Pain around the hip can be from many sources. The type of pain and the location of pain can highlight the potential cause.
Common causes of hip pain are hip osteoarthritis, trochanteric bursitis, Psoas tendinitis, labral tears and hip impingement. Most of these conditions produce long-standing hip pain. Patients usually complain of pain around the groin and upper thigh. Pain that is more on the side of the hip may be related to trochanteric bursitis. Joint abnormalities such as hip arthritis, labral tears and hip impingement produce groin or upper thigh pain. Discomfort in the back of the hip or buttock area could be related to problems with the lower back or sacroiliac joint. Pain related to tendinitis is often associated with movement and a clicking sensation in the joint.
Hip arthritis related pain often tends to be a dull ache of varying intensity. It may produce a sharp stabbing discomfort on certain movements. Patients often describe this like a tooth ache like pain. The pain is made worse on start-up of any activity. Often in late arthritis one may experience night pain and pain at rest. Pain from trochanteric bursitis is localised to the side of the hip and makes it difficult to sleep on the side.
Examination of the hip may help localise where the pain stems from. Movements of the hip joint especially rotational movements will be restricted and painful in hip osteoarthritis. This will be felt on most movements unlike hip impingement where pain is mostly on deep flexion, adduction, and internal rotation of the hip. Trochanteric bursitis often presents with tenderness around the side of the hip on a prominent knuckle of bone called the trochanter.
The most useful investigation for hip pain is an X-ray. This will be arranged on the day of consultation. Osteoarthritis is confirmed when there is irregularity of the joint and the loss of space in the joint on the x-ray. Occasionally the arthritis may be so advanced that the two opposing bony surfaces of the joint are in direct contact with each other (bone on bone change). Sometimes further investigations such as a CT and MRI scan is required. I prefer to do a CT scan when I suspect osteoarthritis that is not seen on the initial X-ray. This is because osteoarthritis may occasionally be on either the front or the back of the hip joint. This is usually not seen on a standard x-ray however a CT scan can identify this. A MRI scan is requested when I require detail of the soft tissues around her hip. This is mainly for cases where I suspect a labral tear or hip impingement. Sometimes a hip injection is required for diagnostic purposes to determine the source of the hip pain. Only through a very thorough medical history, examination and further investigations can the cause of the pain and further treatment be determined. This will be done at your clinic appointment. To book an appointment or make enquiry please use the links below.