This blog is a whistle stop tour round some of the most common problems that can occur in the hip joint. If you are suffering with any hip pain then it is a good idea to seek professional advice via your GP, Physician, Clinician and/or therapist.
Degeneration of cartilage in the hip joint causes osteoarthritis. This makes the cartilage split and become brittle.
In some cases, pieces of the cartilage break off in the hip joint. Once the cartilage wears down enough, it fails to cushion the hip bones, causing pain and inflammation.
The main symptoms of osteoarthritis are pain and stiffness in your joints, which can make it difficult to move the affected joints and do certain activities.
The symptoms may come and go in episodes, which can be related to your activity levels and even the weather. In more severe cases, the symptoms can be continuous.
Other symptoms you or your doctor may notice include:
increased pain and stiffness when you have not moved your joints for a while
joints appearing slightly larger or more “knobbly” than usual
A grating or crackling sound or sensation in your joints
Limited range of movement in your joints
Weakness and muscle wasting (loss of muscle bulk)
Osteoarthritis can affect any joint in the body, but the most common areas affected are the knees, hips and small joints in the hands. Often, you’ll only experience symptoms in 1 joint, or a few joints at any 1 time.
Hip fractures are cracks or breaks in the top of the thigh bone (femur) close to the hip joint. They’re usually caused by a fall or an injury to the side of the hip, but may occasionally be caused by a health condition, such as cancer that weakens the hip bone.
Falls are very common among older people, especially in people aged 80 and over, who may have reduced vision or mobility and balance problems.
Hip fractures are also more common in women, who are more likely to get osteoporosis, a condition which makes bones weak and fragile.
Symptoms of a hip fracture after a fall may include:
not being able to lift, move or rotate (turn) your leg
not being able to stand or put weight on your leg
bruising and swelling around your hip
your injured leg appearing shorter than your other leg
your injured leg turning outwards
A hip fracture will not necessarily cause bruising or prevent you from standing or walking.
Around your hip bone, and other joints, are small sacs filled with fluid that cushion the joint when it moves. These sacs are called bursae.
Bursitis occurs when these sacs become inflamed.
Symptoms may include:
pain on the outside of your hip and upper thigh
pain that starts as sharp pain, causing you to yelp when the area is touched, and later develops into an ache
pain when you get up after sitting for a long time, and which may worsen when you take a long walk, climb a lot of stairs, or squat for awhile
pain that’s worse at night when you lie down or sleep on the affected hip
People with bursitis don’t have pain while standing.
Hip Tendonitis is not uncommon. Your tendons are like cords that connect your muscles to your bones. You have tendons all over your body, from your hands and feet to your legs and hips. When your tendons become inflamed or irritated, this is called tendonitis.
Depending on the tendon that is causing the trouble, you may also see this condition referred to by other names. For example, other names for hip tendonitis include tendinopathy, iliacus tendonitis, and iliopsoas tendonitis.
Your symptoms may include:
You might notice that your pain gets worse when you perform certain activities.
These symptoms don’t always stay in the hip either. Your hips are complicated joints that are crucial to the healthy function of your back and lower body. Because of this, any condition that affects your hips may also affect other body parts.
If you are experiencing pain in your legs, glutes, or groin in addition to pain in your hips, all of your pain may be the result of the same condition—hip tendonitis.
A hip (acetabular) labral tear is damage to cartilage and tissue in the hip socket. In some cases, it causes no symptoms. In others it causes pain in the groin. It can make you feel like your leg is “catching” or “clicking” in the socket as you move it. Over time, labral tears in the hip may cause permanent damage to the joint.
The labrum is a band of tough cartilage and connective tissue that lines the rim of the hip socket, or acetabulum. It cushions the joint of the hip bone, preventing the bones from directly rubbing against each other. The labrum also helps keep the leg bone in place and increases stability of the joint.
