Hip pain is a common complaint that can be caused by a wide variety of problems. It is a symptom of several conditions, including arthritis, hip injuries, bursitis, and childhood illnesses. Athletes who move their hips in multiple directions are more likely to have hip injuries and suffer hip pain.

The location of pain can vary significantly depending on the source that is causing it.

Problems within the hip joint itself usually lead to pain on the inside of your hip or your groin. Pain in and around the hip may also result from injury to the surrounding muscles, tendons, or bursae (small fluid-filled sacs that cushion and lubricate joints). Sometimes, hip pain can be caused by diseases and conditions in other areas of your body, such as your lower back, a condition called referred pain. You can even feel pain that originates in the hip from your leg down to your knee and in your buttocks.

A look at the different conditions and injuries that can cause hip pain, along with conservative ways to treat it.

Common Hip Problems

Many different conditions and injuries can cause hip pain. Some of the more common ones include:

Arthritis

Arthritis is the most common cause of the breakdown of hip tissue. Three kinds of arthritis commonly affect the hip:

  • Osteoarthritis – Also known as degenerative joint disease, this is the most common type of arthritis. It occurs when the protective cartilage that cushions the ends of your bones gradually breaks down over time, causing the bones to rub against each other, causing hip pain and stiffness.
  • Post-Traumatic Arthritis – This is a common form of osteoarthritis that occurs due to a physical injury to any kind to a joint. It is often the result of an injury or fracture that changes the mechanics of the hip joint, making it wear out more quickly as a result.
  • Rheumatoid Arthritis – This is an autoimmune disease, that attacks the hip joint capsule’s lining, known as the synovial membrane. It causes it to become inflamed and swollen. This disease process can eventually destroy cartilage and bone within the joint, leading to pain and stiffness.

Bursitis of the Hip

The bursae are small, fluid-filled sacs that cushions the bones, tendons, and muscles near your hip joint. Bursitis of the hip causes pain in the hip when a bursa becomes irritated or inflamed.

There are two major bursae of the hip, both of which can be associated with stiffness and pain around the hip joint.

The Trochanteric Bursa is located on the side of the hip and separated significantly from the actual hip joint by tissue and bone. Bursitis in this bursa frequently causes pain and tenderness in the outer hip and thigh, making it difficult for those affected to lie on the involved side, causing difficult sleep.

The Ischial Bursa is located in the upper buttock area. Bursitis in this bursa can cause dull pain that is most noticeable when climbing uphill, or after prolonged sitting on hard surfaces.

Avascular Necrosis

Avascular necrosis is a disease that results from the temporary or permanent loss of blood supply to the bone. Without an adequate blood supply, bone tissue starts to die, and as it loses its structural integrity, tiny breaks called microfractures begin to form. These microfractures can cause the collapse of the weight-bearing surface of the bone, causing pain. If the bone affected is near a joint, the joint may also collapse.

Hip Pointer

A hip pointer is a deep bruise to the ridge of bone on the upper outside of your hip, called the iliac crest. It’s often a result of a direct blow to the hip or a hard fall.

Conservative Hip Treatment Options

There are conservative, non-invasive treatment methods available to manage and treat hip pain. On the outset, physical therapy and weight management can provide relief for many.

You can often treat hip pain with the RICE protocol. “RICE” stands for rest, ice, compression, and elevation. It’s a simple self-care technique that can help relieve pain and swelling and promote healing and flexibility.

With RICE, “Rest” with a break in the activity that may be causing pain or soreness to give your hip a chance to recover. “Ice” helps reduce the pain and swelling with cold. “Compression” wrapping for 24 to 36 hours, but not too tightly, will help decrease swelling. And “Elevating” the hip above your heart for a few hours each day will also help to minimize swelling.

Other non-surgical techniques to help alleviate your hip pain include:

  • Cortisone injections are the first line of defense against osteoarthritis symptoms and other joint pain the hips. They can help relieve joint pain and inflammation. These injections usually contain a corticosteroid medication and a local anesthetic. The number of injections you can get in a year is limited because of potential side effects.
  • Platelet-rich plasma (PRP) injections can treat osteoarthritis joint pain. PRP therapy takes a patient’s own blood, concentrates the platelets in that blood, and then reinjects them to accelerate the healing of injured tendons, ligaments, muscles, and joints. Research studies and clinical practice have also shown PRP injections can alter the immune response to help reduce inflammation. Currently however, PRP therapies are not covered by most health care plans.

