As an Orthopaedic Surgeon, my office sees patients with a variety of hip conditions. Hip pain can come on gradually over time or quickly. As we work with a patient, we assess the situation and start with conservative treatments. When appropriate we will recommend surgery, or knee or hip replacement. The most common hip conditions that we see are:
Osteoarthritis and rheumatoid arthritis are most frequently seen in aging adults (adults over age 30 but more commonly over 50.)
Osteoarthritis is also called degenerative joint disease. It causes the cartilage that cushions the bones at the joint to deteriorate. As the bones break down, bone spurs can occur. As the disease progresses, bone rubs on bone causing more pain and loss of movement in the joint.
Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints. It is caused when your immune system mistakenly attacks the thin membrane that lines your joints (the synovium). The synovium makes a fluid that allows the joints to move smoothly. RA causes the fluid to thicken which causes pain and swelling. If the swelling is not managed, cartilage damage can occur. Eventually, RA can cause cartilage loss, uneven spacing between the bones, and joint deformity. All of this adds up to pain and loss of mobility.
There is no cure for osteoarthritis or rheumatoid arthritis but caught early enough the symptoms can be managed. Arthritis is the number one reason people come to see me for knee and hip replacement.
Bursitis is the most common cause of hip pain. Bursa are jelly-like sacs that provide cushioning between bone and soft tissue. Bursa sacs are located throughout the body. There are two on each hip. One is on the outside of the hip, called the trochanter bursa, and one is on the inside of the hip near the groin called the iliopsoas bursa. When these become inflamed because of an injury or overuse they can cause pain as you walk, climb stairs, lay down, etc. The good news is it is treatable once diagnosed.
Osteonecrosis of the Hip
Osteonecrosis of the hip is the third most common reason for total hip replacement. It is a condition that is caused by a discontinuance of blood flow to the top of the thigh bone (femur.) Bones need blood flow to survive. When the blood flow is stopped, the bone will die and start to deteriorate. When caught early, osteonecrosis can be treated by restoring the blood flow. If it is not caught early, total hip replacement is the only option.
A hip fracture is a break in the upper part of the thigh bone caused either by a fall or direct impact to the hip. Hip fractures are diagnosed by x-ray and sometimes with MRI’s. Depending upon the patient’s health and the location of the fracture, the fracture is usually repaired with surgery. The repair might entail repairing the bone with a nail and screws or a plate and screws, or it might require total hip replacement. Hip fractures are best repaired within one to three days of the fracture. After surgery the patient will require physical therapy to get back on their feet.
Hip Labral Tear
At the top of your leg bone is a ball. That ball goes into your hip socket. Covering the socket is soft tissue called labrum that allows the ball to move smoothly in the socket. This soft tissue can be torn due to an injury, structural problems (when the ball doesn’t fit properly in the socket), or degenerative issues (when osteoarthritis sets in and causes the cartilage to wear down.) A hip labral tear may have no symptoms, or you may experience hip pain, stiffness, clicking sounds in the hip when you move, pain in the buttocks or groin, or a feeling of unsteadiness on your feet. The pain may be worse when you move, bend or rotate your hip. An x-ray or MRI is used to diagnose a hip labral tear. Typically, hip labral tears don’t heal on their own, but the pain can be managed. In severe cases, surgery may be necessary.
You’ve no doubt, at one point in your life, pulled a muscle. A muscle strain in the hip is the same thing. However, the strain can range from mild to severe. Depending upon the severity, muscle strains will usually heal up on their own at home. If a muscle is torn, it may require surgery.
Hip tendonitis is a strain of the tendons that are part of your hip flexors. These tendons can be strained by overuse from exercise such as too much bicycling, gymnastics, ballet or running. They can also be strained by a fall or other type of accident. Typically, tendonitis is treated at home with rest, ice, heat and massage, anti-inflammatory medications, and sleeping with a pillow between your legs to reduce strain.
Diagnosing Your Hip Pain
If you are suffering from hip pain, call my office today to schedule an appointment so we can identify the pain and get you back to living pain free. Call (719) 632-7669