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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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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.

Pain from the hip joint may be felt anteriorly (in front of the hip) as groin pain, laterally over the greater trochanter, or posteriorly in the buttock. Sometimes the patient may complain of knee pain which has been referred from the hip.

Trauma to the hip: With a fall, direct blow, twist, or stretch, the pain is felt almost immediately.

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 inflame, causing fluid accumulation.

Pain: Most often pain is felt in the front of the hip, but the joint is three-dimensional. Pain may be also felt along the outside part of the hip or even in the buttock area.

Limp: Limping is the body's way of compensating for pain by trying to minimize 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.

Fracture: 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.

Sciatica pain: Pain from sciatica tends to start in the 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. Loss of bowel and bladder function associated with the pain may signal a neurosurgical emergency and the presence of cauda equina syndrome. If not recognized and treated with immediate surgery, there is risk for permanent damage to the spinal cord.

Arthritis: If arthritis narrows the hip joint or impinges on the way the femoral head can glide in the acetabulum, or if there is a cartilage or labrum tear, the pain may be associated with a "catch," or a feeling like there is something impeding hip movement.

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.

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