus, has a burning character in most cases.
In addition, in the case of a muscular cause, hip pain is described as very extensive and agonizing. The majority of patients report pain radiating into the legs, back or buttocks in the case of hip pain whose cause is not to be found in the area of the hip joint itself. In addition, hip pain with muscular causes is usually strongest in the morning, after getting up or directly after periods of stress.
Adequate, light movement units during the day, on the other hand, usually lead to an improvement in hip pain in the case of muscular diseases or pathologies in the connective tissue. Hip joint arthrosis (coxarthrosis) is one of the most frequent causes of hip pain, along with pathologies of the muscle-ligament apparatus. This disease is a wear-related, slowly progressing, non-inflammatory change of the hip joint.
As a rule, this cause of hip pain mainly affects old and/or overweight people. The most common reason for the occurrence of such a wear and tear disease is a mismatch between the load acting on the joint and the actual load capacity of the various parts of the joint. Other causes of unilateral hip pain are: inflammatory changes in the hip joint (coxitis) infectious inflammation of the hip joint (“hip rhinitis”)Hip rhinitis is also known as coxitis fugax or transient synovitis and is an abacterial, i.e. germ-free inflammation of the hip joint.Hip rhinitis is the most common affection of the hip joint in the growing age.
Typically, this disease occurs between the 3rd and 8th year of life, whereby both younger and older children can contract the disease. Adults can also suffer from hip rhinitis, but this is extremely rare. Hip fever is not contagious.
Skeletal system diseases Skeletal system diseases can also affect the hip joint and/or the thigh bone and can lead to hip pain. These diseases include osteoporosis, which is characterized by reduced bone density, and osteomalacia, which is characterized by painful bone softening in adults due to a lack of vitamin D. Local thickening and deformation of the bone due to increased bone remodeling, known as Paget’s disease, can also cause hip pain. Congenital hip joint dysplasia (developmental disorder of the acetabulum)
- Inflammatory changes of the hip joint (Coxitis)
- Infectious inflammation of the hip joint (“hip fever“)Hip fever is also known as coxitis fugax or transient synovitis and represents an abacterial, i.e. germ-free inflammation of the hip joint.
Hip rhinitis is the most common affection of the hip joint in the growing age. Typically, this disease occurs between the 3rd and 8th year of life, whereby both younger and older children can fall ill. Adults can also suffer from hip rhinitis, but this is extremely rare.
Hip fever is not contagious.
- Skeletal diseasesDiseases of the skeletal system can also affect the hip joint and/or the thigh bone and can lead to hip pain. These diseases include osteoporosis, which is characterized by reduced bone density, and osteomalacia, which is a painful softening of bones in adults due to a lack of vitamin D. Local thickening and deformation of the bone due to increased bone remodeling, known as Paget’s disease, can also cause hip pain.
- Congenital hip joint dysplasia (developmental disorder of the acetabulum)
- Slippage of the growth plate in case of femoral head detachment (Epiphysiolysis capitis femoris)
- Impingement of the hipThe term impingement means something like entrapment or also bumping and describes the bumping of the femoral neck bone against the front roof of the hip socket at the hip. This is favored by certain movements in people with form deviations at parts of the hip joint.
The bending and also the inward movement of the thigh should be mentioned here. Those affected complain of pain located deep in the groin, which initially occurs mainly during prolonged exertion. Especially activities where the movement pattern described above predominates, such as climbing stairs or cycling, cause these complaints.
In case of a Meralgia paraesthetica, the affected persons feel a nerve pain, a so-called neuralgia.
This is caused by an inflammation of the lateral skin nerve of the thigh (nervus cutaneus femoris lateralis). It is usually caused by compression of the nerve in the region of the inguinal ligament or by mechanical pressure from outside, for example from body fat, skin-tight clothing or seat belts (“seat belt syndrome”). Affected patients describe burning pain on the upper outer side of the thigh, which can be accompanied by sensations such as tingling or numbness of the skin.
- Intrabony ganglionAn intrabony (subchondral) ganglion is a small, roundish cyst located in a bone near the hip joint. It can be located either in the femoral head or the acetabulum, where the small cyst is located below the articular cartilage. If the cyst causes an irritation of the nearby hip joint, this can lead to complaints in the hip area.
The term intraosseous ganglion means a benign tumor located in the bone, which can be detected with the help of an X-ray.
- Rheumatic processes
- Meralgia paraesthetica (Bernhardt-Roth syndrome)In case of a Meralgia paraesthetica, the affected persons feel a nerve pain, a so-called neuralgia. This is caused by an inflammation of the lateral skin nerve of the thigh (nervus cutaneus femoris lateralis).This is usually caused by compression of the nerve in the region of the inguinal ligament or also by mechanical pressure from outside, for example from body fat, skin-tight clothing or seat belts (“seat belt syndrome”). Affected patients describe burning pain on the upper outer side of the thigh, which can be accompanied by sensations such as tingling or numbness of the skin.
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