Hip Pain - Hip Arthrosis and Expert Advice
The hip is one of the largest and most complex joints in our body, bearing a heavy load and allowing a wide range of motion. Although the hips are extremely strong, they are not indestructible.
Hip pain can occur due to the natural aging process, that is, degenerative changes, a fall, a fracture, or physical inactivity.
Depending on the underlying cause, hip pain can appear on the inner or outer side of the hip, but also in the groin, thigh, or buttock. Sometimes even pain from the back (caused by a herniated disc) can radiate to the hip.
Hip pain often intensifies with greater physical activity, which leads to a reduced range of motion. Just how serious a problem this is is shown by the fact that in certain cases it can even lead to disability. That is why timely and appropriate treatment is a key step toward a life without hip pain.
Why Hip Pain Occurs
The hip joint consists of the femoral head and the acetabulum of the pelvic bone, which are joined in a way that allows easy movement. The hip is a ball-and-socket joint, providing the greatest range of motion.
While we walk or run, friction and wear between the bones in the socket are prevented by the cartilage, which wears down and becomes damaged over time. Cartilage wear most commonly leads to hip arthrosis, which we will discuss a little later.
Synovial fluid serves to lubricate the joint and keep the cartilage healthy. The stability and movement of the hip are provided by many muscles that are connected to the bones by strong tendons.
Muscles and tendons can tear, cartilage can wear away, and bones can be damaged or fractured, and that is when hip pain occurs. However, hip pain often radiates to the groin, thighs, and as far down as the knees.
Causes and Symptoms of Hip Pain
The most common cause of short-term, acute hip pain is tendon inflammation (tendinitis), which occurs due to excessive exercise. Although it can be very painful, tendon inflammation resolves within a few days.
Clicking in the hip when walking or standing up usually indicates cartilage tearing. Snapping hip syndrome mostly occurs in athletes and dancers.
When blood does not reach the bones, the cartilage wears down, which can lead to the loss of supporting bone. Eventually, the bone fractures or smaller fragments break off. This condition is called osteonecrosis or avascular necrosis.
Hip Fracture
When a hip fracture occurs, there is sudden, severe pain. In athletes, a hip fracture occurs due to prolonged physical strain and cartilage wear.
A hip fracture nevertheless occurs more often in older people and in those who have osteoporosis. Osteoporosis is the loss of bone mass, which makes bones brittle and fragile.
Complications from a hip fracture can lead to the formation of a clot (thrombus) in the veins.
A hip fracture is treated with prolonged immobilization and usually requires surgical intervention, after which physical therapy is essential.
A strong blow or an improper position of the leg can cause hip dislocation. Rest is recommended for recovery, followed later by physical therapy.
The Colon and Hip Pain
Bone cancer, as well as tumors that spread to the bones, can cause hip pain. Hip pain can also occur due to fractures, arthritis, and other conditions.
Besides hip pain that does not stop even during prolonged rest, other problems also point to bone cancer. If the cancer presses on the spinal cord, the symptoms may include problems controlling the bladder and the colon.
However, before you suspect bone cancer because of the aforementioned link between the colon and hip pain, keep in mind that these symptoms can also be a sign of other, more benign illnesses.
Hip Arthritis (Hip Arthrosis)
The most common cause of chronic hip pain is arthritis, a condition accompanied by pain, stiffness, and difficulty walking. There are various types of arthritis, and what they all have in common are the degenerative changes that occur with aging.
Osteoarthritis (hip arthrosis) is a degenerative disease that develops when the cartilage wears down. A joint fracture can also lead to traumatic arthritis, similar to osteoarthritis.
Treatment usually involves anti-inflammatory drugs and corticosteroid injections. Physical therapy is of key importance for stopping hip arthrosis and further cartilage wear.
When the hip joint becomes deformed due to osteoarthritis, a total hip replacement is necessary. This is performed surgically, which subsequently requires recovery from the operation.
Cartilage wear can also be caused by an infection in the joint, which gives rise to infectious arthritis.
Rheumatoid arthritis is an autoimmune disease in which the body’s immune response attacks the joints. For the rehabilitation of arthritis and the prevention of further deterioration, physical therapy is irreplaceable.
What Pain in the Hip and Groin Indicates
If you feel pain in the hip and groin, which most often appears while walking, it is possible that you are dealing with coxarthrosis. Along with limited mobility, a spasm of the muscles on the inner side of the thigh occurs.
Coxarthrosis develops due to damage to the cartilage or the joint surface. If it is detected in the early stages, an effective remedy for hip pain is hyaluronic acid.
Hip Pain When Lying Down
One of the most common complaints, hip pain when lying down, usually occurs when lying on the side where the affected hip is located. As with most other hip conditions, appropriate medication and physical therapy bring relief from hip pain, which significantly reduces quality of life.
Pain on the Outer Side of the Hip
Pain on the outer side of the hip most often originates outside the joint. One of the causes can be trochanteric bursitis. It most commonly occurs in older, obese patients and often makes walking difficult. In the majority of cases, the effective remedy for this type of hip pain is corticosteroids.
Inflammation of the muscle attachments and compression of the lateral femoral cutaneous nerve can also cause pain on the outer side of the hip.
Pain on the Back Side of the Hip
Inflammation of the bursa and the sacroiliac joint, as well as pain from the spine, can manifest as pain on the back side of the hip. Pain due to compression of the sciatic nerve (sciatica) can manifest as pain in the hip and leg.
