Our hip joints are highly robust and designed for repeated motion. However, they are not indestructible, so with age and usage hip pain and wider issues can arise, even in the healthiest of people. Fortunately, these days there are plenty of treatment options available for hip pain, as well as advanced surgery techniques should a full hip replacement be necessary.
About the hip
The hip joint is the largest ball-and-socket joint in the body and is made up of a ball at the end of the thigh bone that fits into a socket, called the acetabulum, in the pelvis.
They join together in a way that allows fluid movement, due to a cushioning of cartilage that helps to prevent friction when the hip bone moves in it’s socket.
Both the head of the femur and the socket are coated in cartilage and a fibrous capsule covers the entire joint, offering support and lubrication.
Hip pain can occur in people of all ages, but it is more common as we get older.
Osteoarthritis – the most common cause of hip pain
The most common cause of hip pain is osteoarthritis, sometimes referred to as arthrosis or osteoarthrosis.
According to Arthritis Research UK, over 8 million people suffer with this condition in the UK alone, with many more worldwide.
Osteoarthritis is, broadly speaking, a bone inflammation, that can affect any joint in the body. It causes pain and stiffness where the inflamed and damaged joints don’t move together as smoothly as they should.
The inflammation causes the cartilage at the end of the bones to become thinner and rougher. Subsequently, the body instinctively attempts to repair the damage yet in doing so the bone underneath the cartilage grows thicker.
Hip pain from osteoarthritis can be a cause of one, or more, of these key symptoms:
- Bony growths, called osteophytes, can grow around the edge of the joint.
- The synovium may also thicken and produce excess synovial fluid, causing the joint to swell.
- The surrounding capsule may also expand and contract in attempts to stabilise the joint.
There is no cure for osteoarthritis, but there are various treatments that can be highly effective. However, whilst surgery isn’t always necessary, sometimes it is the best option.
Approximately 80,000 hips are replaced each year in England & Wales, according to National Joint Registry statistics, so it is becoming a fairly common procedure, that can produce excellent results.
Less common hip pain causes
There are many other, less common causes of hip pain.
Femoroacetabular Impingement
With this condition, the hip bones rub together and catch on each other, because they are abnormally shaped. There is typically extra bone along the head and neck of the femur, or on the rim of the acetabulum (socket), sometimes both.
This friction can over time, cause damage to the soft tissue or even result in osteoarthritis.
Hip Dysplasia
With this condition, there are abnormalities in the hip joint, or in the hip socket, causing them to not fit together in the proper way.
In some cases the hip joint is the wrong shape. In other cases the hip socket isn’t in the correct position, with the socket being too shallow, or out of shape.
Hip pain arises from higher levels of wear and tear to the hip bones and cartilage.
Synovitis
The lining of the hip joint is called the synovium, or synovial membrane. It produces synovial fluid that keeps the joint lubricated. On occasions the synovium gets inflamed and causes pain in the hip area. Causes of synovitis can include complication of an injury, arthritis, an irritation in the joint, or collagen diseases.
Hip Joint Infection
Like other parts of the body, the hip tissue can get infected, such as septic arthritis or osteomyelitis. The symptoms are hip pain with a fever and it is important to see a doctor if you experience this type of hip pain.
It is typically possible to remove affected tissue with key-hole surgery.
Loose bodies
If piece of bone, cartilage or other foreign objects get trapped in the joint, this is referred to as loose bodies. They can occur following a fracture, or due to osteoarthritis and can cause pain in the joint that needs treatment.
Snapping Hip Syndrome
If you move your hip and it snaps or pops, this is referred to as Snapping Hip Syndrome. It can be caused when a muscle or tendon slides over the protruding part of your hip, or it can be caused from injury.
Hip Labral tears
The ring of cartilage that surrounds the outside rim of you hip joint socket is called the labrum. It’s function is to help hold together the ball in the hip joint and your thighbone, within the hip socket.
A labral tear occurs when this cartilage tears with is most common in certain athletes, such as football players, golfers and ballet dancers, due to the type of movement they incur in their activities.
Osteonecrosis
This condition is due to reduced flow of blood in the hip joint, which results in the bone breaking down.
Bursitis
Bursitis is an inflammation of the bursa, which is sac of fluid that sits over your hip joint.
Injury
An injury or fall can cause the hip bone to fracture. This is more common in older people, where bones are generally weaker and causes immediate, sudden hip pain that needs medical attention.
Diagnosing the cause of your hip pain
The location of you hip pain provides clues about the cause.
However, the only way to get accurate diagnosis is to speak with an orthopaedic specialist that can exam you fully using the latest technology.
Generally, hip joint problems cause pain to the groin area or the inside of the hip.
Issues with muscles, ligaments and tendons usually manifest with hip pain on the outer side of the hip, upper thigh or outer buttock.
Sometimes pain from other parts of the body, such as the lower back or groin, travel to the hip area too, so there isn’t always a logical explanation.
Treatment of hip pain is very successful and there are several options to try before surgery needs to be considered.
