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Hip pain

Find out more about the symptoms and causes of hip pain

Hip pain is a common condition that affects people of all ages. In adults, it is very common among people over the age of 60.

On this page, we provide an overview of the healthcare services and treatments available for hip pain at Circle Health Group’s The Priory Hospital in Birmingham.

There are many possible reasons why you could be experiencing hip pain. The cause of your hip pain may be within your hip joint, outside of it, or it may be related to another part of your body.

Here are some of the causes of hip pain that are within the hip joint.

Fractures

A fracture is likely if there has been trauma to the hip, such as an accident or an injury.

Fractures can also be the result of an underlying condition, such as osteoporosis. Usually, fractures cause pain in front of your hip or pain in the groin that gets worse with physical activity.

You may have a sharp pain if you try to put weight on the affected leg or rotate your hip.

Femoroacetabular impingement or hip impingement 

This condition usually affects younger adults and physically active people.

Typically, the pain starts gradually and gets worse when you sit down, when you get up from a seat, when you get in and out of a car, or when you lean forward. The hip pain is mainly felt in the groin, and sometimes it radiates on the side of the hip and in front of the thigh.

Osteonecrosis of the hip

Also known as avascular necrosis of the femoral head, osteonecrosis of the hip occurs when the blood supply to the bone and marrow tissues in the top of the thigh bone is cut off.

Osteonecrosis of the hip is usually the result of other underlying conditions, such as:

  • Alcohol use disorder
  • Lupus or other autoimmune conditions
  • Chronic liver disease
  • Metabolic diseases such as diabetes
  • Radiation or chemotherapy

In many cases, the cause is unknown.

The pain in osteonecrosis is gradual and progresses slowly. You may feel more pain when walking or placing weight on the hip. The pain is usually in the groin and it radiates down to the mid-thigh.

There are several stages to this condition, and pain at rest is a sign that the condition has advanced. Treatment ranges from non-steroidal inflammatory drugs (NSAIDs) to hip replacement surgery, depending on the stage of the disease.                                

Labral tears

Labral tears are tears in the soft tissue that holds the ball and socket joint of the hip together. The pain can set in suddenly, after a traumatic injury, or gradually. The pain is dull or sharp and felt in the groin.

Half of the people with labral tears have pain that radiates to the outer side of the hip, the front of the thigh, and the buttocks. Other symptoms include a catching sensation in the hip or a painful click when you are carrying out an activity that uses the hip.

Osteoarthritis

This is the most common cause of hip pain in older adults.

Osteoarthritis pain is deep and constant and sets in gradually. You may also have stiffness and reduced mobility. Symptoms may get worse when standing for long periods of time and with weight-bearing.

Hip and groin pain in osteoarthritis tends to be worse at the end of the day. It also gets worse with activity. NSAIDs, corticosteroid injections, ultrasound-guided hip joint injections, and physiotherapy are some of the non-operative treatments for osteoarthritis of the hip.

Hip replacement surgery is also recommended for advanced osteoarthritis of the hip, when other treatments have not worked.

Rheumatoid arthritis

This is a condition that occurs when the immune system does not recognise the healthy tissue in the joints and attacks it.

In rheumatoid arthritis, the synovial membrane — which is the tissue that covers the cavities of joints and lubricates them — gets inflamed. This causes the joints to swell and become stiff. Without a healthy synovial membrane, bones rub against each other in the joint and the cartilage breaks down over time.

In rheumatoid arthritis of the hip, the hip pain is typically worse in the morning. It is accompanied by stiffness, and it gets better with activity.

NSAIDs, steroids, and specific drugs for rheumatoid arthritis are the most common options for treatment.

Septic arthritis

Septic arthritis of the hip is an infection in the hip joint that can be caused by viruses, bacteria, or fungi. This is a potentially life-threatening complication and a medical emergency.

Signs of septic arthritis include severe pain when moving, not being able to bear weight on the leg at all, feeling severely ill, and having a high temperature. It affects children more than adults, but it is a medical emergency in both.

If you have any of these symptoms, seek medical help immediately.

Sometimes the cause of your hip pain may be outside of the hip joint. For example, the cause can be related to your nerves, muscles, or the tendons that surround the joint.

Below are some of these causes of hip pain.

Meralgia paresthetica

Meralgia paresthetica is the compression of a large nerve in your leg, called the ‘lateral femoral cutaneous nerve’. This nerve starts from a ligament in your groin area — called the inguinal ligament — and runs all across your outer thigh down to your knee.