Inflammation of the sacroiliac joint (sacroiliitis) is characterized by pain during the night and in the early morning hours, accompanied by prolonged stiffness. Nonsteroidal anti-inflammatory drugs and biologic therapies are used as a remedy for hip pain.
Pain from the spine (lumbar syndrome) is sometimes projected toward the back or front side of the hip. This hip pain originates from damage to the spinal nerve roots due to wear or displacement of the disc. More often, the pain radiates to the back side of the hip, along the leg, and sometimes extends all the way down to the toes.
Hip Pain in Women
Near the hip joint there are fluid-filled sacs called bursae. When they become inflamed, trochanteric bursitis occurs.
The causes of this painful condition can be found in poor posture, an injury, or a fracture, and it occurs more often in women than in men.
Sometimes hip pain occurs because of foot pain, which in women arises from wearing high heels. Namely, high heels force the foot into an unnatural position, at a steep angle. This disrupts the body’s posture and causes hip pain in women.
A Remedy for Hip Pain
Hip pain can be transient and usually disappears after two weeks of taking analgesics. Along with rest, massage, ice and cold compresses, as well as warm compresses, can help reduce pain and swelling.
However, in the case when the pain is extremely severe and does not subside within two weeks, you should see a physiatrist.
An examination is also necessary if you have pain while performing everyday activities, such as climbing stairs or bending forward while seated. Clicking in the joint or a deformed appearance of the joint can indicate serious problems.
During the examination the range of motion in the hips is determined, and additional imaging and analyses may be required. An accurate diagnosis and appropriate treatment are key to a quick and complete recovery.
An X-ray shows the condition of the bones and reveals what is wrong with the hip. Computed tomography (a CT scan) provides a 3D image of the hip. Magnetic resonance imaging (an MRI scan) provides an answer as to what is happening with the soft tissues, such as muscles and tendons.
When an infection or rheumatoid arthritis is suspected, a laboratory blood analysis will be needed.
To relieve pain, analgesics such as ibuprofen are used, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, brufen, and voltaren are also frequently used.
A Cream for Hip Pain
When using medication, keep in mind that NSAIDs can cause numerous side effects, so they should be used moderately and sparingly. The use of creams for hip pain, which can easily be obtained at any pharmacy, is certainly preferable.
Certain creams for hip pain may contain supplements intended for the regeneration and preservation of cartilage. They usually contain comfrey, hyaluron, collagen, and the like.
Take care of your body weight and, with that goal in mind, choose a healthy diet and get enough minerals and vitamins.
Physical Therapy for Hip Pain
An examination at a physiotherapy center will reveal any other problems that are connected to hip pain, such as muscle weakness or loss of movement. Sometimes it will be necessary to work on eliminating problems in other parts of the body, such as the spine or the legs.
Physical therapy, besides exercises, can include the use of numerous modern devices and equipment. Laser is often used for arthrosis and joint pain, followed by electrotherapy, magnetotherapy, and the like.
The most important thing is for the approach to be individual, and for the recovery and exercise program to be tailored to the specific problem.
Exercises for Hip Pain - Kinesitherapy
In addition to the importance of building fitness through daily physical activity, kinesitherapy with strengthening, stabilization, and stretching exercises will speed up the healing process and prevent hip pain from returning.
The physiotherapist will teach you safe and effective exercises that you can later do at home as well. You will also receive advice on other simple activities that can relieve pain, such as swimming or cycling. Even simple marching in place can strengthen the hip muscles.
It is important not to do the exercises on your own initiative, to avoid difficult exercises, and to gradually increase their intensity. For certain exercises, the use of a pool is recommended, because water makes performing the exercises easier and removes some of the stress from the joints.
How Long Recovery After Hip Surgery Takes
When the cartilage wears down and friction appears between the bones, hip osteoarthrosis develops. In more severe cases of this disease, hip surgery, that is, a hip replacement, is necessary. Surgical intervention is also often needed in the case of a hip fracture.
Recovery from hip surgery varies from person to person and depends on how the operation went. Recovery can take several months, while most people begin to move around after a few weeks.
Physical therapy is of special importance in recovery from surgery. The physiotherapist will teach you all the movements you must avoid in order to protect the hip.
What Is Forbidden After Hip Surgery
For at least six months after the operation, you should not rotate or twist the leg. Sitting on low chairs, bending, crossing the legs, and walking up stairs should be kept to a minimum.
Sleeping will also need to be adapted to the recovery. It is recommended to sleep on your back or to sleep on your side with a pillow between the knees.
The physiotherapist will introduce you to a standing-up technique that involves turning onto the non-operated side before you attempt to stand up. Also, recovery exercises should be done with the assistance of a professional physiotherapist.
If, during the hip operation, you had an artificial hip implanted, you need to start the exercises slowly, without heavy load, during the first six weeks.
If you need an examination by a physiotherapist because you feel hip pain, our skilled and experienced team is at your disposal. Regardless of whether it concerns a specific diagnosis or recovery from hip surgery, with appropriate physical therapy it is possible to significantly relieve or prevent the illness and speed up recovery.
Call us or send us a message and take your first step toward a life without pain. The first examination is completely free.
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Related services: for hip pain we recommend kinesitherapy and tecar therapy. To make an appointment, book a consultation.