Hip pain is a significant issue in the United States, affecting up to 10% of the population in any given year, with increased incidence in older adults as well as athletes. It can affect movements such as sitting, walking, sleeping and even standing and pivoting on one foot.
This blog will address the locations of different types of hip pain; describe the types of pains, describe what they feel like in various areas, as well as which kinds of hip pain are common. The top signs to look for if you have hip pain and who to see and what to do to help resolve it.
Hip pain is a significant issue in the United States, affecting up to 10% of the population in any given year, with increased incidence in older adults as well as athletes. It can affect movements such as sitting, walking, sleeping and even standing and pivoting on one foot.
This blog will address the locations of different types of hip pain; describe the types of pains, describe what they feel like in various areas, as well as which kinds of hip pain are common. The top signs to look for if you have hip pain and who to see and what to do to help resolve it.
Types of Hip Pain
Hip pain can be caused by several different muscular and joint changes that can determine where and how it is felt as well as the best way to recover. Hip pain can happen after an injury like a fall, or a sporting collision, or it can come seemingly from nowhere and slowly increase.
Common hip injuries and causes of pain include sprains and strains of surrounding ligaments and muscles, bursitis, arthritis, as well as less commonly, issues with the shape of the hip joint itself.
Most of the above types are related to injury or chronic tension and muscle pulling. Irritated structures due to chronic tension are much more common than due to injury, but both can occur and respond well to rehabilitation. Improper movements, even though small, over a large enough period of time, can affect the shape of the joint as well as the movement of it. This prolonged tension can eventually lead to a loss of range of motion. pain, and changes in movement and function
Additionally, hip pain can occasionally be referred pain from a disc in the lower back and not really a hip issue at all.
Hip pain is also usually unilateral, meaning only found on one side. It can be located at the back, in the buttock, in the groin on the front, or on the side at the widest part of the hips. The location of pain is often a clue as to what caused it, as we will discuss below.
Common Descriptions and Locations
Commonly hip pain can feel dull. It can radiate or move around to other body parts such as the lower back, groin, thigh, or side of the leg. When it refers to the groin it is sometimes described as sharp or grinding. It can be worse with weight bearing on that leg, laying on that side. or worse after prolonged sitting. Occasionally, with bursitis some people have trouble lying on the affected side to sleep. Below are several of the most common types of hip pain and descriptions of their causes and locations.
Trochanteric Bursitis- Hip pain on the side of your leg, sort of at the widest part of the hip, is actually trochanteric bursitis of the hip. It’s not the hip joint itself, and it’s actually part of your femur. A bursa is a fluid filled sac located between a bone and soft tissue such as a muscle or tendon. Its job is to blunt the pressure of the soft tissue on the bone. In the case of Trochanteric Bursitis. The IT band or gluteal muscles have been chronically tight and has pressed the bursa into the side of the femur for an extended period of time. The IT band also connects at the knee and this is one of the primary reasons why knee pain and hip pain sometimes present together. This has caused inflammation which causes pain. This is located on the side of the hip and is often worse with lying on your side and prolonged sitting. It is often very tender to the touch. This type of hip pain responds well to ice on the bursa and fascial work of the IT band. Rest is often helpful as well as gluteal strengthening exercises to take pressure off of the overused IT band.
Arthritis- Arthritic hip pain can be dull or sharp and is often worse when weight bearing on the leg. Pivoting on the effective flag also sometimes makes this worse and can be described as grinding. Typically, this kind of pain begins quite slowly and sometimes has a history of trauma in the past. Arthritis is essentially a loss of joint space (less room) and an increase in bone that occurs due to changes the body makes to the joint as a response to movement and trauma. Significant arthritis also often presents with a reduced range of motion due to the loss of joint space and extra bone.
Muscle Strain- This is one of the most common causes of hip pain as there are several muscles that attach around this area that can cause pain. The adductor muscles, hip flexors, IT band and gluteal muscles can all generate pain in the hip region due to increased tension.
