How to correctly interpret hip pain

How to correctly interpret hip pain

Hip pain, especially in older people, is often hastily attributed to hip arthrosis. However, there can be a variety of different causes for hip pain. Find out here how to correctly interpret hip pain and what you can do about it.

The cause of hip pain can sometimes be difficult to determine

When pain occurs in the hip, it is not always the hip joint itself that is causing the pain – it is not uncommon for the hip pain to come from tendons, muscles, or other joints in the hip area.

Conversely, pain from hip joint diseases often radiates into the back, groin, and leg. In addition, generalized diseases of the skeletal system – such as rheumatic diseases – can cause problems in the hip, among other things.

To make the diagnosis easier for the doctor, it is important to accurately characterize the hip pain in terms of type, occurrence, and duration. For example, is the pain unilateral or bilateral? Is the hip pain noticeable when running, sitting, or lying down? Such information and the description of additional symptoms are important for the doctor to be able to find out the cause of the hip pain.

 

Acute hip pain after injury

If hip pain occurs suddenly, the cause is often a strain in the hip muscles. There does not have to be any trauma in the sense of an accident – often a wrong sudden movement, for example when playing sports, is enough.

You should then take it easy for a few days and cool the affected area. If the pain is very severe or does not improve, you should consult a doctor to be on the safe side to rule out a muscle tear or a bone injury.

A femoral neck fracture is rarely the cause

In rare cases, a  fracture of the femoral neck can also  be the reason for hip pain. Although fractures of the pelvis or hip joint are usually the result of a serious fall or an accident, even   minor trauma can lead to a fracture of the femoral neck , especially in older people with osteoporosis .

This is then manifested by  very severe pain in the hip,  making walking and standing usually impossible.

 

Bursitis: Pain when walking

Inflammation of the bursa ( trochanteric bursitis  ), which acts as a cushion between the tendons or muscles and the thigh bone, can lead to  pulling or stabbing pain in the hip  . The hip pain initially only occurs  when moving  – for example when walking – but later pain also occurs at rest.

The cause is often overload, which leads to irritation of the bursa. But infections,  gout  or after hip surgery can also lead to bursitis.

“Start-up pain” in hip osteoarthritis

Hip osteoarthritis (coxarthrosis) involves gradual destruction of the joint cartilage over the course of several years, which is usually caused by age-related wear and tear. However, injuries, circulatory disorders, metabolic diseases or congenital misalignments of the hip joint can also cause hip osteoarthritis.

Typical symptoms include a  morning “start-up pain”  that improves with exercise, and a feeling of stiffness in the hip. In the later stages, there may be a restriction of mobility and pain at rest – the symptoms may then also occur at night when lying down.

Hip inflammation: Unilateral pain on the right or left

Hip inflammation (coxitis) can be caused by bacteria and usually occurs after hip surgery or a hip puncture. Bone marrow inflammation ( osteomyelitis ) can also lead to hip inflammation due to the spread of bacteria.

A so-called aseptic hip inflammation, i.e. without the involvement of bacteria, can occur, for example, in the context of rheumatic diseases or arthrosis.

Irrespective of the cause, hip inflammation manifests itself in mostly one-sided pain in the hip, which can occur under load and at rest. In addition, there is often swelling, redness, and overheating in the area of ​​the joint.

 

Hip cold after infection

A special form of hip inflammation in children is the so-called hip cold (coxitis fax). This is a temporary inflammation of the hip joint, which often occurs about one to two weeks after a common cold or a gastrointestinal infection.

Symptoms are sudden pain in the groin and hip joint. This pain can even extend to the knee. A hip cold is usually harmless and goes away on its own after about seven to ten days.

Affected children should take it easy and, if necessary, take anti-inflammatory painkillers such as ibuprofen or diclofenac to relieve pain.

In children: rule out Perthes disease

Hip pain in children can often occur as part of growing pains and is then usually harmless. However, Perthes’ disease can also be the cause: In this disease, the femoral head bone dies off due to a circulatory disorder.

Symptoms of Perthes’ disease are pain in the hip and knee, which often occurs on one side. Affected children adopt a protective posture and limp when walking.

The treatment initially consists of relieving the load on the hip joint using splints and crutches as well as special physiotherapy. The children must avoid jumping movements and shock loads. In the advanced stage, an operation may be necessary to prevent malformation of the femoral head.

Epiphysiolysis: emergency in adolescents

If adolescents suddenly experience hip pain that is so severe that walking and standing is no longer possible, the growth plate on the femoral head may slip off (epiphysiolysis capitis femoris). Overweight boys over the age of nine are most commonly affected.

If epiphysiolysis is suspected, you should take your child to an emergency room immediately, because if left untreated, the femoral head can die. To prevent this, an operation is necessary in many cases, in which the growth plate that has slipped off is fixed.

 

Wrong shoes when jogging

If hip pain occurs, especially during or after running training, the wrong or unsuitable running shoes are sometimes the cause. Because if the impact load is not properly cushioned when running and the shoes do not support the foot optimally, the joints will be under stress. Running on a surface that is too hard or uneven can also lead to hip pain when jogging.

The best thing to do is to go to a specialist shop for advice on the best shoes and the right running technique. You should also make sure to warm up with stretching exercises before running and avoid overly intense training. Under certain circumstances, a gait analysis by an orthopedist can also be useful to rule out a malposition of the feet.

hip pain in pregnancy

Especially towards the end of pregnancy, women often suffer from hip pain, which can radiate to the back and legs. This can have different reasons:

  • Hormonal changes cause the pelvic bones to shift and the pubic symphysis, which connects the two halves of the pelvis, to relax. Such pelvic pain is noticeable, for example, when climbing stairs or turning in bed.
  • A one-sided sleeping position can also cause hip pain, since pregnant women usually sleep on their side, especially in the last trimester. The associated pressure on the hip can lead to pain in the long run.
  • Another possible cause is weight gain. This is often associated with changes in the tissue and can also trigger tension due to the changed posture.
  • In addition, pregnant women can experience increased hip bursitis as a result of the increased stress.

If pregnant women suffer from hip pain, they should discuss this with their doctor. Gymnastic exercises or acupuncture often help to relieve the pain or prevent it from developing. A pillow between the legs can also help if hip pain occurs, especially at night when lying down.

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