Hip Pain

Explore the different types, possible causes and treatment options for hip pain
Written by Leah Bell-Steele
Physiotherapist, University of Queensland
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on March 10, 2022
Contributed by Nikita Mistry
Physiotherapist, Western Sydney University

Woman wearing white t-shirt holding on to her right hip in pain

This article was written, reviewed and contributed by some of Australia’s leading experts in the field of hip pain. We aim to empower you to better understand what’s causing your pain and alleviate any concerns or anxiety you may have.

We also hope to enlighten you with some new information if hip pain is something you’ve been dealing with for a long time.

Included below is a practical and actionable treatment plan, backed by the latest medical research to treat your hip pain (including things you can do from home) and help you get back to feeling your best.

Read the information below as we guide you in understanding the different types of hip pain and help you to discover what type you may have.

What is Hip Pain?

Hip pain is a term used for describing conditions or issues that lead to discomfort around the femoroacetabular joint (hip). Injuries to structures, such as the labrum, muscles, ligaments and bone can lead to hip pain. Examples of common hip conditions include osteoarthritis, bursitis and fractures.

According to the Australian Institute of Health and Welfare, hip pain becomes an increasingly significant problem for people over the age of 60 due to the higher rates of hospitalisations. [1] Research has indicated that approximately 10% of people over the age of 40 will experience hip pain.[2]

Like the shoulder joint, the hip joint is classified as a ball-and-socket joint. This characteristic makes it one of the most mobile regions of the body. The downside of being more mobile, means that these types of joints are not as stable which increases the risk of developing hip pain and injury.

Pain is categorised as either acute, subacute or chronic hip pain

Acute hip pain: (0 days - 6 weeks)

Acute hip pain is pain that lasts anywhere from a few days, up to six weeks. The cause of acute hip pain is usually more minor injuries, like muscle strains or ligament sprains. Of course, not all pain has to have damage, sometimes we may just sleep awkwardly or do something else that may flare up pain without any structural damage. This type of pain usually resolves itself with movement and the appropriate rest.

Subacute hip pain: (6 weeks - 3 months)

Sub-acute hip pain usually results from acute pain that doesn’t quite resolve itself. This can be due to more serious injury, or sometimes a poor recovery. If you are still aggravating your hip pain with painful movements then it may take longer to heal and recover.

Chronic hip pain: (3 months +)

Chronic hip pain is defined as pain that lasts longer than three months. Chronic pain is usually more complex and can be difficult to treat. There are usually multiple factors leading to the development of chronic pain, such as other injuries, stress, lack of sleep or other health and lifestyle issues.

What are the symptoms of hip pain?

Hip pain is the general term used to describe pain felt in or around the hip joint. Symptoms of hip pain can range from a dull ache in the hip region to sharp pain in the hip with certain movements. People may also experience pain that radiates down the legs or into the buttocks.

Common complaints of pain in the hip

People may experience

Pain areas: in the hip, muscles and bones, upper leg or buttocks

Sensory: leg numbness or pins and needles

Also common: hip weakness

What causes hip pain?

Hip pain can be caused by either general wear and tear or a specific injury. Wear and tear of the hip joint usually leads to conditions such as arthritis or bursitis, whereas an injury will appear in the muscles and tendons.

According to Healthdirect, hip pain encompasses “pain on the inside of your hip or your groin and pain on the outside of your hip, upper thigh or outer buttock”.[3]

Hip pain can result from a problem in one or several parts of the hip, including:

  • Muscles (strain)

  • Ligaments (sprain)

  • Nerves

  • Bone injuries - the bones of the hip are the femur (ball) and acetabulum of the pelvis (socket)

Common reasons people experience pain in the hip

  • Falls

  • Obesity

  • Excessive exercise

  • Inflamed tendons

  • Arthritis or inflammation of the joints

Common injuries that cause hip pain

Muscle strain

This can occur when the muscles of the hip joint are overstretched beyond their capacity. Sports and physical activities can challenge the flexibility of the muscle and can result in a strain or tears of the tissues.

Hip bursitis

Hip bursitis occurs when the bursa around your hips that lessen the friction between the bones and other structures become inflamed. This can happen with many repetitive movements of the hip, such as during exercise or climbing stairs.

