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Hip Pain

rheumatoid arthritis

The hip is an important joint that you use every day as you walk, run, and jump. Because of this, our hips are especially prone to injury and pain at any stage of life.

At MedStar Orthopedic Institute, our hip doctors specialize in diagnosing and treating a wide range of conditions resulting in hip pain, whether it’s from a sports injury, trauma, or joint inflammation.

No two injuries are alike, so it’s important to seek care if you have any of the following hip symptoms:

  • A joint that appears deformed
  • A limp or lurch to the side with walking
  • Difficulty moving your leg or hip
  • Difficulty bearing weight on the affected leg
  • Intense pain or pain that wakes you from sleeping, especially in the groin/thigh
  • Signs of infection, such as local pain, fever, chills and sweats
  • Thigh and buttock swelling

Learn about some of the most common causes of hip pain below.

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Arthritis is a common hip condition that occurs when the tissue surrounding your joints becomes inflamed. This causes pain, swelling, and damage to the joint, making it hard for you to do everyday activities.

There are different types that affect the hip, including:

Osteoarthritis

Osteoarthritis occurs when the cartilage between the bones at joints wears away as part of the natural aging process. It can occur in any joint in the body. Most often, it develops in weight-bearing joints, such as the hip and knee.

Osteoarthritis develops slowly and the pain it causes worsens over time. Certain factors may make you more likely to develop the disease, including:

  • Increasing age
  • Family history of osteoarthritis
  • Previous injury to the hip joint
  • Obesity

Inflammatory Arthritis

Some types of inflammatory arthritis, including rheumatoid arthritis, may result in dull, aching hip pain. Rheumatoid arthritis is not hereditary. However, researchers believe some people may have a gene that can be triggered by an infection or environmental factor. When this happens, it prompts the immune system to respond by producing a chemical that attacks and destroys the joint surface.

Unlike osteoarthritis, stiffness or pain from inflammatory arthritis may improve with activity. However, since there is no cure, you should see a hip doctor if your pain affects your everyday life.

Post-Traumatic Arthritis

Post-traumatic arthritis is a form of osteoarthritis that develops after you experience an injury to the hip. It can develop years after your injury occurs.

Arthritis gradually worsens over time. The sooner you start treatment, the more likely it is that you can lessen its impact on your life. Although there is no cure without surgery, there are many treatment options to help you manage pain and stay active. However, your doctor may recommend surgery if your pain from hip arthritis causes disability and is not relieved with nonsurgical treatment.

Avascular necrosis of the hip occurs when a part of the bone dies after losing its blood supply. The lack of blood may cause the surface of the bone to collapse, and arthritis will develop. Causes may include:

  • Excessive alcohol consumption
  • Injury to the hip
  • Some diseases
  • Trauma
  • Use of corticosteroids

Symptoms vary depending on the cause, but pain in the hip is common. Although nonsurgical treatment options can relieve pain and slow the progression of the disease, surgery may be your most effective treatment option.

Learn more about hip replacement surgery.

The abductor muscles are located on the side of the hip. These muscles move the leg away from the midline of the body and support the pelvis during weight-bearing activities.

Abductor tears usually occur during the following activities:

  • Changing direction quickly
  • Overstretching the muscle, such as in martial arts high kicks
  • Rapid leg movements against resistance, such as kicking a ball
  • Sprinting

Abductor tears can also occur as a chronic degenerative process, especially in the setting of a diseased abductor tendon.

These tears can cause severe, chronic pain and weakness and may not respond to nonsurgical treatment. However, many of these tears can be repaired by arthroscopic hip surgery.

Learn about hip arthroscopy.

Bursitis is inflammation or irritation of a bursa, a small sac of fluid that serves as a cushion between joints, muscles, and tendons. There is a bursa located on the inside of your hip (iliopsoas bursa) and a bursa on the outside of the thighbone, (trochanteric bursa). When one of these becomes inflamed, it may result in hip bursitis.

Hip bursitis is most common in women and middle-aged adults. You may be at an increased risk for hip bursitis if you have or have had any of the following:

  • Bone spurs or calcium deposits
  • Hip injury
  • Overuse of the hip (Repetitive movement such as bicycling or climbing for a long period)
  • Previous surgery
  • Rheumatoid arthritis
  • Spine disease
  • Weakness of hip abductor muscles

Most people experience relief for hip pain caused by bursitis through nonsurgical treatment options, including physical therapy, activity modification, an anti-inflammatory medication, or a steroid injection. Your hip doctor may also be able to drain the fluid. In rare cases, your doctor may recommend hip arthroscopy, a type of hip surgery to remove the inflamed bursa.

Learn about hip surgery.

Hip impingement occurs when there is excessive bone around the joint socket and/or ball of the thighbone (femur). When that happens, it causes an abnormal shape that impacts the joint's ability to move smoothly. This can damage the surrounding cartilage, causing increased pain in the hip and possibly, hip arthritis.

Symptoms may also include:

  • A feeling of the hip catching or locking during movement
  • Decreased range of motion with hip rotation
  • Discomfort in the hip while sitting or standing
  • Pain in the groin with activity

Also known as femoral acetabular impingement or FAI, hip impingement most commonly occurs in young athletes. However, it can occur at all ages and activity levels.

A hip doctor will use imaging tools, such as x-ray and MRI, to diagnose hip impingement. Nonsurgical treatment options may include rest, physical therapy, and/or steroid injections. If symptoms don’t improve, your doctor may recommend minimally invasive hip surgery called hip arthroscopy.

Learn about hip arthroscopy.

A hip fracture is a break in the upper quarter of the thighbone (femur) that occurs after a fall or direct blow to the hip. In other cases, a fracture may occur gradually as a result of a stress injury. You may be at a higher risk for a stress fracture if you are aging or:

  • Take certain medications, including sleep medications and sedatives
  • Have a chronic medical condition that leads to fragile bones
  • Have a history of tobacco or alcohol
  • Lack essential nutrients in your diet, including calcium and Vitamin D

A hip fracture can limit your ability to move around independently, so it’s important to seek treatment. In most cases, a hip fracture will require hip surgery.

Learn about hip surgery.

The labrum is a structure in the hip that surrounds the pelvic socket and provides some stability to the joint. More importantly, it helps maintain normal fluid in the joint. A tear in the labrum can be caused by injury or overuse. It can lead to pain and catching of the joint.

While many labral tears can be treated by physical therapy or steroid injections in the joint, some cases may require surgery to reattach the tissue to the socket.

Learn about hip arthroscopy.

For a total hip replacement to function effectively, the implant or prosthesis must remain firmly attached to the bone. Over time, however, an implant may loosen from the underlying bone, causing pain in the hip.

It’s not always clear what causes the hip prosthesis to loosen, but factors that may contribute include:

  • High-impact activities
  • Obesity
  • Wear of the plastic spacer between the metal parts of the implant
  • Infection

If you undergo hip replacement surgery at a young age, you may outlive the life expectancy of your artificial hip. As a result, you may be at a higher risk of needing hip revision surgery due to loosening or “wear and tear”.

Learn about hip revision surgery.