The labrum can tear for many reasons. Some people get a torn labrum from falls or car accidents. Sports that require regular rotation of the hip — like golf, soccer, hockey, and ballet — increase the risk. So do running and sprinting.
But almost 75% cases of torn acetabular labrum have no known direct cause. Instead, these tears may develop gradually. Labral tears in the hip have been linked to osteoarthritis. However, it’s not clear if they contribute to its development or are a symptom of it.
Labral tears of the hip are more common in women. They also occur more often in people who have abnormalities of the hip structure, like hip dysplasia and other conditions.
In recent years, experts have found that acetabular labral tears are much more common than once thought. Studies have shown that up to 22% of athletes who complain of groin pain have a labral tear in the hip.
Avascular necrosis (AVN), also called osteonecrosis or bone infarction, is death of bone tissue due to interruption of the blood supply. Early on, there may be no symptoms. Gradually joint pain may develop which may limit the ability to move.
Complications may include collapse of the bone or nearby joint surface.
Risk factors include bone fractures, joint dislocations, alcoholism, and the use of high-dose steroids. The condition may also occur without any clear reason. The most commonly affected bone is the femur. Other relatively common sites include the upper arm bone, knee, shoulder, and ankle. Diagnosis is typically by medical imaging such as X-ray, CT scan, or MRI. Rarely biopsy may be used.
Treatments may include medication, not walking on the affected leg, stretching, and surgery. Most of the time surgery is eventually required and may include core decompression, osteotomy, bone grafts, or joint replacement.
Developmental Hip Disorders
Here are a couple of developmental hip disorders.
Developmental dysplasia of the hip (DDH) is a condition where the “ball and socket” joint of the hip does not properly form in babies and young children.
It’s sometimes called congenital hip dislocation or hip dysplasia.
The hip joint attaches the thigh bone (femur) to the pelvis. The top of the femur (femoral head) is rounded, like a ball, and sits inside the cup-shaped hip socket.
In DDH, the socket of the hip is too shallow and the femoral head is not held tightly in place, so the hip joint is loose. In severe cases, the femur can come out of the socket (dislocate).
DDH may affect 1 or both hips, but it’s more common in the left hip. It’s also more common in girls and firstborn children.
About 1 or 2 in every 1,000 babies have DDH that needs to be treated.
Without treatment, DDH may lead to problems later in life, including:
developing a limp
hip pain – especially during the teenage years
painful and stiff joints (osteoarthritis)
With early diagnosis and treatment, most children are able to develop normally and have a full range of movement in their hip.
Perthes’ disease is a condition affecting the hip joint in children. It is rare (1 in 9,000 children are affected) and it is not clearly understood why it occurs. Part or all of the femoral head (top of the thigh bone: the ball part of the ball-and-socket hip joint) loses its blood supply and may become misshapen. This may lead to arthritis of the hip in later years.
Children with Perthes’ disease usually complain of pain in the groin, the thigh or the knee – particularly after physical activity. They limp and have a restricted range of movement (stiffness) of the hip joint. These symptoms may persist on and off for many months. The disease itself lasts for a few years.
Hip Bone Cancer
Hip bone cancer results from the malignant growth of a tumour in the hip bone. Cancers arising in the bone, which are known as primary bone cancers, are very rare.
The most common symptom of hip bone cancer is pain, which is usually localized to the site of the tumour.
As the tumour grows and spreads through the hip, the hip bone can become weak and structurally unsound
Hip bone cancer can also cause more general symptoms, including fevers and nights sweats, which are periods of intense sweating that occur during sleeping hours. Cancer of the hip bone may also cause fatigue and general lack of energy. The area around the tumour may also become inflamed and swollen. In some cases, hip bone cancer can affect how people walk, causing stumbling, resulting in more falls and fracture complications.
Like I said at the beginning, just a whistle stop tour of common hip disorders and issues. Add to this list musculoskeletal pain, joint restrictions and inflammation.