Doctor's Notes on Hip Pain
The hip joint is where the ball of the thigh bone (femur) joins the pelvis (hip bones) at a socket called the acetabulum. There are many causes of pain in the hip joint or hip area. Some of these are conditions related to the joint, while others involve the muscles, tendons, soft tissues, or other tissues in the area. Among the causes of hip pain include hip fracture, other trauma or injury, arthritis, sprain, sciatica, hematoma, muscle strain, and avascular necrosis.
Signs and symptoms associated with hip pain vary widely and depend on the exact condition that is causing the pain. Symptoms and signs can include
- joint swelling,
- redness,
- warmth,
- injury to the overlying skin,
- bruising,
- groin pain,
- back pain, and
- tenderness.
Other symptoms and signs can include
- limping or gait disturbances,
- an inability to move the hip joint, and
- problems lying on the side of the painful hip.
What Is the Treatment for Hip Pain?
There are many causes of hip pain, and the treatment depends largely on the specific cause. Fractures of the hip may be treated with surgery, including hip replacement. There are many medications available to treat arthritic conditions. Medications to control pain and corticosteroids to reduce inflammation are appropriate for some conditions that cause hip pain. Other treatments can include physical therapy, massage, or exercise.
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Avascular Necrosis
Avascular necrosis (aseptic necrosis or osteonecrosis) is a death of bone, which leads to destruction of the adjacent joint. Causes include fracture, dislocation, steroid medication usage, and excessive alcohol consumption. Risk factors include smoking, pregnancy, radiation therapy and chemotherapy, bone marrow and blood diseases, and the bends. Pain is the main symptom. Treatment involves treating the underlying cause of avascular necrosis and surgery. -
Bruises (Bruising)
A bruise is a common skin injury that results in a discoloration of the skin. Symptoms and signs include pain and discolored skin. Applying a cold compress may speed healing and reduce swelling. Acetaminophen and ibuprofen may be taken for pain. -
Bursitis
Bursitis is inflammation of a bursa. A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. -
Fibromyalgia
Fibromyalgia is an illness with no known cause. Symptoms include chronic pain, fatigue, fibrofog (mental haziness), insomnia, headaches, nervousness, numbness, dizziness, and intestinal disturbances. Treatment may involve acupuncture, massage, biofeedback, antidepressants, Lyrica, Cymbalta, Savella, Flexeril, and Mirapex. -
Iliotibial Band Syndrome (IT Band Syndrome)
Iliotibial band syndrome (IT band syndrome) is an overuse injury often seen in runners. The most common symptom is knee pain. Rest, ice and the use of anti-inflammatory medications may alleviate symptoms. A doctor may prescribe physical therapy if the initial treatment described above is unsuccessful. -
Minimally Invasive Hip Replacement
Minimally invasive hip replacement is surgery performed with smaller incisions, which reduces the trauma to the tissue, reduces pain, and shortens recovery time. Risks include nerve injury, blood clots, fracture, blood loss, infection after surgery, and improper placement of the components. -
Osteoarthritis
Osteoarthritis is not a single disease but a culmination of problems that lead to skeletal joint failure. Symptoms include aching, stiffness, and bone enlargement. Diet, exercise, pain medication, and sometimes surgery treat osteoarthritis. -
Piriformis Syndrome
Piriformis syndrome causes pain in the hip and buttock area. Compression of the sciatic nerve causes the disorder. Associated symptoms include possible numbness and tingling in the buttocks, pain during bowel movements, painful intercourse, and tenderness. Treatment may incorporate medications, stretching, massage, physical therapy, corticosteroid injections, and surgery. -
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Sciatica
Sciatica is lower back pain that radiates through the buttocks and down one leg. Common causes include herniated discs, spinal stenosis, piriformis syndrome, pregnancy, and a pinched nerve. Read about pain relief, symptoms, home remedies, and treatment. -
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Sprains and Strains
An injury to a ligament is called a sprain, while an injury to a muscle or tendon is called a strain. Symptoms and signs include pain, swelling, bruising, and decreased range of motion. Rest, ice, compression, and elevation of the injury is the standard treatment for sprains and strains.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.