In this blog we explore the common causes of hip pain and why it is rarely the hip (or acetabulofemoral) joint itself to blame when “hip” pain is present.
Hip pain is a common presentation in the clinic, and everyone’s differentiation of hip pain is different. The true hip joint is located to the medial side of your thigh, this is where your femur (thigh bone) attaches to the acetabulum of the pelvis, or more commonly referred to as the groin. The joint is a ball and socket joint, designed for high levels of mobility which aids us in playing sports and our daily activities.
Common mechanisms
Hip pain can be caused through many causes, here are just a few we see frequently
- Occupation related – Hip and lower back pain are commonly seen in professions with a lot of sitting and a lot of driving, trades that have heavy toolbelts can commonly cause problems in the hip as well.
- Sport – Overuse and traumatic accidents can cause a multitude of hip injuries. Often sports with high running and jumping loads are frequently causing grief to the hip.
- Chores – activities (or hobbies) such as gardening can cause hip complaints, especially around the spring time when that load increases, spending lots of time in a semi- squat position or on our hands and knees trimming bushes and pulling out weeds. But then other activities such as vacuuming seems to cause pain in many individuals.
- Posture – Any posture that we spend too much time in has the potential to build up pain. Whether it be sitting all day or standing all day. The most important thing to do is keep changing your posture, get that blood moving and use your muscles!
Potential Structural Causes
Because of the high joint mobility and strength required through the hip there are many structures that can be the cause of your hip pain. Some of the common causes are:
- Referred gluteal pain – the glutes are a group of muscles that attach to the posterior part of our hip. Trigger points, weaknesses and strains can refer to the joint as well as the front of the hip and groin pain.
- Impingement – Labral tears (or FAI – femoral acetabular impingement) are a frustrating injury commonly seen in athletes of high intensity sports and runners. This can present as ‘catching’ and sharp pains especially on flexion and rotation. In serious cases arthroscopic surgery may be required when conservative management fails. There are a couple of common variants of impingement and imaging is often required to differentiate.
- Tendinopathy/Bursitis – As the hip and pelvis are common attachment sites for our muscles many tendons can become unhappy. These include quadriceps, adductors and gluteal tendinopathies. This presents as moderate pain at the beginning of activity or early mornings that gradually improve with exercise, only to come back as a gnawing pain a few hours after exercise. This will require activity modification and progressive tendon loading to enable return to sport or activity. Bursitis can be directly related to a gluteal tendinopathy and will often cause pain laying on the affected hip resulting in restless sleep and an inflamed/burning pain.
- Osteoarthritis – Common in the older patients we see in the clinic. Although osteoarthritis is even seen in patients aged in their 40s. This can be due to natural ageing or secondary from previous traumas or overuse from sports or active jobs. Pain can usually be managed through exercise prescription, weight loss and healthy lifestyle choices. If these are not implemented surgery with a partial of full hip replacement may be recommended.
- SIJ sprains – Your sacroiliac joint is where your hips, tailbone and lumbar spine all connect to one another. Depending on which or how many of the ligaments are irritated the pain can spread from the lower back through the hips and to the groin. Patients often notice this pain going from a sit to stand position, feelings of unsteadiness particularly when doing exercise loaded onto one leg (like a lunge or getting in and out of the car). This is also an area commonly sore with pregnant women. Due to the obvious extra load being carried through the joint, but because ligament laxity is prominent to allow to pelvic girdle to change shape for the impending birth. With relative rest from aggravating activities combined with specific exercise rehabilitation a good recovery can be achieved.
Treatments we offer
For your pain we have a wide range of skills that we can utilise, they include but are not limited to :
- EWST Shockwave Therapy – for tendinopathy patients
- Soft and Deep tissue massage
- Dry needling
- Cupping
- Stretching
- Manipulation and articulation
- Exercise prescription
These are just a few of many structures that can cause hip pain and most have different treatment and management strategies, so be sure to book in with one of our fantastic osteopaths today for an assessment and an individualized plan moving forward.