The hip pain in this condition may be worse when you walk, stand, or extend your hips. You may also have a numbing, tingling, or burning sensation on your outer thigh.

Causes of meralgia paresthetica include trauma, overuse, standing for too long, wearing clothing or belts that are too tight, and gaining weight.

Common treatments include NSAIDs, physiotherapy, removing what is compressing the nerve (e.g. losing weight or not wearing tight clothing anymore), local anaesthetic and corticosteroid (steroid) injections.

Piriformis syndrome

Piriformis syndrome occurs when the sciatic nerve near the piriformis muscle is compressed or irritated. The piriformis muscle connects the lowermost vertebrae in the back with the top of the leg.

Piriformis syndrome causes buttocks pain that gets worse when sitting or walking. The pain may or may not radiate down the back of the thigh as a result of compressing the sciatic nerve.

Treatment consists of stretching exercises, NSAIDs, rest, and avoiding or correcting the gait or activity that caused the pain in the first place. Surgery is rarely necessary.

Snapping hip

This condition may cause pain in the front of the hip, although symptoms are usually a painless snapping or popping sound from the hip and a catching sensation.

If the condition is painful, it might be because it caused inflammation of the bursae — sacs filled with fluid that cushion the hip joint. This is called bursitis.

A ‘pulled’ muscle or injured tendon

Sometimes, hip pain can be caused by a ‘pulled’ muscle (muscle strain) or an injured tendon (tendonitis).

A pulled muscle or a swollen and inflamed tendon can cause an immediate and sharp pain that feels worse if you continue the activity. You may also hear a crackling or snapping sound.

If you have pulled a muscle or injured your tendon, you should rest, stop doing the activity that caused the pain, and apply ice. Sometimes you may need physiotherapy or stretching exercises to get rid of the pain.

Trochanteric pain syndrome

Trochanteric pain syndrome is sometimes known as trochanteric bursitis. This is pain around the trochanter — that is, the area around the bony prominence on the outer side of the hip.

People with this condition may have mild stiffness in the morning and may not be able to sleep on the painful side. The pain may come and go, and the area may feel tender to touch.

In some cases, trochanteric bursitis is caused by overuse of the joint. In other cases, it may be caused by inflammation or physical trauma in muscles, tendons, connective tissue, or bursae.

In 90% of cases, treatment with NSAIDs, physiotherapy, and rest is successful. Sometimes, corticosteroid injections or ultrasound-guided injections are necessary. Surgery is only rarely necessary.

Sometimes, you may feel the pain in your hip, but the cause is elsewhere. This is called ‘referred’ pain.

Pain that is felt in your hip can be from regions such as your lower back (lumbar spine) or your knees.

Can sciatica cause hip pain?

Sciatica is a condition in which a person experiences pain all along their sciatic nerve. The pain may start in your lower back, travel down to your buttock and spread all the way down below your knee or into the foot.

Problems with the sciatic nerve can generally be felt as pain in the hip. However, not all problems with the sciatic nerve are sciatica. Piriformis syndrome, for example, can feel similar to sciatica. 

Other causes of referred hip pain

Sometimes, referred hip pain can have an underlying cause in the abdomen or the pelvis.

This is because major blood vessels and nerves that start in the abdominal area can cross the hip joints on their way to the legs.

Causes of hip pain from the abdominal area include:

  • Inguinal hernia
  • Gynaecological causes
  • Crohn’s disease
  • Renal colic
  • Appendicitis
  • Colon tumours
  • Ulcerative colitis

If you experience hip pain that radiates down the thigh or leg, this could be caused by one of the hip conditions highlighted above, or by a problem with the lower back.

Conditions that may cause hip pain that radiates down the leg include:

  • Arthritis
  • Labral tears
  • Osteonecrosis of the hip
  • Piriformis syndrome
  • Hip impingement
  • Referred pain from a lower back problem, such as sciatica or another trapped nerve

Certain conditions that can cause hip pain tend to be more common in women than men. Some of these conditions are:

  • Osteoarthritis: this is twice as common in females than in males
  • Osteoporosis
  • Stress fractures: these may be more common in females as a result of osteoporosis, but some stress fractures are also more common in young female athletes than young male athletes
  • Piriformis syndrome
  • Rheumatoid arthritis

There are also gynaecological and pelvic floor issues that may cause referred pain in the hip. These include:

  • Endometriosis
  • Fibroids

Speaking to your doctor or consultant about your hip pain symptoms will help them to establish the underlying cause of your hip pain.

