CONDITIONS

Hip Pain and Hip Health

Overview

The hip joint is the largest in the body—built to be both durable and allow for fluid movement. Serving as the connection between the legs and the torso, the hip joint plays a critical role in the body’s mobility. It is a ball and socket joint, meaning that the end of the femur bone (ball) sits within a larger indentation in the pelvis (socket), which guides its movement. With each step a person takes, the hip joint endures forces equivalent to two to three times the weight of the body. Though the hip joint is typically a very strong and stable joint, significant impact or accumulated impact overtime can cause injury. Hip injuries are fairly common, and the likelihood of sustaining a hip joint injury increases with age. Though many hip injuries can be treated with a combination of medication and physical therapies, many cases require an entire hip replacement.  Approximately 332,000 Americans received hip replacements in 2010.

What Causes Hip Pain and Hip Health

There are many potential causes of hip pain. If you are experiencing hip pain, make an appointment with your doctor. He or she will be able to best determine the cause of your symptoms.

According to The National Library of Medicine, the following are the most common injuries to the hip joint:

  • Strains/sprains, in which muscle, ligaments, or tendons are stretched or torn. Sprains and strains can be caused by sudden impact or overuse.
  • Bursitis, in which the fluid sac serving as a cushion for the bone becomes inflamed. Bursitis is most often caused by joint overuse.
  • Dislocations, in which the femur (leg) bone becomes dislodged from the hip joint. Dislocations are typically only caused by strong and sudden impact, though abnormalities in the hip joint can make dislocations more likely.
  • Fractures, in which bone breaks. Fractures are typically only caused by forceful impact, though certain diseases that affect bone density, such as osteoporosis, can increase the likelihood of a fracture.

Hip pain may also be caused by existing conditions affecting joint health such as arthritis.

Risk Factors For Hip Pain and Hip Health

There are many factors that can influence your risk of developing hip pain. These include: 

  • Age. The likelihood of hip pain increases with age.
  • Arthritis. Arthritis is an inflammatory disease that can cause hip pain. To learn more about arthritis, visit the Arthritis Condition Center.
  • Physical Activity. Athletes, especially those who undergo high impact training for many years, are more prone to injuries that may result in hip pain.
  • Sex. According to a recent study in the New England Journal of Medicine, women are almost twice as likely than men to need hip replacements. Women are also at a higher risk for diseases such as osteoporosis, which affect bone density. Approximately 70% of hip fractures occur in women.

Diagnosing Hip Pain and Hip Health

Diagnostic procedures for the underlying causes of knee pain vary. If you are experiencing knee pain, see a doctor. He or she will be able to conduct the proper set of diagnostic tests to determine the cause of your knee pain. Tests that your doctor may conduct include:

  • Medical history/family history. A complete medical history, including a list of symptoms and a family history of disease, will help your doctor better understand your risk of certain illnesses/conditions.
  • Physical exam to look for physical signs of knee injury/illness including discoloration, swelling, and warmth.
  • Imaging techniques, which help provide doctors with images of the knee joint tissues/bones. These include:
    • X-rays
    • CT scans (computed tomography)
    • MRI (magnetic resonance imaging)
  • Blood tests to rule out the presence of certain disease-specific proteins.

Living With Hip Pain and Hip Health

The following tips can help you live with hip pain:

  • Seek proper treatment. It may be tempting to delay a doctor’s visit by taking over the counter medications, but if you are experiencing hip pain that lasts more than a couple of days, you should see a doctor. It is also important to see a doctor after a fall or slip if you are experiencing any pain. A minor fracture, sprain, or ligament tear can become more serious if not treated correctly.  Doctors can also help you find the right treatment pathway for conditions underlying hip pain, such as arthritis
  • Give yourself time to rest. If your hip pain is the result of an injury, rest is essential to the healing process. If you have a chronic condition, pace yourself, making sure to not overexert yourself or your joints.
  • Talk to your doctor about your treatment plan and any effects of it that you feel. If a certain treatment method isn’t working or is causing unfavorable side effects, he or she will be able to help you find a plan that better suits your body and needs.
  • Consider all treatment options including physical therapy and surgical options.
  • Know your limits. If you are experiencing hip pain, avoid movements that place stress on the hip joint. These include crossing the leg, bending down beyond 90 degrees, and turning the feet inward.

For tips on living with an artificial hip, visit The American Academy of Orthopaedic Surgeons

Prevention

The following tips can help you prevent hip-related injuries and pain:

  • Keep a balanced diet and take supplements to make up for any nutritional deficits. Proper nutrition is key to maintaining strong, healthy bones as you age.
  • Exercise regularly but remember your own limits. Moderate exercise helps maintains strong muscles and bones, but overexertion can increase your risk of hip pain and injury.
  • Make your home a safe environment. Many hip fractures and falls, resulting in hip injuries, occur at home. Making small changes, such as installing handrails and removing clutter, can help you reduce your risk of fall and injury.
  • Consider taking a bone density supplement in addition to your multivitamin. This is recommended especially for women ages 65 and over, who are at a much higher risk of bone fracture.

Common Treatment

The proper treatment for your hip pain depends on the specific cause of the pain. Your doctor will be able to help diagnose the cause of your pain and choose the best treatment plan available. The most common forms of treatment for hip pain are medication, physical therapy, and surgery.

Medication

Pain relief medications come in different forms and strengths. All medications have side effects, and many pain-relieving medications can be highly addictive. Speak with your doctor about what side effects you can expect from the medications you are taking.