A key to success with conservative hip pain treatment options is to visit a healthcare expert early when the hip pain becomes persistent.

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In the United States, more than 23% of all adults have arthritis. It is the swelling and tenderness of one or more of your joints. It is characterized by joint inflammation, pain, and stiffness, and it typically worsens as you get older.

There are more than 100 different kinds of arthritis and related conditions. The most common types are osteoarthritis and rheumatoid arthritis.

What’s the difference between the two? Osteoarthritis, the most common form of arthritis, involves wearing away the protective cartilage covering bones where they form a joint. On the other hand, rheumatoid arthritis is an immune system disease that attacks the joints – inflaming the protective synovial membrane, causing pain, swelling, and eventually, joint erosion.

We’ll look a little deeper at each of these conditions.

Man rubs his arthritic hands.

Osteoarthritis

Osteoarthritis develops as the protective cartilage that cushions the ends of your bones gradually breaks down over time. This allows the bones in joints to rub against each other. When the cartilage deteriorates, joints no longer have the padding they need to move and extend properly.

This condition causes severe joint pain and stiffness. Although osteoarthritis can affect any joint, it frequently affects joints in the hands, neck, back, knees, and hips.

Inflammatory Osteoarthritis

For years the prevailing view was that osteoarthritis was mainly the result of a lifetime of “wear-and-tear” on joints. As a result, it was easy to classify arthritis as either non-inflammatory, such as osteoarthritis, or inflammatory, such as rheumatoid arthritis.

However, there are forms of osteoarthritis that are now recognized as being inflammatory. This variant typically comes on suddenly in middle-aged women, affecting the joints of the fingers. Thus, it’s crucial to get a proper diagnosis because treatment for this inflammatory form of osteoarthritis is different from the treatment for rheumatoid arthritis or typical osteoarthritis.

Osteoarthritis Treatment

Osteoarthritis pain symptoms can be relieved with medications such as acetaminophen (Tylenol and others) and nonsteroidal anti-inflammatory drugs (Advil, Motrin IB, and others). A physical therapist can also show you exercises to strengthen the muscles around your joint, increase your flexibility, and reduce pain.

If these conservative approaches are insufficient, your doctor may recommend cortisone injections to relieve pain in your joint. If the joint in question is the knee, injections of hyaluronic acid, also known as viscosupplementation, may also offer pain relief by providing some cushioning in your knee.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic, inflammatory autoimmune disorder that can affect more than just your joints. It occurs when your immune system mistakenly attacks your own body’s tissues.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

Rheumatoid arthritis symptoms may include swollen joints and joint stiffness, particularly after waking, fatigue, fever, and appetite loss. Nearly half of those with rheumatoid arthritis also experience symptoms that don’t involve joints but extend to other body structures such as skin, eyes, nerve tissue, and organs.

Rheumatoid Arthritis Treatment

The goals for treating rheumatoid arthritis are to control a patient’s symptoms, prevent joint damage, and maintain a patient’s quality of life and ability to function. Since joint damage occurs within the first few years after the onset of rheumatoid arthritis, it is crucial to diagnose and treat it early to minimize long-term issues. Treatments include medications, rest, exercise, and physical therapy. In some cases, surgery is also appropriate to correct damage to a joint.

The type of medications your doctor recommends will depend on how severe your arthritis is and how well you respond to the medications. These medications include nonsteroidal anti-inflammatory drugs (NSAIDs), Corticosteroids, COX-2 inhibitor, disease-modifying anti-rheumatic drugs (DMARDs), and biologic agents (which tend to work rapidly).

Advances in Treatment

The effects of rheumatoid arthritis and osteoarthritis on a person’s life can range from mild to severe. While they have some similar symptoms, they have very different causes and require different treatments. Osteoarthritis usually affects fewer joints than rheumatoid arthritis and doesn’t involve autoimmune issues, making it easier to treat. The progression of rheumatoid arthritis is more challenging to predict than is osteoarthritis.

Breakthroughs in medical science are also helping researchers optimize existing treatments and develop new treatment approaches for managing rheumatoid arthritis. To learn more about the latest treatment options and how they might help you, talk to your doctor.

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