Pain in the hip is often hastily attributed to hip osteoarthritis, especially in older people. But there can be a variety of different causes for hip pain. Learn here how to correctly interpret pain in the hip and what you can do about it.
Cause of hip pain sometimes difficult to determine
When pain in the hip occurs, it is not always the hip joint itself that causes the pain – it is not uncommon for hip pain to emanate from tendons, muscles or other joints in the hip area. Conversely, pain from diseases of the hip joint often radiates to the back, groin and leg. In addition, generalized diseases of the skeletal system – rheumatic diseases, for example – can cause complaints in the hip, among other areas. In order to make the diagnosis easier for the doctor, it is therefore important to characterize the hip pain precisely in terms of type, occurrence and duration. For example, does the pain occur on one side or both sides? Does the hip pain become noticeable when walking, sitting or lying down? Such information and the description of additional symptoms are important for the physician to find out the cause of the hip pain.
Acute hip pain after injury
If pain in the hip occurs suddenly, a strain of the hip muscles is often the cause. No trauma in the sense of an accident has to have taken place – often a wrong jerky movement, for example during sports, is enough. You should then take it easy for a few days and cool the affected area. If the pain is very severe or there is no improvement, you should see a doctor to rule out a muscle tear or a bony injury, just to be on the safe side.
Femoral neck fracture rarely causative
In rare cases, a femoral neck fracture may also be the reason for hip pain. Although fractures of the pelvis or hip joint are usually the result of a serious fall or accident, especially in older people with osteoporosis, even minor trauma can lead to a fracture of the neck of the femur under certain circumstances. This is then manifested by very severe pain in the hip, with walking and standing usually impossible.
Bursitis: pain when walking.
Inflammation of the bursa (bursitis trochanterica), which sits as a cushion between tendons or muscles and the thigh bone, can lead to pulling or stabbing pain in the hip. Initially, the hip pain occurs only during movement – for example, when walking – but later pain also occurs at rest. The cause is often overuse, which leads to irritation of the bursa. But bursitis can also occur with infections, gout or after hip surgery.
“Start-up pain” in hip osteoarthritis.
In hip osteoarthritis (coxarthrosis), gradual destruction of the joint cartilage occurs over the course of several years, usually caused by age-related wear and tear. However, injuries, circulatory disorders, metabolic diseases or congenital deformities of the hip joint can also cause hip osteoarthritis. Typical symptoms include a morning “start-up” pain that improves after movement, as well as a feeling of stiffness in the hip. In later stages, mobility may be limited and pain at rest may occur – discomfort may then occur at night when lying down.
Hip inflammation: unilateral pain on the right or left side
Hip inflammation (coxitis) can be caused by bacteria and then usually occurs after hip surgery or a hip puncture. However, bone marrow inflammation (osteomyelitis) can also lead to hip inflammation by passing the bacteria on. A so-called aseptic hip inflammation, i.e. without the involvement of bacteria, can occur, for example, in the context of rheumatic diseases or osteoarthritis. Regardless of the cause, inflammation of the hip is manifested by pain in the hip, usually on one side, which can occur under stress and at rest. In addition, there is often swelling, redness and overheating in the area of the joint.
Hip rhinitis after infection
A special form of hip inflammation in children is the so-called hip rhinitis (coxitis fugax). This refers to a temporary inflammation of the hip joint that often occurs about one to two weeks after a common cold or gastrointestinal infection. Symptoms are sudden pain in the groin and hip joint.This pain can even extend to the knee. A hip rash is usually harmless and disappears on its own after about seven to ten days. Affected children should take it easy and, if necessary, take anti-inflammatory painkillers such as ibuprofen or diclofenac to relieve the pain.
In children: Rule out Perthes disease
Hip pain in children can often occur as part of growing pains and is then usually harmless. However, Perthes disease may also be the cause: In this disease, death of the femoral head bone occurs due to a circulatory disorder. Symptoms of Perthes’ disease are pain in the hip and knee, often on one side. Affected children adopt a protective posture and limp when walking. Treatment initially consists of relieving the hip joint with the aid of splints and crutches as well as special physiotherapy. It is important that the children avoid jumping movements and impact loads. In advanced stages, surgery may be necessary to prevent malformation of the femoral head.
Epiphysiolysis: emergency in adolescents.
If adolescents suddenly experience such severe hip pain that walking and standing are no longer possible, the growth plate on the femoral head (epiphysiolysis capitis femoris) may be slipping. Most commonly affected are overweight boys after the age of nine. If epiphysiolysis is suspected, you should take your child to an emergency room immediately, because if left untreated, death of the femoral head can result. To prevent this, surgery is needed in many cases to fix the slipped growth plate.
Incorrect footwear when jogging
If hip pain occurs mainly during or after running training, sometimes the wrong or inappropriate running shoes are the cause. This is because if the impact load is not properly cushioned during running and the shoes do not provide optimal support for the foot, the joints are subjected to incorrect stress. Running surfaces that are too hard or uneven can also lead to hip pain when jogging. It is best to go to a specialist store for advice on the best footwear and the right running technique. You should also make sure to warm up with stretching exercises before running and avoid overly intense training. Under certain circumstances, a gait analysis by an orthopedist may also be useful to rule out a malposition of the feet.
Hip pain during pregnancy
Especially towards the end of pregnancy, women often suffer from hip pain that can radiate to the back and legs. This may be due to a variety of reasons:
- Hormonal changes cause a shift in the pelvic bones and a loosening of the pubic symphysis, which connects the two halves of the pelvis. Such pelvic pain is noticeable, for example, when climbing stairs or turning in bed.
- A one-sided sleeping position can also cause hip pain, as pregnant women usually sleep on their side, especially in the last trimester of pregnancy. The associated pressure on the hip can lead to pain in the long term.
- Another possible cause is weight gain. This is often associated with changes in the tissue and can also trigger tension due to the change in posture.
- In addition, pregnant women may experience increased bursitis in the hip as a result of the increased load.
If pregnant women suffer from hip pain, they should discuss this with their doctor. Often gymnastic exercises or acupuncture help to relieve the pain or prevent its development. A pillow between the legs can also help if hip pain occurs, especially at night when lying down.
