Hip Pains
Anatomy
The hip is a ball and socket joint comprising the acetabulum of the pelvis (socket) and the femoral head (ball). In order to improve stability of the hip there is a roll of soft tissue surrounding the socket known as the labrum. Supporting the joint is a capsule made of soft tissue, which is reinforced by strong ligaments. Around the capsule is muscles that move the hip joint.
Causes
There are multiple structures around the hip that can cause discomfort. In young patients after a traumatic episode, the labrum can get torn and this will manifest in deep groin pain on certain rotatory movements of the hip. They can also get tendon problems and the pain will be dependent upon which tendon is affected.
In the middle aged and elderly the most common cause of hip pain is wear and tear of the joint – arthritis. Again, this is normally felt as pain deep in the groin, worse on walking long distances and may keep the individual awake at night.
Sometimes the shape of the femoral head (ball) is not completely spherical and this can lead to abutment of the ball on the socket (impingement). This can also occur if the socket ‘over-covers’ the femoral head and lead to similar symptoms of pain during particular movements.
Symptoms
Certain individuals e.g. post partum women may suffer pain around the hip due to ligamentous laxity and this may be because of instability of the joints of the pubis. This pain will be felt in the midline and is worse on walking. In those who have abdominal symptoms such as nausea and vomiting, a herniation of bowel may be the cause of the pain. Athletic persons may experience a groin strain, which may be due to an injury to the attachment of the adductor tendons in the inside of the leg.
Treatment
In the elderly with classical X-ray changes then the diagnosis of arthritis can easily be made and treatment of this will be activity modification, weight loss, oral painkillers and, occasionally, hip injections to relieve symptoms. The definitive treatment is a total hip replacement and your surgeon will discuss this operation in further detail with you if your symptoms warrant it.
Because of the complexity and proximity of all the structures around the hip, in the young and middle aged the diagnosis of hip conditions is rarely straightforward. Investigations including but not limited to MRI and diagnostic hip injections may be utilized to eliminate possible sources of pain. Treatment almost always commences with physiotherapy to improve the strength and pattern of hip movement. This may be supplemented with an injection. If the above measures fail to control symptoms, surgical treatment for these hip disorders may be considered depending on the area of pathology and your surgeon can discuss this with you further.
- Foot & Ankle
- Hip
- Knee
- Anterior Cruciate Ligament Rupture
- Medial Collateral Ligament Tear
- Meniscus Tears
- Osteoarthritis of the Knee
- Patella (Knee Cap) Dislocation
- Patella Chrondromalacia
- Patella Tendonitis
- Posterior Cruciate Ligament Injury
- Shoulder
- Acromio-clavicular joint pathology
- Biceps tendinopathy
- Frozen Shoulder
- Impingement
- Instability and shoulder dislocation
- Osteoarthritis
- Rheumatoid Arthritis
- Rotator cuff tear
- Scapular Dyskinesia
- Septic Arthritis
- Spine
- Paediatric Orthopaedics
- Abnormal Shape of Legs
- Cerebral Palsy
- Clubfoot
- Developmental Dysplasia of the Hip
- Flat Foot
- Limb Length Difference
- Polydactyly
- Elbow