Pain on the outside of the hip
Pain that preferentially occurs on the outside of the hip can have several causes, although these may not always be in the hip joint itself. The most common is inflammation of the bursa (bursitis trochanterica) or the hip muscle-tendon attachments in the area of the large rolling hump, which is located in the lateral area of the hip. Typical is a pressure pain in the area of the outer hip/outer thigh, so that the patient often cannot lie on the affected side.
In addition, pain can also occur when walking, running, sitting and climbing stairs. Furthermore, nerve irritation (neuralgia) in the hip area can be the cause of lateral hip pain. On the one hand, small skin nerves in the area of the outer hip can be affected (meralgia paraesthetica in the case of irritation of the N. cutaneus femoris lateralis), but on the other hand, incarcerations, contusions or damage to larger nerves originating from the spinal cord or spinal column (N. ischiadicus, N. femoralis, N. obturatorius) are also possible, which can lead to pain and disturbances in muscle control.
Irritation of skin nerves can be caused, for example, by constant pressure when wearing too tight clothing or by extreme weight gain in the abdomen (even during pregnancy!). Incarceration of larger nerves, such as the sciatic nerve, can be muscularly induced or caused by a slipped disc in the lumbar spine. The irritation of skin nerves is usually manifested by burning, stabbing pain on the outside of the hip, often accompanied by tingling and numbness.
The classic sciatica pain is characterized by stabbing, pulling hip pain radiating into the lower back and the back of the leg, accompanied in one case or another by muscle weakness or numbness in the affected side of the leg.In addition to nerve irritation, traumatic events in the hip area are also possible, so that bruises, strains, sore muscles, bruises or broken bones can lead to pain on the outside of the hip. The possible causes mentioned so far usually lead to unilateral hip pain in the outer area. If pain occurs on both outer sides, more systemic joint diseases must be considered (hip arthrosis, rheumatism, gout, osteoporosis, vascular diseases such as peripheral arterial occlusive disease).
Hip pain can also occur during pregnancy. During pregnancy there is a natural release of pregnancy hormones, which cause the ligaments and joints of the pelvis to become more elastic and looser to facilitate the delivery of the child. This process can cause severe hip pain in some women.
In addition, the increase in size of the child and the increase in weight of the pregnant woman leads to a strong additional load on the pelvis, which further promotes the development of hip pain. In addition, a number of different diseases can be the cause of hip pain during pregnancy. Hip pain, which occurs in the pregnancy, is usually difficult to treat.
Physiotherapy, pelvic floor gymnastics and orthopedic support belts are often prescribed to strengthen the pelvic muscles and relieve the pelvis. Pregnant women should also take care not to lift objects that are too heavy and to take sufficiently long breaks from sitting. Various medications, such as paracetamol, can also relieve hip pain during pregnancy in some cases.
If the pregnant woman suffers very strongly from the hip pain, hormone therapy or even a Caesarean section delivery must be considered if necessary. Also in children, strains of the hip muscles, tears or tears in the hip muscles, as well as fractures of the pelvic ring and the neck of the femur can be the cause of hip pain. However, there are also clinical pictures which typically cause hip pain only in childhood.
This includes, for example, the so-called coxitis fugax, which is also known as hip rhinitis in the vernacular. The hip cold (Coxitis fugax) is an inflammation of the hip joint, which particularly affects children before the age of ten. In addition to hip pain, which occurs suddenly and can radiate into the legs, children also notice a relieving posture with limping and limited rotation in the hip joint.
Usually a banal infection, for example cough or cold, precedes the hip cold. However, the exact cause of the development of hip rhinitis has not yet been conclusively clarified. Hip rhinitis can be diagnosed by means of an ultrasound examination.
In some cases, an X-ray examination is also useful. By sparing the hip joint, the hip cold disappears by itself within one to two weeks. Another clinical picture in children, which is characterized by hip pain and a relieving posture with limping and limited rotation in the hip joint, is the so-called Perthes disease.
Perthes disease is a circulatory disorder of the femoral head of unknown cause. The circulatory disorder leads to reduced blood supply and finally to the death of the bone tissue in the femoral head, which can be accompanied by considerable hip pain. Perthes disease can be diagnosed by means of an X-ray examination.
Perthes disease is treated either conservatively with splints, plasters and walking aids to relieve and stabilize the femoral head, or surgically. During the operation, an attempt is made to support the femoral head and to create an optimal position of the femoral head in the acetabulum. This is a very serious procedure that requires a comprehensive risk-benefit assessment.
Some children may experience hip pain during the growth phase. The pain is called growth pain because it is associated with growth processes. However, the cause of growth pain is ultimately unknown. Growth pain, which typically occurs in the legs, but can also occur in any other part of the body, such as the hip, is usually harmless and usually disappears by itself. Furthermore, congenital malformations of the femoral head and pelvis can cause hip pain in children.In addition, if hip pain persists, a tumor disease of the thigh or pelvic bone should always be considered.
