Hip pain: common causes and treatments

The hip is a large ‘ball-and-socket’ shaped joint, connecting the hip (or femur) bone to the pelvis. Injuries of the hip can come on slowly (chronic) or suddenly (acute) and require a range of treatments.

Chronic hip pain and issues

‘Chronic’ refers to a long-developing, ongoing issue, often relating to an illness or condition. Chronic problems of the hip can cause pain to be felt at the outside hip area, in the groin or inner thigh, and sometimes down the leg or into the knee.

The causes of these symptoms are usually either from injury to structures inside the hip joint (intraarticular) or from structures that surround the joint (extraarticular). In some cases, hip and groin pain may originate from your lower back and spine, rather than your hip.

One of the most common causes of chronic hip pain is osteoarthritis. Osteoarthritis is a condition that affects the cartilage of the bone surfaces gradually, leading to symptoms such as stiffness, swelling and pain around the hip.

The symptoms of osteoarthritis can be more noticeable after periods of inactivity, such as long car rides, or waking up in the morning. Clicking or grinding sensations during movement can sometimes be due to arthritis, but they can also occur in healthy joints.

In some cases, where the osteoarthritis is severe, joint replacement surgery is required and can have excellent outcomes. But current best available evidence recommends that several other treatment options should take priority in the early stages.

These options include a supervised exercise program, education about the condition, and weight management (if applicable). These types of management plans aim to build up the strength and control of your legs, encourage correct movement through your joints which is vital for optimal joint health, and create a plan for how you can get back to the activities that you love.

Acute hip pain and issues

‘Acute’ refers to a sudden, severe onset pain. Acute hip injuries are usually due to high or abnormal load placed through the joint. Situations that may lead to acute injuries include a fall, twisting awkwardly, or being tackled during sports.

In younger people, hip injuries are often the result of a sporting incident. This can be due to an unexpected tackle, increased training load or intensity without warming up appropriately, or a sudden change of direction

In older adults, a common injury is a fracture to the neck of the femur. The neck of femur is located at the top of the thigh bone and is most often fractured as a result of a fall. This injury is considered a medical emergency – it is very serious and should be treated by an emergency doctor immediately.

People are at a greater risk of this type of injury if they suffer from osteoporosis, use medications such as blood pressure and sedatives, or if they are at greater risk of falls. If you feel you may be at risk, your GP and allied health professional team can help to identify and reduce these risks to prevent injury. This may include seeing a physiotherapist, exercise physiologist or dietitian.

Treating acute hip injuries

The R.I.C.E.R principal is recommended immediately following an acute injury, especially within the first 24 hours:

• REST the joint, limiting movement
• Apply ICE for 15 minutes every 2 hours to reduce swelling
• Apply gentle COMPRESSION, such as a compression bandage
• ELEVATE the area above heart level, to reduce the amount of pain and swelling
• REFER, by going to see your GP or allied health professional for guidance and management

In all instances of hip pain, your GP (or emergency doctor) will be able to guide you regarding the extent of the injury and the management that is required.

A physiotherapist will also be important for your assessment and recovery, to manage your healing and symptoms, gradually building up your strength and control, and developing your function so you can successfully return to the activities you love.

Your GP or physiotherapist will refer you to a specialist doctor if required. For example, you might need other assessments, such as MRIs or x-rays. These are only used if a fracture is suspected, if the extent of your injury is unclear, or if further information is needed to manage your rehabilitation. It may be for a surgical opinion, if this is needed.

At Ramsay Health Care, we work with multidisciplinary teams made up of orthopaedic surgeons, medical staff, specialist nurses, physiotherapists and exercise physiologists. For more information, contact us.