Many people suffer from hip pain. What are the causes of hip pain and what can hip pain sufferers do to find pain relief? When a patient visits their doctor complaining of hip pain, the physician must review the patient’s age, activity level and build to appropriately diagnosis the cause. “The first thing to do is to make sure the hip pain is actually hip based,” says Dr. Nathan Wei, a board-certified rheumatologist with more than 30 years of practice and clinical research experience who practices at the Arthritis Treatment Center, based in Frederick, Maryland, which focuses on the latest therapies for rheumatoid arthritis and osteoarthritis. “Sometimes low back problems can result in hip pain obviously alter treatment recommendations.”
As reported by WebMD, the “hip joint is designed to withstand repeated motion and a fair amount of wear and tear. This ball-and-socket joint – the body’s largest – fits together in a way that allows for fluid movement.” “Hip pain can result from the joint; i.e., cartilage problems from osteoarthritis or damage to the labrum, the lip of cartilage within the cup part of the hip that holds the head of the femur,” says Dr. Wei. “Another source of hip pain is damage to the tendons which are like ropes that connect muscle to bone and bursae and the small sacks that cushion the hip which can become inflamed. And sometimes several of these problems can occur together.”
Osteoarthritis of the hip joint is when this joint becomes swollen and inflamed with a breaking down of the cartilage tissue. People with hip-related osteoarthritis may have mobility problems with pain being felt in different locations including the thigh, knee, groin and buttocks.
“Hip pain resulting from osteoarthritis can be treated in several ways,” says Dr. Samantha Traylor, a chiropractor and acupuncturist with Lumin SpineCare, an affiliate of Lumin Health which has eight locations in the Dallas/Fort Worth area. “Physical therapy, acupuncture, chiropractic services and soft tissue work are some of the treatments we employ. Because each patient is unique, we create an individualized treatment plan that takes many factors into account, such as the severity of the condition, the patient’s personal and family medical histories, etc.”
“Many people are led to believe that hip pain is caused by degeneration or osteoarthritis of the hip itself,” says Justin Price, a world-renowned biomechanics specialist and pain-relief expert. The corrective exercise education program he created which has been used to train health and fitness professionals worldwide – The Biomechanics Method® – has helped many patients eliminate chronic muscle and joint pain.
“Having assessed thousands of people with hip pain over the past 20 years, I have found that the two most common causes of hip pain are immobility in the feet/ankles and immobility in the spine,” says Price. “When a person walks, runs or shifts weight from side-to-side during any weight bearing activity, the foot and ankle needs to roll inward to transfer their body weight from left to right and vice-versa. Since the lower leg is attached to the upper leg, this rolling inward of the foot and ankle helps to roll the rest of the leg and hip socket inward which is also a necessary movement needed to perform these activities.”
“If your foot, ankle, and lower leg cannot roll inward effectively, excessive stress is transferred directly to the upper leg and hip resulting in pain,” adds Price. “Similarly, when you transfer weight from left to right your spine should bend slightly left to right with the movement. If your spine lacks mobility and cannot bend well from side to side, then your hips must sway left to right more to take up the slack. Over time, this excessive movement in the hips can also lead to pain.”
When alternative treatment options, non-steroidal anti-inflammatory drugs (NSAID), and even steroid injections fail to reduce the pain sufficiently, surgical options are available. “For a problem like impingement, where the hip has spurs that pinch, arthroscopic treatment may help,” says Dr. Wei.
“For more serious issues, replacement surgery is the only option,” adds Dr. Wei. “For younger patients, resurfacing – a sort of partial replacement, may buy some time.”
Hip pain caused by tendon damage can be treated in multiple ways. “If there’s tendon damage,” I generally first do physical therapy with the patient to strengthen their muscles around the tendon which helps support it and reduce the pain,” says Dr. Traylor. “Ultrasound and electrical stimulation may also be employed.”
Patrick Lerouge, a Restorative Specialist and founder of Evolve Restorative Therapy, who works with patients to eliminate pain, recommends “personal training that focuses on proper movement and physical therapy that balances out the strength. Alternative therapy like acupuncture can work on different meridian systems to balance out energy flow to the areas and tendons in general.”
“One of the most common tendon problems affects the gluteus medius tendon on the lateral/outside part of the hip,” says Dr. Wei. “Platelet-rich plasma (PRP) injected using ultrasound guidance is considered the treatment of choice by many. Other tendon issues also respond to PRP.”
When the bursae are inflamed around the joint, Dr. Wei recommends NSAIDs; physical therapy or steroid injections administered using ultrasound guidance. Dr. Traylor recommends ultrasound and electrical stimulation to help decrease the inflammation and flush it away from the affected area.
With treatment, can hip pain sufferers become pain-free? “Chronic hip pain will respond to appropriate therapy,” says Dr. Wei. “Unfortunately that may still involve hip replacement surgery in osteoarthritis. In the case of soft tissue problems, though, patients should expect improvement.” Dr. Traylor says that with treatment some patients can become pain-free but each patient is different. “Most patients will get some pain relief from one or more treatments,” says Dr. Traylor. “How long they have to be seen and what kind of relief they’ll get is dependent on a variety of factors including what happened to cause the hip pain and arthritis.”
“I believe the body can adjust and heal anything within the right environment,” says Lerouge. “I believe pain sufferers can become pain free, but each person needs to look at the bigger issue. It’s not just physical. I’m not saying the pain is just inside someone’s head, but sometimes people need clarity on what their body needs to do to overcome pain.”
“Clients with hip pain caused by musculoskeletal imbalances should start experiencing pain relief almost immediately using The Biomechanics Method,” says Price. “However, if a client presents with severe degeneration of the hip or another diagnosis such as a labrum tear, they are encouraged to seek medical treatment first before being referred back to The Biomechanics Method to address the underlying causes that led to the degeneration/injury in the first place and prevent any pain/symptoms from returning.”
Sometimes surgery can be averted. “I remember one particular client with chronic hip pain who was scheduled to have hip surgery,” recalls Price. “She decided to try The Biomechanics Method as a last resort in the week before she was slated to go under the knife. She felt such an improvement in her symptoms of pain during the first week that she cancelled her surgery. Within two weeks, this 50-year old woman was pain-free during her daily activities and within six weeks she had even taken up kickboxing (an activity she had always wanted to try, but couldn’t because of a hip pain). Today she is still pain-free and continues to engage in all the activities she loves.”