Understanding Hip Pain: Common Causes and Treatment

Do you suffer from hip pain? If you do, you are not alone. It is actually a very common complaint for those individuals 60 years and older. In a survey of over 6500 adults who were 60 years and older, 14.3% of them reported significant hip pain on the majority of days over the prior six weeks. That is a lot of people with painful hips. But hip pain is not just limited to seniors as many people far younger can have pain in and around the hip joint.

Frequent causes of hip pain

The most common causes of hip pain include bursitis, tendinitis, cartilage tears, and  arthritis. Your doctor will ask you a number of question to help determine what is causing your particular pain. For example, the location and character of the pain (is it sharp, dull or burning, etc) as well as what activities and positions make it better or worse are important clues as to the potential cause of the discomfort. Does walking make your pain better or worse? Does it hurt to lie on your painful side at night? Do you have pain in your back? Sometimes a pinched nerve in the back can cause pain around the hip.

The hip joint is made up of a ball-and socket in which the ball is attach to your thigh and the socket is part of the pelvis. Because the pelvis is attached to the lower back problems in the hip can affect the lower back and visa versa. Furthermore, a primary abnormality in the lower back or knee can cause problems with the hip. In some instances more than one issue is going on such as knee and hip arthritis or a bursitis and sciatica.

What is bursitis?

The dictionary defines a bursa as a fluid-filled sac or saclike cavity, especially one countering friction at a joint.

There are about 18 bursae in the hip region. Of these 18 bursae the most commonly painful bursa is the one over the pointy bone on the outside of the hip know as the greater trochanter. Another bursa that can cause pain is on the front of the hip and it reduces friction between the muscle that flexes the hip and hip joint itself. A common complaint for bursitis on the side of the hip is pain when lying on that side in bed and the need to frequently change sides when sleeping.

Pain is the most common complaint in patients with hip problems. A thorough evaluation including a careful history and physical examination can often times determine the cause. The location of the pain as well as the activities and positions that aggravate and alleviate the pain give the physician clues as the possible causes of hip pain. For example, pain that worsens with or after walking and improves with rest is the hallmark of hip joint problems like arthritis.

X-ray images of a normal hip joint on the left showing space between the femoral head (ball) and socket (acetabulum). On the right the space between the ball and socket have disappeared and the ball and socket are in contact with each other instead of gliding over smooth cartilage.

Pain on the outside of the hip that is aggravated by pressure over the bone is usually related to bursitis or tendinitis. Difficulty sleeping on the painful side is often described as is pain when getting out of bed, a chair or car.

Pain located in the posterior aspect of the hip or the buttock is the least common pain pattern associated with hip issues but is probably the most common when there is a problem in the lower back or sacroiliac joint. Sciatica can sometimes present with only pain in this area and without pain radiating further down into the thigh or leg.