Arthritis: Reasons Why Your Hips Hurt

2 min read

Associate Professor of Nutrition & Dietetics and Accredited Practicing Dietitian, University of South Australia Karen Murphy receives funding and/or support from the National Health Medical Research Council. In the last 10 years she has had funding from Dairy Australia and the Pork CRC.

Inside the Joint

Each hip is a ball-and-socket joint. The ball is the top of your thighbone (femoral head). The socket (acetabulum) is in your pelvic bone. Smooth, slippery tissue called cartilage lets the ball and socket glide against each other when you move. A thin lining (synovium) tops the cartilage and makes a bit of synovial fluid, which further eases rubbing. Tendons, ligaments, and muscles complete the joint.

Osteoarthritis

It's the "wear and tear" type of arthritis that many people get in middle age. Cartilage on the ball end of the thighbone and in the hip socket slowly breaks down and causes grinding between bones. You'll have stiffness, and you might feel pain in your crotch and at the front of your thigh that radiates to your knee and behind. It's often worse after a hard workout or when you don’t move for a while.

Rheumatoid Arthritis

With RA, your immune system attacks parts of your body, which can include the synovium. This normally thin lining starts to thicken and swell and to make chemicals that damage or destroy the cartilage that covers the bone. Doctors don't know why this happens. When one hip is affected, the other often gets it too. The joint may hurt and swell, and you might notice heat and red skin around it.

Sciatica

Too much sitting and too little exercise, among other things, might irritate and inflame the sciatic nerve, the largest in the human body. It runs from the bottom of your spine through your hips and down the back of your leg, which is where you'll feel the pain when it's pinched. It will radiate from the hip and might be mild, sharp, tingly, numb, or even like an electric shock.

Hip Fracture

It's a break in the top part of your thighbone. If you're young and healthy, it takes a lot of power, like a serious car wreck, to do it. But if you're over 65, especially if you're a woman, or you have brittle bones (osteoporosis), even a minor fall can cause it. Your groin and the top, outer part of your thigh will likely hurt, especially when you try to flex the joint. In a complete break, one leg may look shorter than the other.

Dislocation

It happens when the ball on top your thighbone is knocked out of its pelvic socket. It usually takes a lot of force, as when you fall from a ladder or crash a car. All that power often causes other injuries like tissue tears, bone fractures, and could even damage nerves, cartilage, and blood vessels. Get to a hospital. It's very painful, and you won’t be able to move your leg much, if at all, until your doctor starts to treat it.

Dysplasia

Here, the socket of your hip isn't deep enough for the ball to fit firmly inside. The looseness can vary from just a little jiggly, to fairly easy to push out (dislocate), to complete dislocation. Babies may be born with it, or they may get it in their first year. Female, firstborn, and breech birth (feet-first) babies get it more often. You could also cause it if you wrap (swaddle) your baby's legs too tightly.

Bursitis

It's when fluid-filled sacs, or "bursae," that ease friction between muscle, tendons, and bones get irritated and swollen. It can happen on the outside bony part of your hip (trochanteric bursitis), where it causes sharp, intense pain that dulls and spreads out over time. Less often, it happens on the inside (hip bursitis), where it causes pain in the groin. Either may worsen when you walk, squat, or climb stairs

Labral Tear

You can damage the cartilage at the bony edge of your hip socket that helps keep the joint together. You could injure it suddenly in a twisting fall or an accident, or you might simply wear it away with the same motion over time. You might feel clicking sensations and have pain in your groin or hip. You're more likely to get it if you play ice hockey, soccer, football, or golf.

Hip Strain

It's when you overstretch or tear any of the muscles and tendons that help your hip joint move. (It's a "sprain" when it happens to a ligament.) It could affect lots of muscles like your hip flexors, glutes, abductors, adductors, quadriceps, and hamstrings. The area might swell, weaken, and hurt, especially when you use it. Rest, ice, and over-the-counter pain relievers are often enough to get you healthy again.

RICE: Rest, Ice, Compress, Elevate

It's a good first step for any hip pain. Rest, but don't stop all movements (that could make things worse), just the ones that hurt. Ice for 20 minutes at a time, and use a cloth so you won't damage your skin. Compress the painful area with an elastic bandage, but not too much. Loosen it up if you see skin turning blue. Elevate the injured part on a pillow or stool to stop blood from pooling there.

