There are many possible causes of hip pain and discomfort. Finding out what the underlying cause is will probably involve seeing a hip pain specialist.
We will take a closer look at some common hip pain causes in the sections below.
Minor injuries such as hip flexor pain
Hip flexor pain can occur when the hip flexor muscles are pulled, strained, torn, or injured.
Dr Thilagarajah noted that in younger patients, “the actual joint surface of the hips are usually good, so the pain more likely comes from the tissues around the hip. These include ligaments, muscles, tendons.”
Short-term hip pain is common after a minor injury, such as a strained or torn muscle or tendon. You may not have noticed the injury when it first occurred, or may have had some sharp, acute pain that got better over time.
Hip flexor pain treatment
In the case of most minor muscle strains, rest and gentle stretching after a few days will help the injury heal. For these types of injuries, follow the ‘RICE’ method:
- Rest
- Ice
- Compression
- Elevation
It may be difficult to elevate your hip, but be careful not to lie down on the side that is causing you pain or discomfort. If the pain does not subside or is severe, seek advice from a doctor.
Trochanteric bursitis
“There's a very common condition called trochanteric bursitis, in which a protective little pouch of fluid around the outside of the hip gets inflamed,” say Dr Thilagarajah.
When asked about the most common non-arthritic issues with the hips, Dr Thilagarajah immediately noted trochanteric bursitis as a possibility. While anyone can get bursitis, it is more common in women and older people.
The protective pouches of fluid are called bursa, and there is one on each side of your hips. You might feel the pain on the outward sides of your upper thigh, often just on one side. The pain can also radiate higher or lower.
“Most cases of [trochanteric bursitis] are non-arthritic related — they’re due to inflammation from sprains and irritation. They are usually reversible through non-surgical means, which would normally entail physiotherapy among other things.”
The bursa may become irritated from repetitive movements, like cycling, jumping or even standing for long periods. Inflammation can also come from repetitive movements or from sports injuries.
The pain may be worse at night, when you lie down, or if you try to stand up after sitting for a while. Some people find the pain is worse after doing movements that strain the hips, like hiking, walking, or doing squats.
Trochanteric bursitis treatment
People can usually treat trochanteric bursitis at home with ice and anti-inflammatories (such as ibuprofen) to reduce the swelling. It is also important to avoid doing any activities that make the hip pain worse.
In more severe cases, you may wish to use a cane or other assistive device to help you walk. A physiotherapist can recommend exercises and modifications to your usual movements to speed up recovery.
If you are in a lot of pain, a doctor may also provide a corticosteroid injection directly to the area. While corticosteroid injections quickly reduce swelling, they come with their own risks and are not recommended for repeated or long-term use.
Lateral hip pain
The gluteal muscles on the outside of the hip help control the pelvis when walking or standing, and also facilitate hip abduction, which is when you move the hip out to the side.
The gluteal muscles are attached to the outer hip bone by tendons. If these tendons become inflamed or sensitive, you may feel lateral hip pain — pain outside the hip that can radiate down the outside of the thigh toward the knee.
Lateral hip pain treatment
Lateral hip pain should resolve without medical treatment. To speed up recovery and prevent lateral hip pain in the future, avoid:
- Crossing your legs
- Sitting with the knees together and feet splayed, particularly on low chairs
- Standing with more weight on one leg
- Lying on the side that is in pain
If lateral hip pain continues, speak to your doctor for further guidance.
Arthritis
There are several different types of arthritis which can cause hip pain, but osteoarthritis is the most common. Osteoarthritis occurs when the cartilage cushioning the bones begins to wear down and be damaged with age.
Rheumatoid arthritis, on the other hand, is an inflammatory condition that occurs when the body mistakenly attacks healthy joints, causing pain and inflammation.
Arthritis affects about 10 million people in the UK and is more common in women. This is because bones gradually get weaker as levels of oestrogen fall. Some women experience joint stiffness in perimenopause, and in some cases it is self-limiting, meaning that their symptoms end once menopause symptoms subside.
Hip arthritis treatments
For milder cases of arthritis that are causing hip pain, Dr Thilagarajah recommends general fitness, physiotherapy, and simple painkillers.
It is best to avoid surgery unless the hip pain is having a significant impact on your mobility and quality of life, as surgery comes with its own set of risks.
How to relieve hip pain from arthritis
Non-invasive treatment options for how to relieve hip pain include:
- Losing weight with a doctor’s advice if you are overweight
- Increasing your overall fitness by doing gentle exercises, such as swimming and yoga, which do not strain the joints
- Taking painkillers when necessary
“Paracetamol can actually be taken on a regular basis quite safely,” says Dr Thilagarajah. Anti-inflammatories such as ibuprofen are fine for occasional use, but have ‘real risks’ associated with more frequent or long-term use.
“I wouldn't recommend being on anti-inflammatories long term. I would say that if your need for anti-inflammatories is greater, it probably means that you're heading more towards surgery in any case.”
