Causes of pain in the hip

pain in hipFootball coach Ronnie didn't think much of the mild pain in his right hip and didn't let it interfere with his work. But the symptoms persisted. Within a couple of weeks, range of motion in his hip reduced and he developed low back pain as well. He discussed the problem with his team physician, who suggested some exercises. Exercises provided some relief, but a year on and the pain was back with a vengeance. His physician referred him to an orthopedic surgeon. A couple of tests later, Ronnie was diagnosed with osteoarthritis of the right hip. He would need hip replacement surgery to repair the damage to his hip and get rid of the pain permanently.

Hip pain may not be easy to discern. You may think you have pulled a groin muscle, where it could actually be a hip problem. 'Because hip pain often presents in the groin area, a lot of patients come to me thinking they've pulled a muscle, when in fact they have arthritis of the hip or a hip impingement,' says Dr. Thomas Bradbury, assistant professor of orthopedic surgery.

You may have a problem in the hip joint, if you feel the pain in the groin, on the outside of the hip, down the front of the leg, or even in the knee. Sometimes knee pain is the only sign of a hip problem, or maybe, the pain you feel in your buttocks is because of a hip problem. This pain, however, can also be caused by problems with the lower back.

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What causes hip pain? Let's check out the possible causes of your hip pain.

1. Muscle and tendon strain in the hip area can cause hip pain. The strain can occur because of over-stretching, overuse, or a sharp blow to your muscle or tendon. Avoid doing too much too quickly. This may increase your risk of muscle strain. Also remember to warm up properly before exercising.

2. Hip fractures can also cause obvious pain in the hip. It is more common in the elderly as with age the hip bones (or any bone for that matter) become fragile and are prone to fracture. This is called osteoporosis. Osteoporosis related fractures are more common in the hip, wrist, or spine.

3. Arthritis

Arthritis is the most common cause of hip pain. Although the exact cause of arthritis is not known, researchers believe genetics has a role to play in the development of arthritis. Five types of arthritis commonly affect the hip joints.

  • Rheumatoid arthritis: It is a type of inflammatory arthritis in which the synovial lining (a membrane that surrounds the joint like a capsule) swells and causes pain. The swollen synovium produces chemicals that destroy the cartilage covering the bone. Rheumatoid arthritis occurs in both hips at the same time.
  • Ankylosing spondylitis: This is a chronic inflammation of the spine that also affects the joint where the spine meets the pelvis. This causes lower back pain and stiffness. The arthritis may cause inflammation of the hip joint as well, causing pain in the hip. Although more common in men than women, ankylosing spondylitis can affect individuals of any gender and age. It typically starts at the age of 17 to 35 years.
  • Systemic lupus erythematosus: It is an autoimmune disorder that can affect the hip joints, causing pain in the hip. It commonly affects women in the age group of 15 to 35 years.
  • Psoriatic arthritis: Psoriatic arthritis causes joint pain, stiffness, and swelling that can affect any joint in the body. It can affect the hip joint as well. As the name suggests, the condition is related to psoriasis (red scaly patches on the body) and the arthritis develops prior to or after the symptoms of psoriasis are evident.
  • Osteoarthritis: It is the arthritis of the bone that occurs because of wear and tear of the joints. This type of arthritis usually affects the older people and those who are obese. Previous damage or injury to the hip could also cause this arthritis.

4. Hip impingement

This is actually a type of osteoarthritis where there are structural problems with the hip joint. Hip impingement, is usually a congenital (you are born with it) condition in which the hip bones are shaped abnormally and they do not fit together perfectly, so the hip bones rub against each other and cause damage to the joint causing the pain. Sharp stabbing pain occurs in the groin area, more towards the outside of the hip. The pain normally occurs with turning, twisting, sitting, or walking up the stairs. It should not occur when you are sleeping or walking on ground level. The pain can sometimes come through as a dull ache, and not necessarily as a stabbing pain. Unlike rheumatoid arthritis, it affects only one hip.

Hip impingement may also cause a labral tear. The labrum is the ring cartilage that attaches to the rim of the hip socket.

See a doctor if your pain doesn't resolve with hip rest and over-the-counter anti-inflammatory medicines.

5. Avascular necrosis

Avascular necrosis is the death of bone tissue due to a lack of blood supply to the region. When the hip bone is fractured or dislocated, blood supply may be cut off causing necrosis. The bone begins to break and then collapses. Early on you may not experience any symptoms. As the disease progresses, one or both hip joints hurt when you put weight on them, and gradually it may hurt even when you are lying down. Pain can be focused in the groin, thigh or buttock.

6. Cancer

Bone cancer, leukemia (cancer of the blood forming tissues such as bone marrow and lymphatic system), and other cancers that spread to the hip bone can cause pain in the hips.

7. Sciatica

The sciatic nerve is a large nerve that runs from each side of the lower spine through the hips and buttocks, down the back of the thighs, to the feet. The nerve connects the spinal cord with the leg and foot muscles. Sciatica is the pain caused by the compression of the sciatic nerve because of a herniated disk or bone spur anywhere in the pathway. If it is in the hip region, it is the sciatica of the hip. The pain is usually sharp and searing and not dull. See your doctor if the pain persists for more than a week or if it gets progressively worse.

Most cases of hip pain go away on their own or after taking pain medications. However, if you have had a fall or an injury, or the pain gets worse progressively and interferes with your daily activities, check with your doctor.

Image source:Getty Images

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  •, (2014). Femoroacetabular Impingement (FAI)-OrthoInfo - AAOS. [online] Available at: [Accessed 19 Aug. 2014].
  • Washington University Orthopedics, (2014). Arthritis of the Hip - Types, Symptoms, Diagnosis, Treatment. [online] Available at: [Accessed 19 Aug. 2014].
  •, (2014). Avascular necrosis Definition - Diseases and Conditions - Mayo Clinic. [online] Available at: [Accessed 19 Aug. 2014].
  •, (2014). Hip pain Causes - Symptoms - Mayo Clinic. [online] Available at: [Accessed 19 Aug. 2014].
  • Spine-health, (2014). Sciatic Nerve and Sciatica. [online] Available at: [Accessed 19 Aug. 2014].

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