We get asked about hip pain very often in our practice. People ask if we can treat it, what causes it and is it serious. In order to help clarify a couple of things about hip pain and what treatments are available to you, we decided to write about it here so you can access it whenever you’d like.
First, hip pain can be caused by many different things. Some of the more common one’s I will go through here and I’ll mention some others as needed for completeness.
Arthritis is a very common cause of hip pain in people over 50 years of age. The most common type of arthritis is osteoarthritis (OA). This is basically caused by wear and tear on a joint. Even though OA is not an inflammatory arthritis, it still causes inflammation in the joint. The major difference is the inflammation comes from the wear and tear on the joint, not an inflammatory reaction in the joint. Other types of arthritis are known as inflammatory arthritis. These include rheumatoid arthritis (RA), psoriatic arthritis and juvenile rheumatoid arthritis. The inflammatory arthritides are much less common but must be considered, especially there is an underlying history of certain problems. The damage caused by inflammatory arthritis tends to be much more severe and usually occurs in multiple joints.
Today we are going to focus more on the non-inflammatory causes because these are much more prevalent today. However, if you would like to ask us any questions about inflammatory or other more rare causes of hip pain because you think you may be at risk, please do not hesitate to call our office or visit your primary care physician for a thorough workup.
Another common cause of hip pain is bursitis. Now, a bursa is a fluid-filled sac that cushions your bones and tendons near your joints. Bursitis is inflammation of that bursa (sac). Most common areas for bursitis to occur is in the shoulder and hip regions. Treatment for bursitis is usually rest, physical therapy, chiropractic joint mobilization/manipulation, soft tissue manipulation (muscle work) and ice/heat. Over the counter anti-inflammatory medications are often used and helpful. For more severe or recurrent cases, cortisone injections can be used and often work quite well. Pain management like this often works very well in conjunction with chiropractic and physical therapy procedures.
Hip labral tears are another cause of hip pain. The labrum is a cartilage ring that lines the inside of your hip joint and it acts to hold the thigh bone more securely in the joint. It provides a good deal of extra support. Athletes tend to be at a higher risk for this injury but even if you’re a weekend warrior, you can still develop this condition. Again, treatments vary with the severity of the injury. Sometimes conservative treatments such as chiropractic and physical therapy along with some OTC pain medication will do the trick. If the injury or the pain is more severe and has not responded to conservative treatments, then surgery may be required. This is called arthroscopic surgery and is performed by an orthopedic surgeon. The torn piece of labrum may either be removed and the area ‘cleaned up’ or the surgeon may sew the labrum back together, whichever they feel is the most beneficial for you.
Hip fracture is a common cause of hospital admission in people over 65 years of age. According to the CDC, over 95% of hip fractures are due to falls. Also according to the CDC, 1 out of 5 hip fracture patients die within a year of the hip fracture due to complications. Treatment of a hip fracture is surgery and hospitalization, followed by extensive rehabilitation in a nursing home. This is a great reason to work on your strength and balance and avoid this altogether. If you are at risk, get involved in a fall prevention program and make your home more “fall-proof” (they show you how in the fall prevention programs).
A herniated disc in the lumbar spine can refer pain (make it feel like pain is coming from somewhere else) to the hip region. This is why you need to have a thorough exam performed and not just take for granted that the pain in the hip region is actually coming from the hip.
Tendonitis and sprain/strain injuries can lead to hip pain. These tend to respond very well to conservative treatments such and chiropractic care and over the counter anti-inflammatory medications in the beginning for pain control. If you are not a fan of over the counter (OTC) medications, either because they upset your stomach or you just choose not to take them, you may want to consider anti-inflammatory herbal supplements. These are generally safe and effective, however, you should check with your doctor first before beginning any new herbal therapy as they can interact with medications you may be on.
For the sake of completeness, here are some of the more worrisome causes of hip pain that we have seen in practice:
•Cancer – metastatic or primary bone cancer
• Avascular necrosis – death of bone due to lack of blood supply
• Osteomyelitis – bone infection
• Legg-Calve-Perthes disease – childhood condition where blood supply to the head of the femur (thigh bone) is cut-off and the bone begins to die. This can also cause knee pain. So knee pain in kids who have not sustained a knee injury should also have the hip evaluated.
It is generally for this reason why you should have any new onset of hip pain evaluated by a licensed physician. If you are experiencing hip pain and have: not had success with treating it in the past, have not had treatment in the past or it is new onset hip pain, give us a call to explore your treatment options.
Village Center Chiropractic healthcare team