Hip Pain

Understanding Hip Pain

Hip pain can originate from within the hip joint itself or from structures around it. The location and nature of pain help determine the cause. Pain can also be referred from the spine or other areas.¹

Pain Location Clues

• Groin pain - Often from hip joint itself
• Lateral (outer) hip - Often bursitis or gluteal tendinopathy
• Buttock pain - May be SI joint or referred from spine
• Anterior thigh - Can be referred from hip arthritis

Common Causes²

Inside the Joint

• Osteoarthritis
• Inflammatory arthritis
• Labral tears
• Femoroacetabular impingement (FAI)
• Avascular necrosis

Around the Hip

• Greater trochanteric pain syndrome
• Gluteal tendinopathy
• Hip bursitis
• Snapping hip syndrome
• Piriformis syndrome

Diagnosis

• Physical examination
• X-rays
• MRI (for soft tissue, labrum)
• Diagnostic injection

Treatment³

Conservative

• Physical therapy (strengthening, flexibility)
• Weight management
• Activity modification
• NSAIDs
• Walking aids if needed

Interventional

• Hip joint injections
• Trochanteric bursa injections
• PRP (emerging)

Surgical

• Hip arthroscopy
• Total hip replacement (for severe arthritis)

References

1. Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. Am Fam Physician. 2014;89(1):27-34.
2. Lespasio MJ, Sultan AA, Piuzzi NS, et al. Hip osteoarthritis: a primer. Perm J. 2018;22:17-084.
3. Grimaldi A, Fearon A. Gluteal tendinopathy: integrating pathomechanics and clinical features in its management. J Orthop Sports Phys Ther. 2015;45(11):910-922.