Causes of Hip Pain

The hips are the largest joints in the body. Each hip joint contains a ball and socket, which allows lower body movement. Cartilage provides cushioning for the repetitive motion of the hip joints. With age and continued use, the cartilage wears out, which can cause inflammation, pain and tenderness. The hip bones can also fracture or break from falls or other traumatic injuries. Hip pain is very common, and most people experience it at some point in their lives.

What is hip pain?

Hip pain is felt inside or outside the hip joint, buttocks, thighs, or groin. Hip pain can be the result of an injury, overuse, or an underlying health condition, It can be acute or chronic. Sometimes, referred pain (pain originating from other parts of the body) can radiate to the hip.

What causes hip pain?

Hip pain can be caused by various health conditions or injuries:

Osteoarthritis

Osteoarthritis is a degenerative condition that causes inflammation in the joints; it occurs with age or under extreme circumstances, such as joints that bear excessive amounts of weight. It is one of the most common causes of hip pain in older adults. Symptoms include joint stiffness and pain. Severe osteoarthritis may cause deformity of the hip joint. This typically requires a total hip replacement or arthroplasty.

Rheumatoid arthritis

Rheumatoid arthritis (RA) also causes inflammation in the joints it is an autoimmune condition. The immune system mistakenly attacks the linings of the joints, causing inflammation and pain. Chronic inflammation eventually breaks down the cartilage that cushions the hip joint. The stiffness and pain experienced with arthritis in the hip can lead to a limping gait over time. Treatment for hip pain caused by rheumatoid arthritis often includes corticosteroids and anti-rheumatic medications that target the immune system.

Hip fractures

Falling (especially on the side of the body) is the most common cause of hip fractures. Osteoporosis can also lead to hip fractures. Symptoms of hip fractures include, but are not limited to, moderate to severe hip or groin pain, swelling, redness and warmth. Diagnosis includes a physical examination by a physician and X-rays; in some cases, an MRI or bone scan may be ordered. Surgery is usually the treatment for hip fractures.

Bursitis

Bursitis involves inflammation of the bursa(e). Bursae are small sacs of fluid located throughout the body; they serve as cushions between bones and soft tissues (muscles, tendons and skin). Each hip joint contains two bursae. Inflammation of the bursa(e) can occur due to repetitive activity or acute injury. Symptoms of bursitis in the hip are pain, swelling, warmth, redness, stiffness and limited mobility. A physician can perform a simple physical examination to diagnose bursitis. However, X-rays, MRI or ultrasound may be ordered to rule out other causes of hip pain. Treatment involves rest, cold therapy, anti-inflammatory medication and physical therapy. Corticosteroid injections or surgery may be recommended if bursitis is chronic or severe.

Tendinitis

Tendinitis is an aggravation and swelling of a tendon that joins muscles to bones. When tendinitis develops in the hip, it is referred to as iliacus tendinitis or iliopsoas tendinitis. Iliacus tendinitis occurs at the top of the femur in the tendon that joins the iliac muscle (which originates at the hip bone) and the psoas muscle (which originates in the lower spine). Symptoms include pain and tenderness in the front of the hip. Iliacus tendinitis is often the result of repetitively lifting the leg and turning the hip at the same time during activities, such as kicking, squatting, ballet dancing, gymnastics and lifting weights. A physical examination and medical history is usually sufficient for the diagnosis of iliacus tendinitis; however, X-rays, MRI or ultrasound may be ordered. Treatment typically involves rest, physical therapy, hot and cold therapy, massage, and anti-inflammatory medication.

Muscle strain

Muscle strain in the hips can occur from repeated activities. Overusing the muscles causes inflammation, resulting in pain.

Hip labral tear

The rim of the hip socket is lined with a band of cartilage and tissue called the labrum. It prevents the ball and socket from rubbing together. Most cases of a hip labral tear don’t have a direct cause. However, a torn labrum can occur from trauma, such as a car accident or fall. It can also occur from repetitive activities, such as ballet, golf, running, soccer, etc. Sometimes, a hip labral tear doesn’t cause any symptoms. If symptoms are present, they include pain in the groin or a “catching” sensation when moving the hip.

Avascular necrosis (osteonecrosis)

Avascular necrosis occurs when blood flow to a bone is restricted, causing loss of bone tissue. It can develop in any bone but is most common in the hip. Hip fractures, dislocations, or the long-term use of high-dose steroids can cause avascular necrosis of the hip.

Cancers

Bone cancers or blood cancers can cause hip pain.

When to seek medical attention

A health care provider should be seen as soon as possible if hip pain occurs suddenly with no known cause or if redness, swelling or warmth is present around the hip joint. Immediate attention is also needed if a fall or injury results in hip pain, the hip joint becomes deformed, a popping sound is heard when an injury occurs, pain is intense, the leg(s) or hip is immobile, signs of infection are present, or the hip cannot bear weight.