Problems of the Hip and Knee

Hip Pain

Hip pain, one of the common symptoms patients complain of, may not always be felt precisely over the hip joint. Pain may be felt in and around the hip joint and the cause for pain is multifactorial. The exact position of your hip pain suggests the probable cause or underlying condition causing pain. Pain felt inside the hip joint or your groin area is more likely to be because of the problems within the hip joint. Likewise, the pain felt on the outer side of your hip, upper thigh or buttocks may be a result of the problems of the muscles, ligaments, tendons and soft tissues surrounding the hip joint. However certain disease conditions affecting other parts of your body such as lower back or knees also cause hip pain.

The main cause of sudden pain in the hip is an injury resulting in fracture of the hip bone. Hip fractures are common in the elderly individuals because the bones wear out as age advances. Other causes of hip pain may be arthritis, bursitis, infection, low back pain, and osteonecrosis of the hip, sprains or strains and tendinitis resulting from repetitive use. Your doctor will evaluate the condition based on the medical history, physical examination of the hip and thigh region, and diagnostic tests including X-rays and other scans.

Self-care and pain relieving anti-inflammatory medications offer symptomatic relief. However the exact cause for the pain needs to be addressed. Practicing certain measures can avoid aggravation of pain and also improve the quality of life. Avoiding physical activities that may worsen the pain, stretching the quadriceps and hamstring muscles, performing warm up exercises before actual exercise regimen improve the condition. Applying ice packs over the region of pain for about 15 minutes three to four times daily reduces both pain and swelling. But if you have an injury with severe hip pain and swelling, talk to your orthopedic surgeon immediately for better treatment outcomes.

Hip Bursitis

Hip bursitis is a painful condition caused by inflammation of a bursa in the hip. Bursae are fluid filled sacs present in joints between bone and soft tissue to reduce friction and provide cushioning during movement.

The bony prominence of the hip is called greater trochanter and is present on the outer side of the upper thigh bone or femur. The bursa overlying it is called trochanteric bursa. Another bursa is located towards the groin region and is called iliopsoas bursa. Bursitis of the trochanteric bursa is more common than that of iliopsoas bursa.

Causes

Trochanteric bursitis is often seen in people involved in sports such as football and soccer which involve a lot of running. This can lead to overuse and irritation of the bursa causing inflammation. Bursitis may sometimes result from an injury or fall to the hip or after a surgical procedure of the hip. Spine disease, rheumatoid arthritis and leg length inequality increases the risk for developing hip bursitis.

Symptoms

Trochanteric bursitis results in pain on the outer side of the hip which usually increases with prolonged walking or climbing stairs. The pain is felt more while getting up from a chair and in the night when lying on the affected side. Inflammation of the iliopsoas bursa however results in pain in the groin region.

Diagnosis

Tenderness and swelling in the area of pain over the bursa during the physical examination of the hip confirms the diagnosis of Hip Bursitis. To check for any bone spurs that could be causing irritation of the bursa your doctor may order an X-ray. If the reason for the pain is not very clear the doctor may order an MRI to view the soft tissues and structures not visible on X-ray.

Conservative Treatment Options

Treatment goals for bursitis are focused on resolving the inflammation and pain. Rest is advised and activities causing the bursitis pain are restricted. Anti-inflammatory medications are prescribed to reduce the inflammation and pain. Physical therapy and treatments with heat, ice and ultrasound sometimes are recommended. An injection of corticosteroid medicine may be administered to reduce the inflammation. Sometimes a second injection is necessary if the pain returns after a few months. These nonsurgical treatments provide relief from hip bursitis in the majority of cases.

Surgery

Sometimes, however, your doctor may recommend surgical removal of the bursa if you do not respond to conservative treatment measures.