Solving Hip Pain

There’s almost no limit to the ways patients describe hip pain—aching, burning, sharp, throbbing, dull, hot, radiating, searing, and even “stabby.” But no matter the descriptor, hip pain can be very limiting. From interrupted sleep and reduced balance to painful walking or even standing, it can limit your ability to engage in desired routines and can affect your quality of life.

The key to treating hip pain is figuring out what’s causing it. But because the cause of pain can originate from places other than the actual hip joint—for example, your back, groin, or even a hernia— it can be a bit of a puzzle to figure out how to treat it.  Imaging, a medical history, and a physical exam all help to inform the diagnosis and the treatment. In many cases, pain can be addressed with simple exercises, rest, ice, and oral or topical medications.

Here’s a look at four of the most common issues we see in our practice along with the first-line treatments we recommend:

Muscle strain or tear
If you have pain in your groin area, it might be the result of a strain or tear of muscles or other soft tissues in the lower abdomen. This type of injury often occurs in sports involving a lot of extreme twisting and turning, such as basketball, and especially in those who aren’t in peak physical condition (i.e. weekend warriors).

Treatment: For mild strains, several weeks of rest along with ice and anti-inflammatory medication can provide relief and help with healing. More serious strains might require support by physical therapy to heal. For some tears, surgery may be required.

Bursitis
Pain on the outside of your hip, thigh, and/or buttocks is a common symptom of bursitis. Pain from bursitis often persists whether your resting, active, or lying still. Caused by inflammation of the fluid sacs that keep tendons and muscles from rubbing directly against the hip bone, bursitis is especially common in older adults.

Treatment: Rest, ice, and anti-inflammatory and/or pain medications are commonly used to treat bursitis. Deep tissue massage techniques often help and can even be self-applied with a foam roller. You can roll the painful area of your body over the roller (a round piece of hard foam) to massage. Physical therapy can often assist with improving pain. In extreme cases, cortisone injection may be recommended to help with inflammation.

Tendonitis
Tendonitis occurs when you overuse or strain the tendons in your hip region. Activities that involve repetitive motion, such as long distance running, dance, or soccer, commonly contribute to tendonitis. Symptoms include soreness of the tendon—especially during movement—and tenderness to the touch. 

Treatment: Patients with tendonitis are encouraged to take a break from their activities causing the strain. Ice and anti-inflammatory medication should be used to help with swelling and tenderness. In addition, physical therapy may be recommended to help build strength and flexibility. At the end of the rest period—typically 1 – 2 weeks—patients should ease back into their routines to avoid re-injury.

Osteoarthritis
Osteoarthritis is a very common cause of stiffness and dull persistent hip pain, especially in older adults. The pain stems from a breakdown of the cartilage that cushions your hip bones and buildup of bone spurs that stiffen the motion in your hip. When this happens, the bones in the joint no longer fit together neatly and, eventually, begin to rub together when in motion. The pain gradually increases over time while you feel stiffness and the range of motion decreases. In addition to aging, traumatic injuries and high-impact sports can increase your chances of getting osteoarthritis.

Treatment: Early treatment for osteoarthritis includes rest, ice, activity modification to lower impact activity like swimming, bicycling, and walking and over-th- counter anti-inflammatory medications. If symptoms worsen, ultrasound-guided cortisone injections or platelet-rich-plasma injections to the hip joint can be consider to alleviate the symptoms. In severe case, where symptoms worsen and do not improve, hip replacement surgery is very successful in restoring function and a pain-free life.  

If you’re suffering with lingering hip pain, contact SVMC Orthopedics to schedule an appointment with a provider. Relief may be easier to achieve than you think.

Michaela Schneiderbauer, MD, is the medical director of SVMC Orthopedics.