The hip joint is a ball and socket joint and has a wide range of movement. Its one of the most mobile joints in the human body.
Hip pain is a common complaint that can be caused by a wide variety of problems. The precise location can provide clues about the underlying cause.
Problems within the hip joint itself tend to result in pain on the inside of your hip or your groin. Hip pain caused by problems with muscles, ligaments, tendons and other soft tissues that surround your hip joint usually presents with pain on the outside of your hip, upper thigh or outer buttock. It can sometimes be caused by diseases and conditions in other areas of your body, such as your lower back.
Common Symptoms of hip pain
Local Hip Discomfort
Common hip conditions with local hip discomfort or around the hip joint
This refers to degenerative changes of the hip joint and may require a hip replacement surgery such as a partial hip replacement or a total hip replacement depending on the severity of the condition. A partial hip replacement surgery would involve replacing of the head of femur (thigh bone) while a total hip replacement surgery would involve replacing the hip socket as well.
Hip fractures usually occur due to traumatic incidents. It will be difficult for someone with a hip fracture to bear weight and this requires immediate medical attention. If the fracture is severe, it may require a hip joint replacement surgery. Sometimes, hip fractures may also occur in older adults with low bone mineral density. These fractures are known as stress fractures. Imaging tests are required to diagnose a fracture.
Rheumatoid arthritis (RA) is a chronic and progressive autoimmune disease. It causes inflammation, swelling, and pain felt in and around the joints.
Snapping hip syndrome
Snapping Hip Syndrome is a condition that is characterized by a snapping sensation, and/or audible “snap” or “click” noise, in or around the hip when it is in motion. There are various causes for snapping hip syndrome, which can be further classified as external, internal, or intra-articular in origin.
Referred pain is felt in a region away from its source. For example, a pinched nerve in the lumbar spine (lower back) region can present in the hip, knee or foot which is away from the source.
Common hip conditions with referred or radiating pain
Prolapsed intervertebral disc with nerve impingement
Iliotibial band syndrome
The Iliotibial band (IT band) runs from the side of your hip to the outside of your knee joint. Overuse and repetitive flexion and extension of the knees usually cause this type of injury. It occurs when the IT band becomes tight, irritated, or inflamed. This tightness causes friction on the outside of the knee when bending.
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Causes of hip pain
- Poor posture
- Poor exercise technique
- Lack of training or preparation for sport and exercise
- Tight muscles
- Stiffness in joints
- Myofascial tightness
- Nerve irritation or compression
- Tissue Injury (e.g. due to trauma or repetitive strain)
- Sedentary lifestyle
A physiotherapist/physical therapist is an expert in musculoskeletal disorders and can diagnose and identify the source and cause of hip problems to design a specific treatment plan to relieve hip pain, and to help patients retune to their normal lifestyle.
Diagnosis is often made using a range of assessment tools. These tools include:
A physiotherapist will observe a person's typical static postures (i.e. in sitting, standing and lying down) as well as the person's usual movement patterns in their daily life (e.g. walking and working) and in their sport (i.e. sporting techniques). These observational findings provides vital information for the physiotherapist to identify risk factors for hip pain, the likely cause for injury or overload, and to guide subsequent assessments and tests.
2. Manual Palpation
Physically palpating (i.e. feeling) a person's area of discomfort and the regions around it would provide a physiotherapist with valuable information about the texture, tightness, rigidity, temperature, and alignment of the neck structures. This in turn informs the physiotherapist of the possible reason for the hip pain, the likelihood of inflammation, and whether it is localised or potentially referred from a different area such as the lumbar spine.
3. Range of Motion Testing
Hip movement will be assessed when diagnosing the cause of discomfort. This is a test of how much or how far a person can flex, extend or rotate the hip. Often, the neighbouring joints are also assessed to identify if the hip discomfort is arising solely from the hip or is related to other areas in the body.
4. Joint Mobility Testing
Joint mobilisation is a skill that physiotherapists are trained in in their undergraduate degree programs. This technique is used to assess a joint's movement and to test for joint stiffness and/or stability. A skilled therapist will be able to feel if there's any issues with the hip joint or the hip socket when ranging the hip.
