Hip Pain and Injury

Hip arthritis (osteoarthritis) is a common condition that develops over time as people age. While it can occur in any joint in your body, it is most often found in the hip or knee, weight-bearing joints. Unfortunately, there is no cure for hip arthritis, but with early treatment, it’s possible to effectively manage your pain and remain active.

The most common symptom is hip pain or stiffness that impacts your ability to do tasks like tie your shoe, rise from a chair or walk for even short periods of time. Additional symptoms could include:

• Groin or thigh pain that radiates to your buttocks or knee
• Activity-induced pain
• Feeling that your joint has locked or is sticking; you might also hear a grinding noise during movement
• Lower range of motion in the hip
• Weather-induced joint pain

Following a diagnosis by an exam and/or imaging studies, hip arthritis treatment typically consists of:

• Lifestyle changes (fewer stairs, lower-impact activities, weight loss)
• Physical therapy
• Additional support (cane, crutches, walker)
• Over-the-counter or prescription medications
• Surgical hip treatments

At OrthoNebraska, treatment plans are developed collaboratively between you and your care team, while discussing the risks and benefits as they pertain to you individually.

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Bursitis occurs when bursae are inflamed. Bursae are small sacs filled with fluid that are located between bones and soft tissue. Creating a cushion, they help prevent friction in areas of the body such as the hips, elbows, shoulders, knees and heels.

If you suffer from hip bursitis you will likely feel hip pain that extends to the outside of the thigh area. Most patients describe earlier pain as being sharp and intense while later the pain may be described more as an ache, covering a larger area of your hip. Pain is often worse at night when laying on the affected hip but can also be felt when you’re getting up after sitting for an extended amount of time. Longer periods of walking, climbing stairs or squatting can also trigger pain.

Risk factors that can lead to the development of hip bursitis include:

• Repetitive stress injury
• Hip injury
• Spine disease
• Differing leg-lengths
• Rheumatoid arthritis
• Previous hip surgery
• Bone spurs or calcium deposits

Treatments for hip bursitis often does not involve surgery. Adjustments to your lifestyle can help you find relief:

• Avoid activity that triggers symptoms
• Pain and inflammation medications
• Devices like a walking cane or crutches can offer support
• Physical therapy
• Injections

On rare occasions, surgery may be recommended to relieve a patient of hip bursitis. During an outpatient procedure, the bursae are removed, and treatment will likely be followed by rehabilitation.

If you are diagnosed with hip bursitis or any other orthopedic ailment, your treatment plan will be developed collaboratively between you and your OrthoNebraska care team.

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Typically, a hip dislocation only occurs when there is major force to the area causing the head of the femur (thighbone) to come out of its socket in the pelvis (hip bone). This type of condition is commonly caused by car collisions or major falls.  It can also happen after major surgery due to bad positioning before tissue is able to heal fully.

The greatest symptom of hip dislocation is pain and the inability to move your leg. If nerve damage is also present, you could lose feeling in your foot or ankle area as well.

A hip dislocation is a medical emergency. Do not try to move and call for help immediately. Often an orthopedic surgeon can diagnose a hip dislocation by looking at the position of the leg, however there are typically other injuries caused by the accident or fall, which will require a thorough physical evaluation.

A hip dislocation will likely require a reduction or the process of setting the bones back into their appropriate position. If there is other damage such as to the nerves, blood vessels or cartilage, additional treatment may be needed. Beyond a reduction, additional treatment options include:

• Hip injections
• Hip scope
• Hip replacement

If you suffer a hip dislocation, the OrthoNebraska team will work closely with you to develop a treatment plan that best fits your needs, goals and lifestyle.

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Hip dysplasia is a genetic condition when the socket of the hip joint doesn’t grow properly enough to cover the head of the femur (upper leg bone).  This results in the cartilage wearing away, bone on bone rubbing and as result sometimes early arthritis.

While dysplasia is often able to be diagnosed earlier, the physical symptoms often aren’t noticeable until adolescence, so that is when patients typically seek treatment. Symptoms include:

• Groin pain (more common) or outside hip pain (less common)
• Pain that worsens over time and with activity
• Locking, catching or popping in the hip or groin area

Mild hip dysplasia may be treated by lifestyle modifications, physical therapy and medications. However, these are all temporary solutions and the condition should be monitored to ensure they don’t worsen. Moderate cases of hip dysplasia will typically involve a surgical treatment to correct the bone socket called an osteotomy. In severe cases where the joint deteriorates, a hip replacement may be the only option. This is why early treatment of this condition is essential.

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A break in the upper part of the femur (thighbone) is considered a hip fracture. This condition most often affects elderly patients with weakened bones, but it can occur in younger patients due to a fall from a greater height or a vehicle collision. Much like a hip dislocation, a hip fracture should be considered an emergency.

Most often, a patient experiences high levels of pain in the groin or upper area of the thigh if they have a hip fracture. It is impossible to stand, bear weight or move the upper part of your leg or knee but you would be able to move your ankle and toes.

Nearly all hip fractures require surgical treatment, the sooner the better. Treatment will depend on the type and location of the fracture, and the age and level of health of the patient. Regardless of the type of fracture, most patients can get out of bed and begin physical therapy the day following surgery.

At OrthoNebraska, your treatment plan is developed collaboratively between you and your care team, while discussing the risks and benefits as they pertain to you individually.

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Hip impingement is a genetic condition in which extra bone growth causes a poor fit in the hip joint, which is a ball-and-socket joint. Over time, this extra friction damages the joint. This condition is much more common in women.

There are three types of hip impingement, all of which have different symptoms and treatments based on the specific anatomy of irregular bone growth.

Symptoms of hip impingement, diagnosed as femoroacetabular impingement or FAI, include:

• Pain in the groin (more common) or outside of the hip (less common)
• Stiffness
• Sharp pain when turning, twisting or squatting

Mild cases may be able to be resolved by activity modifications, NSAIDs or physical therapy. However, the vast majority of people will eventually require a hip scope surgery to avoid having to make lifelong accommodations to combat the condition.

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Hip strains happen when muscles surrounding the hip joint are stretched or torn, and are typically classified as mild, moderate or severe.

Symptoms may include:

• Pain when active
• Swelling or weakness
• Inability to move the hip fully into all positions (range of motion)

Most strains are mild or moderate, and will respond to alternating heat or ice therapy. Feel free to try that at home. However, if the condition does not improve, seeing a hip specialist may be beneficial for home exercises or physical therapy. Surgery would be extremely rare and needed only when a muscle detaches from the bone.

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