Medications

Nonsteroidal anti-inflammatory drugs, or NSAIDs, are often used to lessen pain and inflammation for arthritis and other painful hip problems. Most are pills, but creams and gels are also available. Your doctor can help you treat more serious pain and underlying conditions with corticosteroids, pain relievers, and drugs to treat autoimmune and inflammatory diseases.

When to Go to the Doctor

If home care doesn't curb your pain, make an appointment with your doctor. Ask someone to drive you to the emergency room if an injury caused your hip pain and your hip doesn't look normal, or you can't move your leg or put weight on it. You should also go to the ER if you have intense pain, sudden swelling, or any sign of infection like fever, chills, and red skin.

Diagnosis

Your doctor will want to know about your symptoms and health history. Be sure you mention any falls or injuries you've had, and any other joints that bother you. Your doctor will also examine your hip and might check to see how well it moves (range of motion). You may also get blood tests or imaging, like an X-ray or MRI.

Prevention

Some of the same things that help treat hip pain can make it less likely for you to get it in the first place. For example, if you're overweight, losing even a few pounds may ease stress on the joint. Exercise (ask your doctor about the right amount) can also help. Take it easy. Start with a warmup and stretch, stop when something hurts, wear the right shoes, and seek soft surfaces like hiking trails, not hard ones like asphalt and concrete.

Arthritis: Ways to Ease Hip Pain

Don't Wait: Lose Weight

For every 10 pounds of extra body weight you carry, there's an added 50 pounds of pressure on your hips and knees. If your joints are feeling the strain, find a weight that works best for you and talk to your doctor about the best ways to slim down. It'll ease your hip pain and make it easier to move around.

Take a Load Off

Your weight isn't only about body fat: Your hips also absorb the weight of everything you carry in your hands and on your back. To take the pressure off, use a handcart for groceries and use luggage with wheels. If you carry a purse, consider a backpack style so the weight is even across your back.

Move It to Lose It

It makes sense to rest your hip until the pain eases up. Once it does, prescribe yourself a daily dose of exercise to build stronger muscles and keep joint stiffness at bay. Ask your doctor whether low-impact activities like walking, swimming, or yoga would help ease your condition.

Avoid High-Impact Exercise

Movement will help your hips, but this isn't the time to take up downhill running or kickboxing. Start slow with a few minutes on a stationary bike or elliptical. As soreness gives way to strength, you can bump up the length of your workouts.

Water Workouts

For the ultimate low-impact exercise, use a pool or spa. Water supports your body and takes some of the stress off your joints. It also allows for freer, smoother movements and provides good resistance to make your muscles stronger. Talk to your doctor or a physical therapist about exercises that will help your hips.

Stretch, Strengthen, and Stabilize

There are also specific exercises that can help with hip pain. They can work the parts of your body that support these joints, including your legs and core. To get the right routine and form, it's best to work with a professional, like a physical therapist. And don't push yourself -- if you feel pain during a workout, stop.

Use Heat and Cold

Have a bag of frozen veggies handy? Wrap it in a thin towel and press it directly onto your hips to ease pain. Use warmth -- like a hot shower or compress -- to loosen up muscles right before you stretch.

Heal Without Heels

Sometimes the answer for hip pain is right under your toes. High heels put your foot at an unnatural angle and can throw off your body’s alignment, which can cause hip pain. Try flat shoes instead, and avoid standing for too long in one stretch. ust be sure the flats have good arch support and some cushioning to help absorb shocks.

Over-the-Counter Meds

Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, are a common way to take the edge off when your hip hurts. If you can't take them (maybe because of allergies or stomach problems), try acetaminophen instead. Ask your doctor to recommend the best type and dosage for your condition, and to make sure these pain relievers are safe for you.

Consider Other Medicines

In some cases, hip pain is part of a bigger issue, like arthritis, an injury, or a pinched nerve. With these conditions, you'll need something stronger for the pain. For example, if you have rheumatoid arthritis (RA), your doctor might recommend a steroid to ease inflammation or a biologic that works with the parts of your immune system that make your joints inflamed.

Try an Alternative Therapy

If traditional therapies don't work, shift to a mind-body approach. You may have more success with acupuncture, massage, or a chiropractic adjustment.

MedicineNet

Any opinions, views and beliefs represented in this article are personal and belong solely to the author/s and do not necessarily reflect the opinion, views and beliefs of the organisation and employees of New Image™ International

Disclaimer: Any opinions, views and beliefs represented in this article are personal and belong solely to the author/s and do not necessarily reflect the opinion, views and beliefs of the organisation and employees of New Image™ International

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