Common Causes of Hip Pain… and Solutions You May Not Have Heard About

Most people are familiar with arthritis, the degenerative joint disease that can cause joint pain, stiffness, and swelling throughout the body. Osteoarthritis is likely to develop as people age, and it is estimated that over 32 million people in the US have this form of arthritis. However, there are many other common types of arthritis, including rheumatoid arthritis and psoriatic arthritis.

Arthritis can become part of a negative feedback loop very quickly. It often becomes better with gentle exercise, but arthritis pain makes it difficult to exercise, so people with this condition tend to become more sedentary, leading to a worsening progression. Weight gain can contribute to this cycle too.

Pain in the hip is not unusual with arthritis, and it can radiate to other areas as well. In addition, the cartilage in the ball and socket hip joint wears down, taking away the joint's gliding motion. As a result, walking long distances and climbing stairs usually make pain and stiffness worse.

Many sports injuries fall into the acute category, meaning the injury and resulting pain are usually sudden, and previously there was no pain. Muscle and ligament tears that happen from trauma and twisting, for example, can cause acute hip pain. Ligaments connect one bone to another and are present in all the joints of the body.

Some sports injuries produce more gradual hip pain too. Some hernias can worsen over time, as can partial tears and injuries from repetitive motion (see below). Any sport, from basketball to ballet, can subject athletes to hip pain caused by overuse if they repeat the same movements over and over again. Sometimes athletes start to compensate for pain by altering their movement — consciously or unconsciously — which can worsen the injury in the long run or cause pain elsewhere in the body.

It’s not just athletes for whom repetitive motion can be harmful. Anyone who repeats the same movement many times, such as manual laborers, can develop hip pain. Tendons and bursae can become inflamed and cause unbearable pain. Tendons connect muscle to bone, and bursae are the tiny fluid-filled sacs that sit in joints to provide lubrication.

There are two bursae in the hips that commonly become inflamed (bursitis). One is at the bony point of the hip on the greater trochanter of the femur, a protrusion on the top of the thigh bone where it joins the pelvis. When this bursa becomes irritated, it’s called trochanteric bursitis. It can become painful sleeping on that side, and walking or running can make it worse. In addition, people with tight iliotibial (IT) bands, the thick mass of tissue that runs along the outside of the thigh, can easily develop trochanteric bursitis, or existing bursitis can be exacerbated by their anatomy, where the IT band tends to pull tightly across the greater trochanter.

The other hip bursa that can become inflamed is the iliopsoas bursa on the inside of the hip. This typically results in pain in the groin area.

Additionally, many muscles and pieces of connective tissue present in the pelvis can become irritated with overuse. It’s a very active joint, so you can imagine the potential for wear and tear there.

Sometimes pain that originates in the back can radiate to the hip. This is because nerves in the spine pass through the pelvic area on their way to the legs. In addition, the sciatic nerve that runs from the lower back to the feet commonly troubles many people.

It’s important to determine whether the sciatic nerve is irritated by something going on in the spine, like a bulging disc, or whether the inflammation occurs further along the nerve. Degenerative disc disease, where the cushions between the vertebrae of the spine lose mass and their lubricating ability, can also cause low back pain that travels to the hip.

Chronic pain in the hip and pelvic floor region can be a problem for many women and may have gynecological roots as well as other causes, including:

• Endometriosis

• Fibromyalgia

• Musculoskeletal problems, particularly during and after childbirth

• Fibroids

• Irritable bowel syndrome (IBS)

• Interstitial cystitis (AKA painful bladder syndrome)

• Post-hysterectomy complications

• Chronic inflammatory disease following sexually transmitted infection

There are other possible diagnoses in this category, including cancer, so it’s vital to determine the root of hip pain if musculoskeletal issues have been ruled out and a medical cause is likely.

People who frequently sit, whether behind a desk or the wheel all day, are prone to hip problems. Poor posture, inadequate support, or the wrong sitting surface can worsen this.

Those with arthritis can find it is exacerbated by long periods of sitting. Another common problem is piriformis syndrome, which can also be provoked by some kinds of exercise. The piriformis muscle lies deep in the buttocks, extending between the sacrum at the base of the spine and the greater trochanter of the femur at the point of the hip.

When it becomes tight, the piriformis can not only pull on the hip, causing or worsening trochanteric bursitis, it can irritate the sciatic nerve, which runs over, under, or through it, depending on your anatomy. When this happens in piriformis syndrome, it results in pseudo sciatica, which mimics sciatica caused by disc problems in the spine itself. As a result, you may have hip and buttock pain or pain and numbness or tingling going down the thigh to the lower limb.

If you’ve had hip pain, you probably know the drill. You go to the doctor, and they propose some conventional medical treatments. These include:

• Cold packs and heating pads

• Massage

• Over-the-counter anti-inflammatory drugs (NSAIDs)

• Prescription medications, including antidepressants, anticonvulsants, and opioids

The problem with these treatments is that they aren’t long-lasting and don’t get to the crux of your hip pain problem. Instead, they cover it up, often with side effects that cause a new range of issues, from high blood pressure and internal organ stress to extreme drowsiness and even addiction.

If these measures don’t bring relief, your physician may recommend surgery, which has its own list of downsides, including:

• Expenses not covered by insurance (deductible, copays, refused charges)

• Intrusive pre-op testing

• Disruption and downtime during recovery

• Complications of anesthesia

• Post-operative medical problems

• Failure to achieve desired results

A better approach is to look for treatments that try to cure the cause of your hip pain. And if it can’t be eliminated, pain should be managed with non-surgical options that are less dangerous and last longer.

At Core Medical & Wellness, you’ll find alternative hip pain treatments that don’t involve surgery. It starts with a consultation to look at your medical history and personal account of what’s going on, paired with a physical exam and medical imaging, if necessary. From there, we build a plan together to tackle your pain.

Core Medical & Wellness is made up of a team of rheumatologists, sports medicine practitioners, orthopedists, spine specialists, and doctors practicing men’s and women’s health. Hip pain treatment options include:

• Spinal cord stimulation

• Nerve blocks and epidurals

• Fluoroscopic-guided hip injection

• Endoscopic discectomy

• Sacroiliac joint and piriformis injection

We also offer innovative regenerative medicine treatments with platelet-rich plasma (PRP) and bone marrow concentrate (BMC). These non-surgical injection treatments use elements derived from your blood to reduce inflammation and initiate long-term healing with cells that keep renewing. It’s one of the latest areas of sports medicine and degenerative joint disease treatments, with the potential to completely change how hip pain is managed and eliminated.

Ready to learn more and find out what’s causing your hip pain, so you can start on a journey to feeling better? Call Core Medical & Wellness at 888-521-0688, or reach out online to start the conversation today.