Sciatica

Sciatica usually refers to pain that begins in the lower back and radiates down the leg due to compression of the sciatic nerve.

Osteoarthritis

As we get older, the protective cartilage of the hip joint eventually wears down, resulting in friction of the joint or contact between the head of the thigh bone (femur) and the pelvis. Osteoarthritis may cause pain and inflammation.

Hip fractures

Hip fractures are rare but can occur, particularly as we age. As we get older, our balance can be compromised, resulting in an increased risk of falls. Additionally, bone density generally decreases as you age, making your bones more susceptible to breaking.

Common conditions that cause hip pain

Several conditions may present with hip pain. If you have any of these conditions, hip pain could be one of the symptoms:

  • Osteoarthritis

  • Osteoporosis

  • Rheumatoid arthritis.

Sports that increase the risk of hip pain

High impact sports with lots of hip movements and sudden stops and direction changes increase the risk of hip pain. Here is a list of the most common sports that result in hip pain:

  • Skiing

  • Basketball

  • Tennis

  • Long jumps

  • Football

  • Soccer

  • Running

How is hip pain diagnosed?

There are several options available when it comes to diagnosing the underlying cause of your hip pain. One of the most common, and one that is recommended by Australian GP’s, is an assessment from a physiotherapist.

Physiotherapists are highly specialised medical professionals that diagnose and treat many types of pain and joint issues. Given hip pain is an extremely common complaint, and something that physiotherapists see regularly, the process of diagnosing it is straightforward.

Like visiting your local doctor, a physiotherapy assessment will start with your physiotherapist asking you vital questions about your health. This is referred to as a consultation. Your consultation will last for about 30 to 60 minutes. It would be best if you took this time to discuss relevant issues relating to your frustrations and struggles.

After establishing the background of your condition, the physiotherapist will perform specific physical tests to determine the most possible cause of your pain and rule out other conditions.

Following your initial assessment, you will be provided with a specific treatment plan based on your condition. This will include:

  • Number of treatment sessions

  • List of exercises you need to do at home

  • Strategies to manage the pain and prevent worsening of the condition

  • Timeline of your full recovery.

How is hip pain treated?

Hip pain can be frustrating and limit your mobility. Problems in the hip joint can affect the quality of your life and should not be ignored.

There are several options when it comes to treating hip pain. One of the more common, and the treatment option that is referred to by most Australian GP’s is physiotherapy.

Middle-aged man being treated for hip pain by a physiotherapist

Hip pain is an issue that physiotherapists come across regularly, and the process of treating it is straightforward. Following an initial consultation, the physiotherapist will be in the best position to determine your treatment plan.

Treatment of hip pain will reduce your pain and improve your mobility by building your muscle strength and joint stability. This will allow you to recover faster from injury and allow you to get back to the things you love.

A combination of manual therapy, modalities and strengthening exercises will be given to you by your physiotherapist. Physiotherapists are experts in dealing with pain and musculoskeletal conditions.

Depending on the severity of your hip pain, a physiotherapist may provide you with a combination of the following types of treatments:

  • Strengthening exercises - Specific exercises tailored to improve your hip pain

  • Manual therapy - Hand-on physiotherapy, used to help reduce pain and increase range of motion in your hip

  • Stretching - Stretching will help lengthen muscles and increase range of motion

  • Joint mobilisation techniques - Specific joint mobilisations are used to reduce stiffness in particular areas

  • Dry needling - A technique used to help alleviate pain and reduce muscle tension

  • Heat therapy - Used to reduce tension and pain in acute situations

A typical physiotherapy session will last anywhere between 30-60 minutes, and it is not uncommon for patients to feel the benefits in just one session.

Next step - Creating a treatment plan made for you.

Following your initial appointment, the physiotherapist will craft a tailored treatment plan that will highlight what course of action is required. This will include what exercises you need to do at home and provide you with a timeline for how long it should take for a full recovery.

Self-care strategies

Whilst physiotherapy is a common choice for professional help, it doesn’t mean there aren’t things you can do to help accelerate your recovery.

If you think you have hip pain, here are the best things you can do and avoid.