If you have hip pain that is interfering with your daily activities such as work or exercise, or if your hip pain is preventing you from doing the things you used to enjoy, it may be time to see a hip specialist.

You can skip waiting times by choosing Circle Health Group’s The Priory Hospital — the largest private health clinic in Birmingham.

The hospital has an exceptionally high patient satisfaction rate, with over 98% of patients saying they are likely or extremely likely to recommend the hospital to their friends and family. The hospital offers a team of highly specialised and internationally trained hip consultants who place the patient at the centre of the interaction at all times.

Diagnosing hip pain

To accurately diagnose the cause of your hip pain, your consultant will ask you a series of questions in your initial appointment.

This will help establish your medical history and narrow down the potential causes of your hip pain. For example, things like your age and gender can already help your consultant zoom in on a set of causes that may be more likely.

They will also ask you questions about any history of traumatic injuries, as well as detailed questions about the type of pain you are experiencing, when you are experiencing it, what helps or worsens the pain, and so on.

Your consultant will then perform a physical examination to evaluate your hips, back,

your tummy, as well as any vascular or nerve-related issues.

To get to the root cause of the hip pain, your consultant will likely request a series of imaging tests. These tests can be:

Different imaging tests are recommended depending on the suspected cause. For example, an X-ray may work best to detect a bone fracture, whereas an MRI may work better to diagnose any soft tissue problems.

Treating hip pain

Once the cause has been identified, and you received a diagnosis, you and your consultant will establish a treatment plan that works for you.

Depending on what is causing your hip pain, you may require treatments that range from simple, non-operative therapies (such as rest, painkillers, and physiotherapy) to surgical treatment.

Physiotherapy

The Priory Hospital offers several types of physiotherapy that can help relieve the pain, depending on where the source of the hip pain is located.

General physiotherapy can help with muscle strains and injuries, joint pain and arthritis, cartilage tears, etc.

The hospital also offers:

  • Physiotherapy specifically for groin strains
  • Physiotherapy for muscular aches and pains
  • Physiotherapy for back pain and sciatica

At The Priory Hospital in Birmingham, we offer a number of private physiotherapy services that can help with hip pain.

Injections and surgery

The Priory hospital offers a wide range of other hip treatments, such as hip injections. These are injections with steroids that can help reduce inflammation in your joints.

Hip specialists at the Priory hospital also perform operative treatments to treat hip pain, such as:

Costs are an important part of your hip pain treatment plan, and Circle Health Group hospitals like The Priory offer fixed price packages that include the initial consultation, treatment, and aftercare.

You can pay for your consultation and treatments using private health insurance if you have it, or you can pay yourself.

At Circle Health Group, you have the option to spread the cost of your treatment through a flexible instalment plan, which makes private healthcare a lot more affordable than you might think.

The Priory Hospital and its outpatient department are located in Edgbaston, Birmingham. The hospital also offers outpatient services at Sutton Coldfield.

Priory Hospital’s address is Priory Road, Edgbaston, Birmingham, West Midlands, B5 7UG.

 

Specialists offering Hip pain

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Mr Ravichandran Karthikeyan

Consultant Orthopaedic Surgeon

MBBS FRCS (Trauma and Orthopaedics) PGCE FHEA

The Priory Hospital

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Mr Akshay Mehra

Consultant Orthopaedic Surgeon

MBBS MRCS MSc FRCS Orth

The Priory Hospital 1 more The Droitwich Spa Hospital

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Mr Divya Prakash

Consultant Orthopaedic Surgeon

MBBS, MS (Orth), FRCS (Ed), FRCS (Glas), MCh Orth (L'pool), FRCS Orth

The Priory Hospital 1 more The Edgbaston Hospital

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Mr Nikhil Kharwadkar

Consultant Orthopaedic Surgeon

FRCS (Orth), MS (Orth), DNB (Orth)

The Edgbaston Hospital 1 more The Priory Hospital

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Mr Michael Parry

Consultant Orthopaedic Surgeon

BSc, MBChB, PGCME, MD, FRCS

The Droitwich Spa Hospital 1 more The Priory Hospital

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Mr Ronan Treacy

Consultant Orthopaedic Surgeon

MB ChB, MD, FRCS, FRCS Orth

The Droitwich Spa Hospital 1 more The Priory Hospital

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