Hip Pain

Hip pain is the broad term for pain in or around the hip joint. The pain may not necessarily be felt in the hip and may extend to the groin or thigh. Hip pain is a common symptom that can arise due to various causes, including hip injuries, fractures, or medical conditions such as arthritis.

Typically, you can manage hip pain at home by taking a break from physical activities and by using over-the-counter pain relievers. However, if the pain persists or worsens, you may need to seek medical treatment.

With nearly a decade of experience, Dr. Ulric Bigby offers comprehensive treatment for hip pain and other hip-related conditions. His expertise extends to both non-surgical approaches and surgical interventions, including hip replacement surgery.

The hip, which is a ball-and-socket joint, is a robust and stable joint. The hip joint is the juncture where the thigh bone (femur) ball joins the pelvis at a socket known as the acetabulum. Cartilage covers both the femur and the acetabulum within the hip joint.

Enveloping the hip joint is the synovium, a tissue that generates synovial fluid to lubricate the joint and nourish its cartilage. Cartilage acts as a protective layer between the hip joint bones, preventing friction and minimizing the impact during walking or hip movement.

Ligaments surrounding the hip joint connect the femur bone to the bony pelvis. There are a number of muscles and tendons that glide around the hip joint. 

Bursae, tiny sacs filled with fluid, provide gliding surfaces for muscles and tendons around the hip joint. Major arteries and veins pass the front of the hip joint. The largest nerve in the body, the sciatic nerve, passes behind the hip joint.

One of the large joints in the body, the hip joint, offers the greatest range of motion, including the forward and backward movement of the thigh. 

Usually, hip pain can be a result of overexertion, which can lead to inflamed tendons and tissues. In such cases, the pain resolves within a few days with proper rest and care.

However, persistent hip pain may be a result of specific medical conditions. These include: 

The most common cause of constant hip pain is arthritis. The typical symptoms of arthritis include pain, swelling, and stiffness in the joints. Various types of arthritis that cause hip pain include:

• Osteoarthritis (OA) is the most common type of arthritis that results from the age-related natural wear and tear of cartilage surrounding the joints.  
• Rheumatoid Arthritis (RA) is when the body's immune system mistakenly attacks the joints, potentially affecting both cartilage and bones.
• Ankylosing spondylitis is a form of arthritis that causes chronic spine inflammation. The symptoms include lower back pain, hip pain, and a stiff back.

Bursitis is another potential source of hip pain, characterized by painful swelling in a small sac filled with fluid, known as a bursa. Hip bursitis occurs when the bursa in the hip becomes irritated and inflamed.

Factors that can contribute to the development of bursitis include hip injuries, excessive use of the joints, or posture-related issues.

Hip fractures are common in older adults, primarily attributed to age-related bone weakening. Hip fractures can lead to sudden and severe hip pain, and they require immediate medical attention. A hip fracture can give rise to complications such as the development of a blood clot in the leg. 

A hip fracture usually requires surgery to be corrected. Physical therapy is also suggested post-surgery for full recovery. 

Hip pain and its symptoms can differ based on what's causing it. Symptoms include:

• Limping
• Joint pain
• Groin pain
• Loss of motion in the hip
• Warmth
• Swelling over the hip
• Tenderness of the hip
• Difficulty sleeping on the hip
• Trouble with putting on shoes or socks

The intensity of the symptoms can vary depending on the cause. Your pain might worsen with activity and lead to a reduced range of motion. Persistent hip pain can sometimes lead to a limp.

If your hip pain persists for more than two weeks without any improvement, it's time to consult your doctor. The diagnosis of hip pain includes:

1. Physical examination of your hip to evaluate its range of motion and to gather sufficient information for planning treatment.  During the examination, the internal and external rotation of the hip is accessed to identify the positions that exacerbate pain, and tenderness is identified by gently pressing over the inflamed areas.
2. Imaging tests of your hip to identify the cause of your pain. Based on your symptoms and conditions, the tests may include:
   • • X-rays which reveal the bone condition of the hip.
     • MRIs which provide detailed images of soft tissues like muscles and tendons connected to your hip.
     • CT scans which can help assess the hip joint's shape.
3. Blood tests if an infection or rheumatoid arthritis is suspected to cause your hip pain.

If rest and at-home care don't alleviate your hip pain, additional treatments may be recommended. Treatment for hip pain is determined by its severity and underlying cause.

1. Medications: If muscle or tendon strain is causing hip pain, you can use over-the-counter pain medications like acetaminophen or nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen.
2. Physical Therapy: Tailored movement, exercises, and activities can help improve hip mobility. Physical therapy effectively reduces pain and strengthens the soft tissues and joints. 
3. Occupational Therapy: Occupational therapists modify daily activities suspected to be significant contributors to your pain and recommend equipment or adaptations to reduce strain on the hip.
4. Steroid Injections: Injections of cortisone medication (steroids) are administered to alleviate the inflammation.

Not everyone experiencing hip pain will require surgery, but surgical intervention might be required if other treatments prove ineffective. 

Hip fractures are also a common cause of hip surgery to stabilize and secure the bone in place. 

Surgical options to treat hip pain include:

1. Hip Replacement Surgery will replace your hip with an artificial implant (a prosthesis).
2. Anterior Hip Replacement is an anterior(front) approach to hip replacement. The surgery involves a small incision near the front of the hip and less damage to surrounding muscles and tendons. 
3. Revision Hip Replacement is a corrective surgery if issues such as loosening, infection, or failure arise with a hip replacement.
4. Minimally Invasive Hip Replacement is a surgical procedure that aims to minimize the trauma to surrounding tissues during hip replacement. 
5. Acetabular Labrum Surgery reshapes the hip to enhance joint movement, alleviate pain, and reduce stiffness. 

Long-term hip pain can lead to a permanent limp and hinder your daily activities. Whether your hip pain is minor or severe, addressing it now can prevent long-term issues. Dr. Ulric Bigby is a top-rated orthopedic surgeon who can diagnose your hip pain and provide comprehensive treatment options. 

Schedule your consultation online or get in touch with Dr. Bigby at one of his three locations:

• Hanover: (410) 768-5050
• Arnold: (410) 349-9930
• Kent Island: (410) 643-3410