Patient Education – The Hip

The hip joint is the junction between your body and your legs. You depend upon it to help you walk, sit and stand. We usually don’t think much about our hips except at they relate to our appearance unless we have pain in that area. There are numerous causes of pain in and around your hip. Not all of them relate to the joint itself.

Anatomy of the hip - Click to enlarge

You may have no discomfort in your hip area. If you do have pain or discomfort in this region, there are a number of causes:

• Disease in the hip joint itself – e.g., degenerative arthritis
• Inflammation of a bursa near the hip joint -- e.g., trochanteric bursitis
• Tightness and muscle spasm of a nearby supporting muscle – e.g., piriformis syndrome or an iliopsoas sprain.
• Trauma -- e.g., a fracture
• Rarely infection in the joint itself or nearby tissues
• Disease in the bone near the joint – e.g., aseptic necrosis, or a bone tumor
• Inflammation of the joint caused by a systemic disease – e.g., – juvenile rheumatoid arthritis

As we say in medicine “common things are common”, so as you read this remember that the first four items cause the vast majority of hip related discomfort.

As we have all lived longer through better nutrition and medical care, we can quite literally wear out our hip joints. That process is called degenerative arthritis. So arthritis and bursitis are common causes of hip related pain in older people. If you want to rate yourself with regard to your risks of developing degenerative arthritis or just learn more about arthritis in its many forms, the Arthritis Foundation has a very informative website.

If you have chronic significant hip pain, many find significant relief from surgical replacement of the entire joint. This operation and the subsequent rehabilitation require a significant commitment from the patient and the surgical and rehabilitation teams, but have excellent outcomes. There are lots of web sites that can help you learn more about this but good places to start include:

• www.orthop.washington.edu/hip_knee
• www.med.virginia.edu/medicine/clinical/orthopaedics/hipman.html
• www.vh.org/Patients/IHB/Ortho/HipReplace/HipReplace.html

Tightness in the ligaments and muscles surrounding the hip occurs for many reasons. Our largely sedentary lifestyle commonly leads to reduction in the range of motion of our joints. When this happens, these tight ligaments and muscles can easily occur with what would otherwise be normal movements. This problem can be easily prevented through regular exercise and stretching. Once pain develops due to this cause, often physical therapy can hasten recovery. Information on the benefits of exercise and stretching for these and other joint disorders is available at:

• www.arthritis.org/conditions/water_exercise.asp
• http://www.enteract.com/~bradapp/docs/rec/stretching/stretching.txt
• www.findarticles.com/cf_dls/m0675/n4_v16/20923578/p1/article.jhtml

If you are having hip pain or discomfort, you may need to see a physician to get a proper diagnosis and begin to think about the options available to make you feel better. Some problems can be treated with medication, others with physical therapy, exercise, and stretching/strengthening, and some may require surgery. Modifications of activity patterns, the use of specialty braces and orthotics, and modification of you home environment are just a few examples of other helpful strategies that can lead to a better life if you have pain or loss of function.