Hip Pain: Symptoms, Causes, Exercises and Treatment

• The pain can take different forms – most often sharp, dull or aching.
• It is often accompanied by a feeling of stiffness or limited range of motion.
• Sometimes swelling of the joint is also added.
• Pain can occur when sitting, lying down or walking.

The place where the pain comes from indicates what is causing it. Pain inside the joint or in the groin: indicates a problem directly with the hip joint. Pain around the joint, in the thigh or buttocks: this is usually a sign of problems with the muscles, ligaments or tendons in the hip area^[1],[2]

Hip pain from the spine is not uncommon and is usually related to problems in the lower back. Patients sometimes describe it as back pain shooting into the hip. ^[3]

Hip pain, a common problem in older age, can make walking and sitting difficult. It can be acute or chronic. It depends on how long the painful condition lasts. Acute pain lasts for days or weeks. Chronic pain is long-term and lasts for more than 3 months. ^[4]

Hip pain can have various causes. In general, they can be divided into five categories:

1. Arthritis and osteoarthritis (inflammatory joint disease and degenerative joint disease with cartilage wear). This group includes, but is not limited to: rheumatoid arthritis – a chronic inflammatory disease affecting the joints psoriatic arthritis – an inflammatory joint disease occurring in patients with psoriasis (psoriasis)

2 . Neurological disorders (sciatica – sciatica, nerve oppression, etc.)

4. Cancer (bone tumors, leukemia)

5.

• Osteonecrosis – the death of bone tissue,
• fibromyalgia – chronic, non-inflammatory pain syndrome of the musculoskeletal system,
• osteomyelitis – inflammation of the bone marrow,
• Osteoporosis – loss of bone mass referred to as bone thinning. ^[6]

Women may also experience hip pain in pregnancy. This is a common condition caused by hormonal changes, increased weight or a different posture. The problems usually dissipate after childbirth. ^[7]

• The problem limits your normal daily activities (e.g. hip pain when walking or hip pain when sitting),
• the pain gradually worsens,
• pain and other difficulties repeatedly return,
• hip pain at night disturbs sleep. ^[8]

A doctor will perform a basic examination to check the mobility and pain in your hip and assess any swelling or signs of inflammation.

Diagnostic imaging – X-ray, ultrasound, magnetic resonance imaging or computed tomography– is also used. Laboratory blood tests can reveal an inflammatory disease that is causing the hip pain.

• Hip pain affects 10% of the population.
• Problems are more common with increasing age. ^[9]
• Women report hip pain more often than men.
• A survey of people aged over 60 showed that 14% of respondents had experienced significant hip pain on most days in the six weeks prior to the survey. ^[10]

Hip pain can be dealt with in different ways. The exact form of treatment depends on the cause of the difficulty. Generally speaking, medication, physiotherapy or surgical procedures are used in the treatment.

Medication for hip pain

Pain of muscular origin or osteoarthritis:

• over-the-counter painkillers,
• anti-inflammatory drugs,
• prescription painkillers,
• muscle relaxants – if the hip pain is caused by muscle tension.

Rheumatoid arthritis:

• non-steroidal anti-inflammatory drugs,
• corticosteroids,
• disease-modifying drugs (DMARDs),
• biological treatment. ^[11]

Surgical treatment is used in the most serious cases, such as fractures, cancer, necrosis, bone marrow inflammation, etc. In some diagnoses (e.g. osteoarthritis), the solution is to replace the hip with an artificial joint (total hip replacement). ^[14]

Pain after hip surgery is normal, but should gradually ease. By 12 weeks after surgery, it should be almost gone. ^[15]

Some hip problems are related to wear and tear and age, in other cases musculoskeletal disorders are to blame. Although not all problems can be completely prevented, basic preventive measures can delay or slow the development of hip pain.

What else helps?

• Stretching and strengthening in the hip joints and trunk.
• Correct posture.
• Regular sports that do not put excessive strain on the hips (e.g. swimming, yoga, walking).
• Healthy diet and maintaining a reasonable weight. ^[16]

Tip: Hip pain when running ? Try swapping running for walking.

• Start your day with exercise. Do stretching and strengthening exercises, ideally as recommended by a physiotherapist. For example, strengthening the outside of the thighs is important. Example exercise: lie on your side and lift the other ‘top’ leg approximately 15 cm in the air. Leave it raised for 5 seconds and put it back down. Repeat the exercise 10 times. If possible, do the exercise on both sides of the body. If hip pain is too uncomfortable when lying on your side, you can do the exercise standing up.
• Avoid activities that involve jumping or impact on the lower limbs. Instead of running, take up walking.
• If you experience pain in your hip during the day, you can relieve it with a cold compress. The cold also helps against inflammation. Cool your hip for 10-15 minutes and repeat the compress four times a day.
• Take advantage of the beneficial effect of heat. Heat soothes sore arthritic joints, increases circulation and promotes healing. A warm compress also prepares muscles well for exercise. ^[17]
• Hip pain when sleeping on your side can be caused by an unsuitable mattress. A mattress that is too hard can put pressure on the hip and cause pain. So make sure you sleep properly. If you sleep on your side, try putting a pillow between your knees. ^[18]

Remark: Hip pain exercises – get advice from a physiotherapist. Hip pain at rest – may be caused by inappropriate sitting with legs crossed and without back support.

Knowing your diagnosis is the key to managing hip pain and staying as active as possible. This enables your doctor to recommend appropriate treatment and regimes. If you avoid bad habits (poor posture, sedentary lifestyle, being overweight) and take care of your body (regular exercise, stretching), you can stay active even with hip disease. ^[19]

You can also support good joint health by eating a good diet. Recommended foods include:

• Foods rich in calcium – dairy products, tofu, almonds.
• Leafy greens, broccoli, turnips – in addition to calcium, they contain vitamin K and magnesium and thus promote bone density.
• Fatty marine fish, fish oil – contain omega-3 fatty acids, which have anti-inflammatory effects, and vitamin D. The body needs it for calcium absorption.
• Nuts and seeds – thanks to calcium, magnesium and phosphorus, they are important for healthy bones.
• Bone broth – contains amino acids, glucosamine and chondroitin.
  All these substances help to keep the joints in good condition. ^[20]

The German pain specialist Roland Liebscher-Bracht has developed a method that relieves patients of pain naturally and in the long term. These are various exercises that promote mobility and strengthen the muscles.
In the case of right hip pain, for example, this exercise:

• Prepare an exercise belt designed for this exercise (an alternative is a conventional belt) and sit on the edge of the chair.
• Place your right leg in the loop on the exercise belt and pull your leg up to place it on your left knee.
  You should feel a stretch in your hip.
• After two minutes, return the leg to its original position.
  If at first you are unable to raise your leg fully, add a few centimetres each day to gradually get to the desired position. ^[21]

Liebscher und Bracht hip exercises to promote mobility and relieve pain can be found at: https://www.liebscher-bracht.com/en/encyclopedia-of-pain/hip-pain/exercises/

• Hip pain medications do not always have the necessary or long-lasting effect and hip surgery may not be appropriate or affordable for all patients. In addition, up to 15% of people continue to have pain after hip replacement.
• In these cases, doctors are looking at new treatments – radiofrequency ablation is an example. The essence of the procedure is to apply a radiofrequency current to the nerves that send pain signals from the affected joint. Their “deactivation” relieves patients of pain or alleviates painful conditions. It is used, for example, for pain caused by osteoarthritis. ^[22]