Things to do:

  • Cold compress / Heat: If you just injured your hip within the past 24 hours, you can use an ice pack to decrease the pain and control the inflammation around the hip joint.

In contrast, if you are having persistent hip pain for a few days now, you could apply a hot compress on the muscles of the hip joint. This would relieve muscle spasms and increase circulation in the soft tissues around the hip.

  • Gentle Stretching: Stretching of your hip muscles can help reduce hip pain and relieve muscle tension.

  • Rest: Take a break from doing activities that put pressure on your hip joint. Sleep and drink a lot of water to help your body recover from injury.

Things you should avoid:

  • Avoid activities that worsen the pain: Avoid activities that put too much pressure on your hip or require bending at the hip joint.

  • Avoid sleeping on the painful side: Sleeping takes about 6 to 8 hours, and this is a lot of time to take pressure off your hip and heal your injury. Be sure that you are not sleeping on the painful side of your hip to minimise the contact and pressure at the hip joint.

  • Avoid sitting for an extended amount of time: Sitting puts a lot of weight on the hip, especially when you are slouching. Be sure to sit correctly when you work on a computer.

Do I need a specialist or surgery?

Hip pain can be caused by something more serious. For example, traumatic injuries and motor-vehicle accidents, especially among the aged, can cause fractures of the thigh bone (femur) at the hip joint.

Diagnostic imaging may be done such as an X ray, CT scan, or MRI to identify fractures and other severe medical conditions. You may also get a blood test to make sure the problem isn’t related to a disease that causes pain.

In some cases, hip replacement surgery is required to remove the damaged part of the hip joint and replace it with an artificial hip component to act as a functional hip joint and restore mobility.

It is standard for surgeons and physicians to refer patients who undergo hip replacement surgeries to physiotherapists.Physiotherapy can significantly improve the outcome of surgery and ensure the optimal recovery of the patients.

If your GP determines that your hip pain is of musculoskeletal origin, they may coordinate with your physiotherapist to provide you with proper treatment.

What is the recovery time / prognosis for hip pain?

Depending on the nature and severity of the root cause of your hip pain, it may take one to six weeks for the injury to heal. Physiotherapy can improve the outcome and provide faster recovery from injury while preventing secondary complications.

You may immediately feel signs of relief during your physiotherapy treatment. Generally, you will be asked to continue with your program to strengthen your muscles and improve joint stability to prevent future injuries.

Important factors in your recovery post-treatment:

  • Sticking to the program created by your physiotherapist

  • Resuming sports gradually

  • Paying attention to pain and resting as necessary.

Other factors that may influence your recovery time:

  1. Injury severity

  2. Age

  3. Overall health.

Can pain in the hip be prevented?

It’s almost impossible to guarantee prevention of hip pain; however, you can decrease the risk.

  • Move your hip: Exercises and stretching allows healthy movement of the hip joint. Mild exercises can improve circulation and mobility of the hips. This can also prevent pain that’s caused by osteoarthritis.

  • Eat a healthy diet: Include protein from whole food in your diet to ensure healthy muscle and bone building.

  • Manage your weight: Excessive weight puts your hip joint under a lot of stress and pressure, which may lead to wear and tear of the hip’s cartilage.

  • Wear appropriate shoes: Good shoes reduce the impact on your lower body joints such as the ankles, knees and hips. You can ask your physiotherapist for advice for proper footwear based on your lower body screening.

The outlook and the main takeaways

If there is one thing to takeaway from this article, it’s that there are many types, causes and severities of hip pain, and the most important thing you can do is listen to your body and get some help treating your hip pain. Book a time, and have your hip pain diagnosed by a physiotherapist today.

Anatomy of the Hip

The hip joint is a ball and socket joint that allows an extensive range of motion and promotes mobility. Strong muscles, ligaments and tendons surround it. The thigh bone (femur) and the pelvis (acetabulum) forms the hip joint.

Written by Leah Bell-Steele
Physiotherapist, University of Queensland
Published on March 7, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on March 10, 2022
Contributed by Nikita Mistry
Physiotherapist, Western Sydney University
Sources
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Last medically reviewed on March 10, 2022
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