Does any of this sound familiar?
- Groin, buttock or inner thigh pain, especially with weight bearing movements?
- Painful clicking in the groin?
- Knee pain
- Pain when going up stairs, vacuuming, walking or getting in and out of the car?
- Tenderness over the hips on either side of your low back?
- Tightness behind your hip joints when stretching?
- Pain in any of the areas above during or since pregnancy?
- Can’t lie on one side because of a deep pain around the hip against the bed?
- Toying with the idea of a hip operation?
- Stiff hip that doesn’t seem to move as much as the other?
If you have answered yes to one or more, I imagine life can be quite difficult at times. You may be suffering with hip pain – here at Shefford Osteopathic Clinic we are trained to asses and treat your hip pain, getting you moving again and on with your life.
What is hip pain?
Hip pain involves any pain in or around the hip joint. Hip pain is a common complaint that can be caused by a wide variety of problems. The precise location of your hip pain can provide valuable clues about the underlying cause.
Hip-related pain is not always felt directly over the hip. Instead, you may feel it in the knee, middle of your thigh or in your groin. Similarly, pain you feel in the hip may actually reflect a problem in your back, rather than your hip itself.
Some anatomy: by hips, many people mean the bony areas where we rest our hands. These are the hip bones (or ilium) of the pelvis, far from the actual hip joints. These are where your thigh bones join the pelvis.
The hip is a ball and socket joint – the largest in the body – that attaches the leg to the torso of the body. In the hip joint, the head of the femur (thighbone) swivels within the acetabulum, the socket, made up of pelvic bones.
The hip has two main functions; mobility, propelling the leg forward, and stability, linking the lower limb to the torso. The hip joint is designed to withstand repeated motion and a fair amount of wear and tear and fits together in a way that allows for fluid movement.
It supports most of the body’s weight and is key to maintaining balance. Because the hip joint and hip region are so crucial to movement, arthritis and bursitis in the area can be especially painful.
Hip pain is often difficult to describe, and patients may complain that the hip just hurts. The location, description, intensity of pain, what makes it better, and what makes it worse depend upon what structure is involved and the exact cause of the inflammation and injury.
Depending on the condition that’s causing your hip pain, you might feel the discomfort in your:
- inside of the hip joint
- groin – this may feel like a tightening or throbbing in the inner thigh
- outside of the hip joint – pain over the outside of the hip is usually not caused by a hip joint problem, and is more commonly related to hip bursitis or a trapped nerve in the lower region of the back.
- low back pain – is one of the most common hip pain symptoms. Pain in the hip can cause trapped nerves and therefore result in lower back pain, which is typically a dull throbbing pain. If it is left untreated it can severely limit mobility.
- knee pain – generalised or on the inside aspect
- leg pain – can be caused by problems within the hip joint. For example, groin pain that originates from the hip can travel down to the thigh or knee. This may produce a sensation of leg weakness or tingling.
Pain from other areas of the body, such as the back or groin (from a hernia), can radiate to the hip.
Patients may experience the related symptoms of Buttock Pain, Back Pain, and/or Muscle Cramps. You might notice that your pain gets worse with activity, especially if it’s caused by arthritis. Along with the pain, you might have reduced range of motion.
Call your GP if your pain doesn’t go away, or if you notice swelling, redness, or warmth around the joint. Also call if you have hip pain at night or when you are resting.
GET MEDICAL HELP RIGHT AWAY IF:
- The hip pain came on suddenly.
- A fall or other injury triggered the hip pain.
- Your joint looks deformed or is bleeding.
- You heard a popping noise in the joint when you injured it.
- The pain is intense.
- You can’t put any weight on your hip.
Limp: Limping is the body’s way of compensating for pain by trying to minimise the amount of weight the hip has to support while walking. Limping is never normal. Limping produces abnormal stresses on other joints, including the back, knees, and ankles, and if the limp persists, these areas may also become inflamed and cause further symptoms.
Despite its durability, the hip joint isn’t indestructible. With age and use, the cartilage can wear down or become damaged. Muscles and tendons in the hip can get overused. The hip bone itself can be fractured during a fall or other injury. Any of these conditions can lead to hip pain.
