Walking, sitting, running, or dancing – it’s all in the hips. Our hips bear the majority of the body’s weight, but overuse of the hip joint can cause pain that hinders your movements.
The team at SportsMed-Wheaton Orthopaedics can help by properly evaluating your specific medical situation and develop a personalized treatment plan that will alleviate your hip pain and restore your mobility.
How the Hip Works
The top of the thigh bone (femur) fits inside the socket of the pelvis (acetabulum). A thin tissue called synovial membrane cushions the hip joint. In a healthy hip, synovial membrane lubricates the cartilage and eliminates almost all friction when moving the hip joint. When the bone and/or cartilage of the hip becomes unhealthy or damaged, the joint can stiffen and cause pain. The most common cause is a fracture or injury to the hip. As people get older and experience trips and falls, hip fractures become more frequent.
Common Causes of Hip Pain
Osteoarthritis and rheumatoid arthritis are two of the most common reasons for hip pain in older adults. Inflammation occurs in the hip joint and breaks down the cartilage over time. Treatment may include anti-inflammatory medications or anti-rheumatic drugs. Sometimes treatment is as simple as applying ice to the affected area for 15 minutes a day and resting as much as possible.
This is an inflammation of the fluid-filled sacs inside the joint that helps protect the muscles and tendons. It occurs usually after constant and repeated movements.
This is an inflammation of the tendons in the hip that attach the bones to the muscles. It can usually be relieved by using over-the-counter pain medication and a non-steroidal anti-inflammatory medication.
Femoroacetabular impingement (FAI) is a condition where the bones of the hip are abnormally shaped. Because they do not fit together perfectly, the hip bones rub against each other and cause damage to the joint.
Types of impingement:
Pincer – This type of impingement occurs because extra bone extends out over the normal rim of the acetabulum. The labrum can be crushed under the prominent rim of the acetabulum.
Cam – This is where the femoral head is not round and cannot rotate smoothly inside the acetabulum. A bump forms on the edge of the femoral head that grinds the cartilage inside the acetabulum.
Combined – Here both the pincer and cam types are present.
- Pain in your hip when walking or standing after sitting for a long period of time
- Tightness or a popping sensation in the groin area or the front of the pelvis
- Limited range of motion in the hip and an increased pain when doing physical activities.
Initially pain can be temporarily relieved through rest, but may flare up again when physical activity resumes.
A hip fracture is a break in the upper quarter of the femur (thigh) bone. There are three different types of hip fractures:
1. Intracapsular Fracture —
These fractures occur at the level of the neck and the head of the femur, and are generally within the capsule. The capsule is the soft-tissue envelope that contains the lubricating and nourishing fluid of the hip joint itself.
2. Intertrochanteric Fracture —
This fracture occurs between the neck of the femur and a lower bony prominence called the lesser trochanter. The lesser trochanter is an attachment point for one of the major muscles of the hip. Intertrochanteric fractures generally cross in the area between the lesser trochanter and the greater trochanter. The greater trochanter is the bump you can feel under the skin on the outside of the hip. It acts as another muscle attachment point.
3. Subtrochanteric Fracture —
This fracture occurs below the lesser trochanter, in a region that is between the lesser trochanter and an area approximately 2 1/2 inches below .
A patient with a hip fracture will have pain over the outer upper thigh or in the groin, and find significant discomfort with any attempt to flex or rotate the hip.
Depending on the type of break, severity of the break and the condition of the patient, a surgical repair may note be feasible. We immobilize the hip, prescribe anti-inflammatory medicine, and confine a patient to bed rest while monitoring the healing process with frequent X-rays.
Depending on the type of break, severity of the break and damage incurred, screws and plates may be used to realign the bone and joint. Additionally, cleaning the joint of bone fragments and repairing any damage to the tendons and ligaments is also performed.
Common Treatments and Surgical Solutions for the Hip
Depending on the type of impingement, the following treaments may be provided:
- Activity changes
- Non-steroidal anti-inflammatory medications
- Physical therapy
Arthroscopic surgery to repair or clean out any damage to the labrum and articular cartilage; further correction of the FAI by trimming the bony rim of the acetabulum and shaving down the bump on the femoral head.
Hip Arthroscopic Surgery
This type of surgery is used for a variety of hip conditions, primarily the treatment of labral tears. Other less frequent conditions treated through hip arthroscopy include tendon or ligament injuries.
Hip replacement is usually a last resort treatment for patients with severe hip pain. In this procedure, the diseased bone and cartilage are replaced with an artificial joint, called a prosthesis, which is comprised of metal and plastic material. It provides pain relief and restored function for usually 25 years or longer.