Hip Pain

What is pain in the hip?

Pain in the hip, or coxalgia, is pain caused by disorders of the hip joint and the tissue surrounding the hip joint.

Causes

Pain in the hip can have many causes, the most common being osteoarthritis and bursitis of the hip. Osteoarthritis of the hip is more frequently seen above the age of 50; other factors such as congential diseases, certain sports and accidents involving the hip may also play a role in the development of osteoarthritis of the hip. Obesity does not play a role in the development of hip osteoarthritis, but it does aggravate pre-existing hip osteoarthritis. The development of bursitis of the hip is clearly associated with pre-existing osteoarthritis of the knee or of the hip and with pre-existing back problems.

Signs and symptoms

The patient may feel radiating pain on the front and outer side of the thigh down to the knee, in some cases accompanied by groin pain and usually brought on by impact-loading activities. Patients also complain of morning stiffness that disappears within an hour of getting up. In hip bursitis the pain is felt above the hip joint and on the side of the upper leg, radiating to the knee and sometimes down to the ankle. Patients mainly complain of pain at night when lying on the affected hip.

How is hip pain diagnosed?

In hip pain, an examination of the lower back, the pelvis and the knee must always take place. Since patients mainly complain of pain in the groin it is also important to examine the groin. A neurological examination is carried out to exclude a herniated disc. The SI-joint must also be examined thoroughly. Other causes are tumours, fractures, disorders of the head of the femur and infections. In hip bursitis, it is important for the doctor to put local pressure on the bursa in order to demonstrate painful bursitis of the hip.

Do I need additional examinations?

Diagnostic examination for other non-physical factors important for your pain, have already been done by yourself trough filling out your pain questionnaires.
Blood tests are required when systemic conditions such as rheumatoid arthritis are suspected.
If the hip problems continue to persist: X-rays, Ultrasound and an MRI scan.
A bone scan will be performed if a tumour is suspected.

What are my treatment possibilities?

Multidisciplinary Treatment

Depending on the cause of your pain, your pain specialist will decide whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, apart from physical treatment, other methods of treatment will be suggested.

Non-physical Treatments

If the results of your pain questionnaire are abnormal, your pain specialist will offer you one of the non-physical treatments listed below:

Physical Treatments

Medication

Anti-inflammatories (short period)

Other Treatments

Interventional Pain Treatments

Local injection of the hip bursa