Hip pain is one of the most common musculoskeletal complaints and can affect both the hip and the hip joint. The causes of hip pain are varied and range from muscular problems to advanced osteoarthritis. Hip pain often initially occurs only during physical activity but can also become chronic. A typical symptom is pain in the hip that may radiate into the leg, thigh, or groin.
Inflammation, hip impingement, or avascular necrosis of the femoral head are also possible causes. The exact cause of the symptoms should be determined through a medical examination. Modern imaging techniques help detect hip joint disorders at an early stage. Targeted treatment can relieve hip pain and improve mobility.
Hip Pain and What Might Be Causing It: The Main Causes
The hip joint is involved in all movements between the spine, torso, and legs. It is therefore hardly surprising that improper movement and overexertion are among the most common causes of hip pain. Pretty much everyone has experienced hip pain to some degree at some point in their lives. Anyone who has experienced severe pain knows just how much it can interfere with daily life.
When searching for the causes, a thorough and differentiated evaluation is important, as hip pain can stem from various underlying causes. The appropriate form of treatment, of course, depends on the specific cause.
In older age, hip pain is often the result of wear and tear (osteoarthritis). Since the hip joint is subjected to intense stress throughout life, it is particularly susceptible to wear and tear. Signs of wear and tear usually do not appear until middle age. However, this is not necessarily the case. Depending on an individual’s physical condition and lifestyle, wear and tear in the hip joint can become noticeable much earlier—for example, following an accident or a severe hip injury sustained at a young age.
Sometimes hip pain can also be a symptom of an inflammatory condition, such as rheumatism. Patients usually also experience pain in other joints (e.g., the fingers) and often report morning stiffness in their hands. A feeling of fatigue and fever are also sometimes accompanying symptoms.
Occasionally, however, the hip joint may be “affected” by another condition that has nothing to do with the joints. This can occur, for example, a few weeks after an infection (gastrointestinal, flu-like, viral, etc.); according to current medical understanding, this is referred to as reactive arthritis.
In addition, metabolic disorders or blood disorders such as gout or hemochromatosis can also affect the function of the hip joint. Overuse injuries can also lead to pain in the hip area, for example, when a bursa becomes inflamed.
However, especially among athletes, pain can also occur in the muscle-tendon area. For example, if the hip flexor is strained, the pain may radiate into the hip. Conversely, pathological conditions affecting the hips can also cause pain in the legs or the groin area. Conditions such as avascular necrosis of the femoral head also manifest as hip pain in advanced stages. Congenital conditions, such as hip dysplasia, can also cause pain in the hip joint.
The following factors can lead to hip pain:
- Injuries and accidents
- Congenital joint malformations
- Degenerative diseases
- Inflammation
- Overuse or injuries in the muscle-tendon area
- Circulatory disorders
- Metabolic disorders
- Bursitis
- Joint effusion
Symptoms: How hip joint pain manifests itself
Hip pain can be just as varied as the causes of these problems. Generally, a distinction is made between pain that is triggered by activity and pain that occurs even at rest.
If the pain is only noticeable during activity, it is often a sharp, sudden, or gradual pain. Pain that occurs at rest often feels dull.
The Diagnosis: Movement Tests and Imaging Procedures
Of course, there are diagnoses—such as injuries involving fractures or dislocations—that can be made very quickly.
Since hip pain can have various causes, a thorough diagnosis is extremely important. This begins with taking a medical history (anamnesis). During this process, the patient provides a detailed account of current and past symptoms. In addition, the location of the pain is determined and its intensity assessed. Even at this stage, an experienced orthopedic surgeon can form initial suspicions and rule out potential causes.
The medical history is followed by a comprehensive physical examination. Naturally, the focus is on the hip joint, but the spine and knees are also examined. In addition, various movement tests can be helpful for diagnosis. These are used by orthopedic surgeons and sports medicine specialists to differentiate between various clinical conditions.