Over-the-counter (OTC) pain medications include:

  • Acetaminophen (Tylenol, aspirin-free Excedrin). Acetaminophen works on the parts of the brain that receive the “pain messages.”
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin/Advil) or naproxen (Aleve and Naprosyn). NSAIDs also reduce inflammation (swelling and irritation) and are also available in prescription strength.
  • Topical pain relievers are also available without a doctor’s prescription. These products include creams, lotions, or sprays that are applied to the skin in order to relieve pain from sore muscles and arthritis. Topical pain relievers may be especially effective in dealing with the pain of arthritis in joints (including knee) back pain, and even headache pain. These include:
    • Counterirritants, such as menthol and camphor, which create a burning or cooling sensation to distract from the pain
    • Salicylates, which relieve pain using the same ingredients as aspirin.
    • Capsaicin, the substance responsible for the spice of hot chili peppers, which relieves pain topically in an unknown manner.

Prescription pain relievers include:

  • Corticosteroids. Prescription corticosteroids provide relief for inflamed areas of the body by easing swelling, redness, itching, and allergic reactions. These include:
    • Bethamethasone (Celestone)
    • Prednisone
  • Opioids. These are narcotic pain medications that contain natural, synthetic or semi-synthetic opiates. Opioids are often used for acute pain, such as short-term pain after surgery. MedlinePlus, a service of the U.S. National Library of medicine warns that these drugs can be abused, can be addictive, and have been associated with accidental overdose deaths. Always take opioids precisely as prescribed.  Typically, prescriptions should not last more than three or four months:
    • Codeine
    • Fentanyl (Duragesic) — available as a transdermal patch
    • Hydrocodone (Vicodin)
    • Hydromorphone (Dilaudid)
    • Meperidine (Demerol)
    • Morphine (MS Contin)
    • Oxycodone (Oxycontin, Percocet, Percodan)
    • Tramadol (Ultram)

Surgery may be necessary for patients experiencing chronic hip pain or for those who do not experience relief with other treatment methods.

In some cases, arthroplasty, or hip replacement, may be necessary. In arthroplasty, damaged or diseased areas of the hip are removed and replaced with artificial parts. Provided the surgery is successful, the artificial parts decrease pain and allow for increased mobility. The success rate for hip replacement surgery is very high, with only 3-5% of patients requiring re-operation in the first ten years after surgery. Artificial hips are also extremely durable, lasting on average thirty years before requiring replacement. In rare cases, arthroplasty can lead to infection, blood clots, and abnormal bone growth. Talk to your doctor about whether or not arthroplasty is right for you.

Physical therapy is a necessity after many surgical procedures to help regain strength and mobility of the hip. It can also help reduce pain and increase mobility for patients experiencing hip pain who have not undergone surgery.  

Walking aides such as canes and walkers may be prescribed temporarily after surgery during rehabilitation periods, or as permanent aides to take weight off the hip joint and reduce pain.

Complementary and Alternative Treatment

According to the National Center for Complementary and Alternative Medicine (CCAM), the current available evidence is not strong enough to allow definite conclusions to be reached about whether any complementary approach is effective for chronic pain. However, a growing body of scientific evidence suggests that several approaches may help to manage pain. These include:

These approaches are:

  • Chiropractic treatment. Chiropractic treatment focuses on the restoration of the skeletal system, which may help relate certain forms of joint pain.
  • Acupuncture. Acupuncture is a form of traditional Chinese medicine in which small needles are inserted into the body at specific points designed to restore the flow of bodily energy. Studies have shown that acupuncture treatments are effective at stress relief and pain relief.
  • Massage. Studies show that massage therapy can help reduce pain and stress levels.
  • Mind and body techniques such as yoga, tai chi, and meditation. These may help strengthen the body and mind to better handle the stresses of pain.

Care Guide

If you are caring for a loved one who is experiencing hip pain, consider the following:

  • Be sympathetic. If you aren’t a pain-sufferer yourself, it can be difficult to sympathize with someone who is experiencing a great deal of pain. Do your best to listen to your loved one and put yourself in their shoes.
  • Encourage doctors’ visits, whether it is the first visit or a follow up visit. This will help to ensure your loved one is getting the proper medical attention.
  • Respect new limits. Hip pain may create new limits for your loved one’s mobility and energy.
  • Be positive and encouraging without disregarding the pain that your loved one is feeling.
  • Encourage a healthy lifestyle. Promote a healthy diet and physical activity within the limitations of your loved one.

When To Contact A Doctor

If feelings of pain in the hip last for several weeks and/or become disruptive to daily life, schedule an appointment with your doctor. He or she will be able to help diagnose the source of your pain. If you are experiencing sharp, intense hip pain, contact emergency services.

If you are taking pain medication and experience any of the following symptoms, call your doctor immediately:

  • Nausea/vomiting
  • Stomach pain
  • Dizziness
  • Changes in sleep habits
  • Irregular heart rate
  • Chest pain**
  • Sudden weight loss/gain
  • Rapidly worsening pain

** If you experience chest pain, call emergency services. This may be a sign of heart attack.

Questions For Your Doctor

To find a general physician, visit www.healthgrades.com

To find an orthopedists (doctor specializing in musculoskeletal care), visit AAOS

To find a pain management specialist, visit pain.com

Questions For A Doctor

You may want to ask your doctor the following questions:

  • What is causing my pain?
  • How long wills the pain last?
  • What treatments are available?
  • What are the side effects?
  • How long will treatment last?
  • Should I consider surgical options?
  • What surgical options are available to me?
  • What are the benefits and risks of surgery?
  • What can I do to manage my pain?
  • Should I be concerned about developing other conditions as a result of my pain?
  • How will my condition limit my mobility?