Hip Care Overview

Hip pain is common, especially among older adults. You may not feel the pain at your hip. Pain caused by hip problems is often felt in your:

• Groin
• Thigh
• Knee
• Buttock

Pain in the groin or knee is typically caused by a problem within your hip joint. Pain in thigh or outer buttock is often caused by problems with ligaments, muscles and other tissue around the hip joint.

Hip pain has many causes, from arthritis to injuries and accidents. Among older adults, nearly 1 in 4 have pain from osteoarthritis in the hip. Being overweight increases your risk.

Among young people, dancers, gymnasts or other athletes who move their hips in many directions are at greater risk of hip injury.

Causes of hip pain include:

• Arthritis – Osteoarthritis occurs as cartilage in the hip joint gradually wears away, and typically gets worse with time. Less common forms of arthritis in the hip include rheumatoid arthritis, an auto immune disease that causes inflammation of the joint. Ankylosing spondylitis is a form of arthritis that causes low back pain, which can affect the hip.
• Bursitis – Swelling in the fluid-filled sacs that cushion spaces around the bones of your hip, acting like shock absorbers.
• Hip fractures or dislocation – This injury from falls or accidents is most common among older, frail people.
• Hip flexor strain – Muscle strains usually result from sports.
• IT band syndrome – The iliotibial band that extends from the outside of the hip to the outside of the knee can become tight from overuse and rub against the hip.
• Hip labral tear – This tear to soft tissue covering the hip socket usually results from an accident or sports injury. 
• Pinched nerves or sciatica – Nerve pain can travel from the lower back, through the hips and buttocks. Sometimes this pain is caused by a herniated disk that puts pressure on part of the nerve.

Your doctor will ask questions to get your medical history, and do a physical exam to check for mobility, swelling, bruising or tenderness.

Your doctor may also recommend other tests, including: 

• X-ray – X-rays use electromagnetic waves to take pictures of the bones in your hip. They can detect fractures and deterioration of the joint.
• MRI – Magnetic resonance imaging uses a powerful magnet and radio waves to create 3D images of the tissue inside your hip. MRIs help find tears to soft tissues such as tendons, ligaments, muscles and cartilage.

Treatment depends on the cause of your hip pain.

• Rest and ice – Stop activities that make the hip pain worse. Apply ice wrapped in a towel for 15 minutes every hour. Lift your hips and legs above the level of your heart, supported by cushions or pillows. Wear a compression bandage or compression shorts to keep pressure on your hip.
• Medications – Anti-inflammatory medicine such as ibuprofen (Motrin) or naproxen (Aleve) can help ease swelling. Acetaminophen (Tylenol) can help relieve pain.
• Physical therapy – Your hip becomes more stable when the muscles around it are stronger. Physical therapy can help you learn safe and effective exercises to strengthen those muscles.
• Injections – Corticosteroid shots may help reduce inflammation and pain for a few months.
• Hip replacement surgery – The surgeon replaces damaged bone and cartilage in your hip with an artificial joint made of metal alloys and medical grade polyethylene (plastic). Most hip replacements last at least 15 to 20 years. More than half last 25 years.