Pain in the hip can result from a number of factors. Abnormalities of the skin, nerves, bones, joints, blood vessels, and soft tissues of the hip can all result in pain.
These are some of the conditions that are most likely to cause hip pain:
Arthritis: Arthritic conditions such as osteoarthritis and rheumatoid arthritis are among the most common causes of hip pain, especially in older adults. Arthritis leads to inflammation of the hip joint and the breakdown of the cartilage that normally cushions your hip bones. The pain gradually gets worse as the arthritis progresses. People with arthritis also feel stiffness and have reduced range of motion in the hip.
Stiffness and grinding in the hip are typically symptoms of hip arthritis. You may also describe a click, catch, or feeling that range of motion is somehow impeded. Usually, there is pain almost immediately that does not get better as activity continues.
Pain from arthritis tends to be worse after a period of inactivity and gets better as the joint “warms up” with use. But as activity increases, the pain will return.
Trauma to the hip: With a fall, direct blow, twist, or stretch, the pain is felt almost immediately.
Hip fractures: Fractures of the hip are a particular problem in elderly people. With age, the bones can become weak and brittle. Weakened bones are more likely to fracture during a fall. With a hip fracture, there is an acute onset of constant pain after the injury that usually is made worse with almost any movement. The muscles that attach to the hip cause the fracture to displace, or move, and the leg may appear shortened and rotated outward. If no displacement occurs, the leg may appear normal. Pelvic fractures may have pain similar to a hip fracture but the leg appears normal.
Overuse injury: The onset of pain may be delayed by minutes or hours as inflamed muscles surrounding the hip joint go into spasm or joint surfaces become inflamed, causing fluid accumulation. Overuse injuries may also cause cartilage or labrum damage resulting in inflammation, pain, and limping.
Bursitis: Inflammation of the small, fluid-filled sacs (called bursae) that protect muscles and tendons is usually due to repetitive activities that overwork or irritate the hip joint. This is tenderness and swelling, occasionally with redness over the side of the hip. You will experience discomfort on lying on the painful side and symptoms tend to be worse in the mornings. With bursitis it hurts when you get up from a chair, walk, climb stairs, and drive
Tendinitis: Tendons are the thick bands of tissue that attach bones to muscles. Tendinitis is inflammation or irritation of the tendons. It’s usually caused by repetitive stress from overuse.
Muscle or tendon strain: Repeated activities can put strain on the muscles, tendons, and ligaments that support the hips. When these structures become inflamed from overuse, they can cause pain and prevent the hip from functioning normally. The most common strains are groin pulls and hamstring strains.
Cancers: Tumors that start in the bone (bone cancer) or that spread to the bone can cause pain in the hips, as well as in other bones of the body.
Avascular necrosis (also called osteonecrosis): This condition occurs when blood flow to the hip bone is reduced and the bone tissue dies as a result. Although it can affect other bones, avascular necrosis most often occurs in the hip. It can be caused by a hip fracture or dislocation, or from the long-term use of high-dose steroids (such as prednisone), among other causes.
Sciatica pain: Pain from sciatica tends to start in the lower back and radiate to the buttocks and to the front or side of the hip. It may be described in different ways because of nerve inflammation. Some typical descriptive terms used for the pain of sciatica include sharp, stabbing, or burning. The pain of sciatica may be made worse with straightening the knee, which stretches the sciatic nerve and may make it difficult to stand from a sitting position, or walk with a full stride. There may be associated numbness and tingling. Physical examination may be able to map out which nerve root from the spine is involved. Loss of bowel and bladder function associated with the pain may signal a neurosurgical emergency and the presence of cauda equina syndrome. If not recognised and treated with immediate surgery, there is risk for permanent damage to the spinal cord.
How will osteopathy help?
As you can see hip pain can affect you in many different ways and has many different causes. Here at Shefford Osteopathic Clinic we are trained to examine, diagnose, develop a treatment plan and give you hands-on treatment.
Osteopathic treatment is aimed at:
- releasing the tension in the muscles,
- correcting the alignment of the bones,
- reducing inflammation, and
- increasing lymphatic drainage and circulation.
We will give advice on exercise, nutrition and how to adapt activities so you can still enjoy them with less pain.
The first treatment for most conditions that cause hip pain is to rest the joint, and allow the acute inflammation to subside.