5. Strength Testing
To assess the integrity and function of muscles in the region, a physiotherapist will also assess a person's strength in the hip and knee, as well as in the abdomen and spine stabilizers. Testing of strength in the legs cues the physiotherapist in on the neurological status of the person as well as to identify any movement pattern issues that is contributing to the hip pain.
6. Neurological Testing
Due to the narrow passages in which nerves travel within and around the spinal column, a physiotherapist will always assess the nerve system in a person. These tests can include a series of coordination tests, strength tests, sensation tests, and an assessment of the person's reflexes.
7. Gait Analysis
A physiotherapist can analyze the biomechanical faults in a person's walking pattern and identify impairments through observation.
8. Red Flag Testing
Red flags are symptoms and alert signs that indicate serious underlying pathology and conditions. A licensed and professional physiotherapist is trained to identify them through common subjective complaints as well as through special tests. These assessments allow urgent and/or sinister conditions to be identified and treated early.
9. Gait Analysis
If a physiotherapist suspects possible structural injuries or deviations, he or she will refer a patient for further medical imaging and a review with an orthopaedic surgeon. Imaging tests are not necessary in the diagnosis of hip pain, but in cases where red flags are suspected, imaging such as Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) scan, and X-rays can help to confirm diagnoses and guide potential surgical management(s).
Hip pain can be treated with medical interventions such as the use of analgesics, with surgical interventions (such as a hip replacement), or with conservative management like physiotherapy/physical therapy.
The treatment of hip pain depends entirely on the cause of the problem. Therefore, it is important that you understand the cause of your symptoms before embarking on a treatment programme. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.
Not all of the treatment options listed are appropriate for every condition.
The first treatment for most conditions is to rest the joint, and allow the acute inflammation to subside. If the symptoms are severe, crutches or a cane may be helpful as well.
Ice and Heat Application
Ice packs are mostly used for acute injuries or joint infection to help minimise swelling and relieve pain while heat pads are used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area. Improved blood flow is helpful for wound healing or chronic persistent swelling.
Physiotherapy / Physical therapy
This is an important aspect of treatment for almost all orthopaedic conditions. Our physiotherapists can help to increase strength, regain mobility, and return patients to their pre-injury level of activity. A combination of manual therapy, use of modalities and exercises will be rendered by your physiotherapist depending on your condition.
If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment must be directed at the specific cause of your problem. You should see your orthopaedic surgeons or doctors for further advice when:
- You are unable to walk comfortably on the affected side due to severe pain or weakness
- You have an injury that causes deformity around the joint
- Your hip pain occurs at night, or pain worse even after resting
- You have long term hip pain that persists beyond a few days
- You are unable to bend the hip
- There is swelling of the hip or thigh area
- There are signs of an infection, including fever, redness, warmth
- You can unable to get any pain relief with medications, physiotherapy/physical therapy or other treatments
- You experience any other unusual symptoms
This would be recommended to you by your surgeon depending on your diagnosis, severity of your condition and your physical goals. If your hip pain is caused by wear and tear of your joints, your surgeon would likely recommend a hip replacement surgery.
What do we do at Balance Core?
At Balance Core, we strive for excellence in providing an accurate diagnosis and managing pain with effective treatment(s). We believe in ensuring a systematic review of a person’s posture, body alignment, movement patterns and habits to identify the root cause of problems.
Our physiotherapists/physical therapists are highly trained in manual palpation and observation to identify the sources of discomfort. This allows us to help our clients and patients to minimise their symptoms in a few sessions and to empower them to continue managing their conditions with a targeted treatment program.
We use a combination of manual therapy (i.e. hands-on techniques), adjunct modalities such as dry needling, taping, ultrasound therapy and TECAR therapy, as well as exercises to help our clients and patients to achieve their goals.
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Get your treatment started by scheduling a call with us. We will get back to you soon.
Frequently Asked Questions
Your physiotherapist will perform a thorough assessment to evaluate the problem and identify the problem’s root cause. A detailed explanation will be given so that you can fully understand your issues and the outline of subsequent physiotherapy treatment plans.
Thereafter, a treatment involving muscle release, specific muscle activation or joint mobilization, etc. will be rendered to provide symptomatic pain relief and address underlying root problems.