In addition to a consultation and a thorough examination, the use of imaging techniques may be appropriate depending on the symptoms. Important information about the condition of the hip joint is provided, for example, by
- ultrasound examinations (sonography),
- X-rays,
- computed tomography (CT), and
- magnetic resonance imaging (MRI).
What can be done? The most important treatment methods
Treatment depends on the underlying cause of the hip pain.
If, for example, the issue is muscular problems or improper weight-bearing, professional physical therapy can help. The therapist may perform a gait analysis or use targeted exercises to correct any muscular imbalances.
Following accidents or other injuries involving cartilage damage or bone involvement, surgical treatment is often necessary. Here, too, physical therapy can help reduce pain or manage it long-term. If metabolic disorders or inflammatory processes are present, appropriate medications are prescribed.
If the patient suffers from gout, for example, anti-inflammatory medications may be considered for treatment. Ibuprofen or diclofenac are particularly commonly prescribed in such cases. Cold therapy can also provide relief. In addition, patients with gout must adjust their diet to reduce flare-ups and the associated pain.
Hip surgery is considered the treatment of choice when conservative treatments are no longer effective. Thanks to advances in modern medicine, procedures such as arthroscopic hip surgery (arthroscopy) can be used to remove inflamed synovial tissue or reduce excess bone that causes femoro-acetabular impingement (FAI).
The use of an artificial hip joint should only be considered after conservative therapy has been exhausted. You may also want to seek a second opinion at a center that specializes in such procedures (“Maximum Care Endoprosthesis Center”).
Minimally invasive surgical procedures, in which no muscle groups need to be cut (“Micro-hip”), are particularly gentle. In an artificial hip joint, the acetabulum and femoral stem should be aligned with each other in such a way that a range of motion free of impingement is ensured in everyday life (“key-lock surgical technique”). Precise digital surgical planning and intraoperative verification of the trial components using fluoroscopy enable an accurate reconstruction of the hip anatomy.
The following treatment methods may be used for hip pain:
- anti-inflammatory medications
- For gout: dietary changes
- Surgical repair of bone and cartilage defects
- Physical therapy for muscular problems
- Joint-preserving measures
- Hip replacement as a last resort
Which doctor treats hip pain?
Doctors from various specialties collaborate to treat hip pain: For problems involving cartilage, bones, muscles, tendons, and ligaments, the orthopedic surgeon is the first point of contact.
For metabolic disorders such as gout, both internists and rheumatologists may be consulted.
Occasionally, inguinal hernias can also cause pain in the hip area; in such cases, surgeons are the doctors of choice. Here, too, after reviewing imaging results and conducting clinical examinations, the physician will discuss an appropriate treatment plan with the patient.
FAQ
What are the most common causes of hip pain?
The most common causes of hip pain are osteoarthritis, hip osteoarthritis, inflammation, muscular issues, and hip impingement. In addition, bursitis, misalignments, infections, or conditions such as avascular necrosis of the femoral head may also be responsible. Since there are many possible causes, a thorough evaluation is important.
What are the symptoms of hip pain?
Hip pain can be sharp, aching, or chronic. The pain is often felt in the groin, buttocks, or on the outer side of the thigh. Another typical symptom is limited mobility of the hip joint. Severe hip pain can also make climbing stairs, sitting for long periods, or walking difficult.
When should you see a doctor for hip pain?
You should see a doctor if hip pain occurs suddenly, worsens, or persists for an extended period. A medical examination is particularly advisable in cases of swelling, inflammation, severe hip pain, or difficulty walking. Older adults should also seek an early evaluation.
Why does hip pain often occur on one side?
Unilateral hip pain is often caused by overuse, muscular issues, or changes in the hip joint. The cause of hip pain can include, for example, hip osteoarthritis, hip impingement, or inflammation. Hip pain can radiate into the thigh or leg.
How is hip pain treated?
Treatment for hip pain depends on the underlying cause. Common approaches include physical therapy, anti-inflammatory medications, and targeted exercises. In cases of advanced joint wear or severe hip osteoarthritis, surgery may be necessary. The goal is to relieve symptoms and maintain hip mobility in the long term.
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