Pain around the hip bones (the ilia)
Pain around the bony areas of the pelvis is very common, just as pain in the shoulders nearly always accompanies a neck problem.
The reason is simple: the nerve supply to the muscles here comes from the low back, and painful lumbar restrictions can sensitise these nerves and the muscles they serve.
Remember, nerves not only register pain and sensation, but they also carry signals telling a muscle to contract and relax. So a stimulated nerve may not only make the muscle feel sorer, but tighter as well. Unfortunately this can also make it frustratingly resistant to stretching no matter how much you try!
The solution is simple – free up the low back to normalise the nerve function. However, if muscles have been over stimulated for long enough, they can continue grumbling on even after the spine has been freed up. In this case, treating the area with soft tissue work will help a lot.
An over-strained muscle is painful, but can usually be linked in the patient’s mind to a specific event usually involving an accident or some hard or unusual physical activity. When injured, ankle or knee pain can result in a person having to hitch the hip up on the affected side as part of a limp when walking. This causes tightening of the muscle that does this because the normal use pattern of that muscle has changed dramatically.
Following Hip fracture / Hip replacement:
Here at Shefford Osteopathic Clinic we can help you during the recovery process. The use of crutches and the extra demands placed on other parts of your body can create fatigue and aches and pains else where. We will remove any compensatory strain patterns by treating your entire body – and once the fracture has sufficiently recovered – muscles contractures that remain will be released to reduce the likelihood of developing arthritis. Exercises are also prescribed to improve balance and to build muscles that may have wasted from splinting.
Not all ‘hip’ pain comes from the hip:
Apart from the low back (mentioned earlier) or serious disease, another major cause is the sacro iliac joint (or s.i.j). This can be injured from a sideways fall onto a hip bone, a sudden jolt from a missed step, or from pregnancy.
Hip pain prevention
The body is a machine that needs to be well looked after over a lifetime. By maintaining a normal body mass index and avoiding obesity, providing a good diet to build strong bones, and by exercising routinely to preserve normal range of motion of the hip, osteoarthritis of the hips and back pain may be avoided.
For individuals of all ages, it is important to maintain good strength, flexibility, and posture throughout life to allow the hip to move and function normally.
- Try to avoid activities that aggravate the pain.
- Sleep on your non-painful side with a pillow between your legs.
- Wear flat shoes that are cushioned and comfortable
- If you are overweight, losing weight may help
- Try not to stand for long periods of time. If you must stand, do so on a soft, cushioned surface.
- Stand with an equal amount of weight on each leg.
For hip pain related to overuse or physical activity:
- Always warm up before exercising and cool down afterward.
- Stretch your quadriceps and hamstrings.
- Avoid running straight down hills – walk down instead.
- Bicycle or swim instead of run.
- Reduce the amount of exercise you do.
- Run on a smooth, soft surface, such as a track, instead of on cement.
- If you have flat feet, try special shoe inserts and arch supports (orthotics).
- Make sure your running shoes are made well, fit well, and have good cushioning.
Medications that prevent osteoporosis in women should be considered to minimise the risk of hip and back fractures in at-risk women. These include calcium, vitamin D, and bisphosphonates (Actonel, Boniva, Fosamax). Bone mineral density screening may be a reasonable screening tool.
For older individuals, it is important to minimise the risk of falling and breaking a hip or sustaining other injuries related to a fall. Preventive measures include:
- wearing well-fitting shoes with a good tread,
- using a cane or walker for stability if needed, and
- making certain that walking areas in the home are free of clutter. The use of area rugs and mats should be avoided.
What to do now ……
If you’ve come to this website looking for help, then don’t in silence suffer any longer.
Contact us immediately on 01462 811006 for a consultation and let’s assess your condition.
At the assessment, we’ll take some details from you and build your case history. We’ll discuss why you’ve come to see us and where you have any aches and pains. Then we’ll examine you with the aim of giving you the appropriate treatment.
This will take a little while to complete, but it’s a necessary part of the ethical guidelines we work to. The guidelines are there to make sure everything is done professionally and to a high standard of patient care. I’m sure you agree that’s a good thing!
If you have any questions about what we do and how we do it, call us on 01462 811006 or use the contact form below – and we’ll be happy to help.