The hips are the largest weight-bearing joints in the body. These important and hard-working structures make it possible to perform many daily movements and activities, such as walking, sitting, and bending. Along with repetitive use comes the potential for injury. Therefore, hip pain is very common.
How Does Hip Pain Develop?
The hip joint consists of a ball at the top of the thigh bone (femoral head) and a socket in the pelvis, which are connected by strong ligaments that stabilize the bones. Damage to any of these tissues can lead to pain. The five most common sources of hip pain are:
1. A Muscle Strain
A hip strain occurs when a muscle that supports the hip joint is stretched beyond its normal limit. This type of injury can occur suddenly through trauma, such as a fall or a direct blow during contact sports, or gradually through overuse if a muscle or tendon has become weakened due to repetitive movements.
Oftentimes, hip strains occur near the point where a muscle joins with the connective tissue of a tendon, which secures the muscle to a bone. A severe strain may cause a partial or complete tear of muscle fibers or the combined muscle and tendon. Depending on the severity of the injury, a hip strain may cause mild to severe pain.
2. A Bone Fracture
A hip fracture is a break or crack in the upper portion of the thigh bone (femur) near the point where it meets with the pelvic bone in the hip joint. The most common cause of this painful injury is trauma from a fall, direct blow, or car accident.
There are three main types of hip fractures. The first is a femoral neck fracture, which is a break that occurs 1-2 inches below the hip joint. The second is an intertrochanteric hip fracture, which is a break that occurs 3-4 inches below the hip joint. Because a femoral neck fracture can potentially interfere with the blood supply to the femur, it is generally considered to be a more serious injury than an intertrochanteric hip fracture.
The third type of hip fracture is a stress fracture, which is a crack in a bone that occurs when minor injuries build up beyond the capacity of the bone to repair itself. Stress fractures are particularly common among athletes. During high-impact activities, such as running, the hip joint absorbs significant pressure. Repetitive use can lead to the development of a stress fracture in the hip over time.
In addition to severe hip pain, a hip fracture may cause swelling, bruising, knee pain, low back pain, or an inability to walk or bear weight on the affected leg. In some cases, the affected foot turns outward at an unnatural angle, making the affected leg appear shorter than the other leg.
The weight-bearing surfaces of all joints, including the hips, are coated with articular cartilage, which serves as a cushion and allows the bones to glide smoothly against each other during movement. Osteoarthritis is an age-related degenerative joint condition that causes articular cartilage to gradually break down and wear away, eventually leading to painful bone-on-bone contact.
Hip arthritis may produce an ache that originates at the front of the groin and travels down the thigh. Additionally, pain may be felt at the side of the hip, buttocks, or the back of the thigh. The pain may worsen during weight-bearing activities, such as standing and walking, or certain movements, such as rising from a seating position.
4. Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic autoimmune condition that most often affects the small joints in the hands and wrists, but can also affect larger joints, such as the hips. RA occurs when the body’s immune system mistakenly attacks the healthy lining of a joint (synovium), causing it to become inflamed. An inflamed synovium may thicken and erode nearby cartilage and bones.
Hip RA can cause severe pain, stiffness, and swelling in the groin, hip, and thigh. Other symptoms include unexplained fatigue and loss of appetite, and pain, swelling, and stiffness in other joints.
Bones are living tissues that are constantly developing and strengthening. Up to approximately age 20, the body produces new bone faster than it breaks down old bone, and overall bone mass continually increases. Most people reach their peak bone mass by age 30, after which the bone remodeling process gradually slows down.
Often related to the natural aging process, osteoporosis (“porous bones”) is a condition in which the rate of bone loss outpaces the rate of bone growth. As a result, the bones become brittle, fragile, and prone to fractures. While osteoporosis in not painful in and of itself, the associated bone fractures can cause pain. Hip fractures are among the most common broken bones associated with osteoporosis, mainly because the risk of falling increases with age, and weakened hip bones can easily fracture, even in a relatively minor fall.
Consult With an Experienced Hip Specialist
If you’re living with hip pain and considering surgery, contact the office of Peter D. Vizzi, MD, to request a consultation. Dr. Vizzi is a board-certified orthopedic surgeon who is dedicated to providing quality orthopedic care to active individuals from the Lafayette, LA, area. After reviewing your medical history and lifestyle, discussing your symptoms, and examining your painful joint, Dr. Vizzi will help you explore all appropriate treatment options, including the latest conservative alternatives to total hip replacement surgery.