Hip Problem Information

Hip Problem Information

Some Common Hip Pain include: 

Hip Fracture
Trochanteric Bursitis

Hip Pain Overview

The hip joint attaches the leg to the torso of the body. In the hip joint, the head of the thigh bone (femur) swivels in a socket made up of pelvic bones, called the acetabulum. While many causes of hip pain can arise from the joint itself, there are numerous structures surrounding the hip that can also be the source of pain. Trauma is often the cause of hip pain, but any source of inflammation may cause pain in the hip area. Pain is one of the symptoms of inflammation along with swelling, warmth, and redness; together these are signals that a problem may exist.

Hip Pain Causes

Pain can arise from structures that are within the hip joint or from structures surrounding the hip. The hip joint is a potential space, meaning that there is a minimal amount of fluid inside it to allow the femoral head to glide in the socket of the acetabulum. Any illness or injury that causes inflammation will cause this space to fill with fluid or blood, which stretches the hip capsule and results in pain. The femoral head and the acetabulum are lined with articular cartilage that allows the bones to move in the joint with less friction. Also, the socket area of the acetabulum is covered with tough cartilage called the labrum. Just like any other joint cartilage, these areas can wear away or tear and be the source of pain. There are thick bands of tissue that surround the hip joint, forming a capsule. These help maintain joint stability, especially with movement. Movement at the hip joint is possible due to the muscles that surround the hip and the tendons that attach across the hip joint, allowing motion in different directions. Aside from movement, these muscles act in concert to maintain joint stability. There are large bursas (closed fluid-filled sacs) that surround areas of the hip where muscles intersect and allow the muscle and tendon to glide more easily. Any of these structures can become inflamed. Pain from other sources can be referred to the hip, meaning that while the hip hurts, the problem originates elsewhere. Hip pain is a non-specific complaint that requires the health care practitioner to find the underlying cause.

Picture of the Anatomy of the Hip
 

Hip Fracture

Falls are the most common reason that elderly patients break a hip. The fracture is due to a combination of two effects of aging, osteoporosis (thinning of bones) and a loss of balance. These two risk factors precipitate many falls. When health care practitioners talk about a hip fracture, they really mean a fracture of the proximal or upper part of the femur. The precise location of the fracture is important, because it guides the decision of the orthopedic surgeon as to which type of operation is needed to repair the injury. Aside from a fall, any trauma can potentially cause a hip fracture. Depending upon the mechanism of injury, the femur may not break; rather, a portion of the pelvis may be fractured. The initial pain may be in the hip area, but examination and X-rays may reveal a different source of the injury. Trauma can also cause a hip dislocation, in which the femoral head loses its relationship with the acetabulum. This is almost always associated with an acetabular (pelvic bone) fracture.

Picture of the Location of Most Hip Fractures
 

Hip Fracture

Contusions (bruises), sprains, and strains may occur as a result of trauma, and even though there is no broken bone, these injuries can still be very painful. Sprains are due to ligament injuries, while strains occur because of damage to muscles and tendons. Because of the mount of force required to walk or jump, the hip joint is required to support many times the weight of the body. The muscles, bursas, and ligaments are designed to shield the joint from these forces. When these structures are inflamed, the hip cannot function and pain will occur.

Overuse Injuries

Hip pain may also arise from overuse injuries in which muscles, tendons, and ligaments can become inflamed. These injuries may be due to routine daily activities that may cause undue stress on the hip joint or because of one specific strenuous event. Overuse may also cause gradual wearing away of the cartilage in the hip joint, causing arthritis (arth=joint +it is=inflammation). 

Certain other structures should be mentioned as a cause of hip pain because they become inflamed. The iliotibial band stretches from the crest of the pelvis down the outside part of the thigh to the knee. This band of tissue may become inflamed and cause hip pain, knee pain, or both. This is a type of overuse injury that has a gradual onset associated with tightness of the muscle groups that surround the knee and hip.

Hip Pain Symptoms

Hip pain is often difficult to describe, and patients may complain that the hip just hurts. The location, description, and intensity of pain; what makes it better and what makes it worse depend upon what structure is involved and the particular structure that is inflamed or injured. 

Trauma to the hip: a fall, direct blow, twist, or stretch, the pain is felt almost immediately. 

Overuse injury: the onset of pain may be delayed by minutes or hours as inflamed muscles surrounding the hip joint go into spasm or joint surfaces inflame, causing fluid accumulation. 

Pain: Most often pain is felt in the front of the hip, but the joint is three-dimensional. Pain may be also felt along the outside part of the hip or even in the buttock area. 

Limp: Limping is the body's way of compensating for pain by trying to minimize the amount of weight the hip has to support while walking. Limping is never normal. Also, when limping occurs, abnormal stresses are placed on other joints including the back, knees, and ankles. 

Fracture: With a hip fracture, there is an acute onset of constant pain after the injury that is made worse with almost any movement. The leg may appear shortened and rotated outward. Pelvic fractures may have similar pain. 

Sciatica pain: Pain from sciatica tends to start in the back and radiate to the buttocks and to the front or side of the hip. It may be described in different ways because of nerve inflammation. Some descriptive terms used may include sharp, stabbing, or burning. The pain of sciatica may be made worse with straightening the knee which stretches the sciatic nerve and may make it difficult to stand from a sitting position, or walk with a full stride. 

Arthritis: If arthritis narrows the hip joint or impinges on the way the femoral head can glide in the acetabulum, or if there is a cartilage or labrum tear, the pain may be associated with a "catch," or a feeling like there is something impeding hip movement. 

Pain from arthritis tends to be worse after a period of inactivity and gets better as the joint "warms up" with use. But as activity increases, the pain will return.

Find out Hip Pain Problem can be more effectively treated. 
For enquiries, Call:(+65) 6471 2743