The pain and tenderness are located based on what muscle is causing the issue. It can be at the front of the hip, on the gluteal area, and nearer the groin, or on the outside of the leg. All types of muscle strain of the hip would be more common in people who have a seated job. These types of injuries often happen without a known injury.
This muscle tension can be due to over or under activity and is often based on faulty movement patterns that can result from poor posture, repetitive tasks or previous trauma. When it is IT band tension, that can also create trochanteric bursitis over time. This type of pain usually responds well to heat and stretching, dry needling and functional exercise to return the muscles to normal function and tension.
Labral tear- You can also have pain on the front or back of the hip that can be sharp and grinding when you are weight-bearing on the affected leg. They can sometimes refer to the groin as well. If you have that combined with a painful range of motion on that hip, then an MRI would be recommended to see if you have a labral tear. Labral tears can be the result of a trauma, or ‘repetitive micro-trauma’ that has slowly frayed the tissue over time.
Signs to look for- Some common descriptions heard when describing hip pain include snapping, grinding with weight bearing, tension in the hip flexors, not being able to stand up straight following prolonged sitting, and tenderness. Pain is often preceded by a slow loss of full range of motion, so having trouble sitting cross legged, having trouble getting up from the floor, and consistent tension and trigger points/knots are all good signs to watch out for.
Treatment and Who to see
The vast majority of the previously discussed types of pain respond well to rehabilitation. Exceptions that would not respond as well to a conservative approach would include bone on bone arthritis and some of the issues that can change the shape of the ball and socket joint. These frequently require surgery to address.
Successful rehabilitation often includes strengthening of the gluteal muscles, stretching of the IT band, hip flexors and adductors as well as core stability work. There are various therapies to release tight muscles such as dry needling, stretching, and types of soft tissue work. Rehabilitation should focus on correcting the improper movement patterns that led to the imbalances in the first place. That may include changes in work posture and overall ergonomics to have a lasting effect.
Of rehab would include using a lacrosse ball or tennis ball to work out trigger points and tension in the gluteal muscles., various stretches to stretch the IT band. Hip flexor muscles and adductors of the hip. And most importantly, strengthening exercises to strengthen the muscles. Whose lack of activity most likely caused the issue in the first place.
A functionally rehabilitative chiropractor is an excellent place to start for hip pain because they will be able, through the examination, orthopedic tests, and range of motion tests, to determine if your pain is from something like a labral tear, which can sometimes be rehabbed to the point where it doesn’t hurt, but also sometimes requires a referral to a surgeon or for a steroid injection. And they can also tell the difference between the other three kinds that can, for the most part, be functionally rehabilitated to get back to proper movement and be pain free.
Beginning your assessment with a chiropractor is a great choice as they can order X-rays and refer to a specialist if indicated. If rehabilitation seems appropriate, as is usually the case, then you are already in a great place to start!
At Integrated Health Solutions, we include a functional assessment of movement of the area of pain in every examination so we can discover why muscles are tight, sore, or inactive. These findings drive the rehabilitation in the treatment plan in order to improve patient outcomes and get a faster result.
Hopefully if you have hip pain, you have recognized some signs and symptoms in yourself and have an idea of where to start! No matter what type of pain, don’t simply put up with it, between conservative treatments and medical interventions, if necessary, hip pain is very treatable.
Sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC8022067/#:~:text=The%20prevalence%20of%20hip%20pain,%2C%20and%20neuropathies.%5B3%5D
Prepared and written by Dr. Elizabeth Bouse
Integrated Health Solutions Inc.
6330 E. 75th St. Suite 124 Indpls, IN 46250
971 N. Delaware St. Indpls, IN 46202
430 N. Rangeline Rd. Carmel, IN 46032
Questions on how we can help? Call us for an exam and consult today!
P: 317-449-2020
E: amie@ihsindy.com
