Hip Pelvic Pain

Hip pain is a common complaint seen across all ages and stages of life. The hip joint plays an important role in most activities of daily living and can be impacted on by surrounding structures of the body, such as the low back, pelvis, knee and foot. This can make diagnosing hip complaints difficult and is why a thorough examination and history is important to identify your problem.

Causes

Factors causing hip pain include:

Age

Biomechanical/movement dysfunction

Overweight/obese

Referred pain from the low back

Sport/exercise type

Trauma

Hip pain treatment

Treatment will be dependent on your diagnosis but may include soft tissue massage, stretching, joint mobilization, dry needling and prescribed exercises from your practitioner. If further management is required, such as a surgical opinion or imaging (XRay, MRI), your practitioner will be able to help arrange a referral for you.

Types of hip pain

 



Femoroacetabular impingement (FAI)

Is due to a variation of hip joint structure in some individuals. FAI can be associated with pain at the front or side of the hip and/or groin region. It may cause pain due to irritation of surrounding joint structures such as hip joint cartilage. With FAI, pain can often be worse when the hip is flexed and/or rotated.


Gluteal Tendinopathy

Is a condition of the hip where pain is often located on the outside of the hip due to disruption to the tendons of the gluteal muscles. The pain can be associated with direct pressure to the area (i.e. sleeping on side), crossing legs, altered walking or running mechanics and prolonged sitting/inactivity. A reduction in hip strength and flexibility may also be noted.

Bursitis

Pain on the outside of the hip may be due to inflammation of the bursa that surrounds the joint. A bursa is a fluid filled sack that allows the muscles and tendons to move smoothly over their adjoining bones. When the bursa is inflamed, each time the muscle wants to contract it rubs on the already painful bursa. Walking or lying directly on the hip is often very painful in patients with bursitis.

Hip Osteoarthritis

Osteoarthritis (OA) is the most common of all the arthritides and is frequently seen in the hip joint. OA of the hip is associated with pain and stiffness around the hip, which is often worse first thing in the morning, after rest and with increased activity. OA is mostly seen in people over 50 years old but may occur earlier especially with a history of trauma.

Pelvic instability

Pelvic instability often occurs during or after pregnancy. Pelvic instability may present as low back pain, pain when rolling in bed, pain walking up stairs, pain during exercise or pain radiating into the buttocks. It is often due to muscle imbalances and weakness in muscles associated with the lumbo-pelvic region. Identifying which areas need to be relaxed and which need to be strengthened is important and can be achieved through clinical pilates.

Low back referral

There are times when hip pain may not be originating from the hip itself but from other structures of the body. Occasionally, low back pain referral may be causing your hip pain. This can be due to a number of reasons but may be due to lumbar disc injury, lumbar facet joint sprains and sacroiliac joint sprains. Only a thorough examination and history is about to differentiate the origin of your pain.