Hip pain is a common problem for both adults and adolescents. Issues within the hip joint can lead to strain on the inside of the hip or groin. Pain on the outside of the hip, upper thigh, or outer buttock is usually an indication of problems with muscles, ligaments, tendons and other soft tissues. Conditions affecting other areas, such as the lower back or nerves, can also cause hip pain.
One of the most common causes of hip pain is fracture. This risk increases with age as bones thin and weaken, causing osteoporosis. This condition affects mostly women, but men over 65 years are also at risk. Young, active individuals are also susceptible to stress fractures of the hip. These tiny, imperceptible cracks in the bone are caused by repeated high-impact activity. Pain from a fracture is usually felt in the anterior hip or groin.
Tendinitis refers to inflammation of the tendon. The condition can affect any tendon in the body, but most commonly occurs around shoulders, elbows, wrists, knees, and hips. An inflamed tendon increases the risk of rupture, which requires surgical repair. Ballet dancers, gymnasts, older individuals, and long-distance runners are at greater risk of tendinitis. Anterior hip and groin pain that worsens during physical activity characterizes this pain. The individual may hear a pop sound when the hip is flexed or extended. It is important to note that pain in the hip may actually originate from the knee (referred pain). Inflammation of the tendons tendinitis surrounding the knee or a tear in the tendon that attaches the muscles in the anterior thigh to the knee can cause pain in the groin.
Bursitis is the inflammation of small fluid-filled sacs called bursae, which cushion bones, muscles, and tendons near joints such as the shoulder, knee, ankle, elbow, and hip. Their purpose is to help reduce friction around the joints. Two significant bursae in the hip may become inflamed, causing pain. One is near the greater trochanter, the bony point of the hip, and the person may feel lateral hip pain. The iliopsoas bursa is inside the hip. Inflammation here is iliopsoas bursitis. Anterior hip or groin pain characterize issues with this bursa.
Osteonecrosis is the death of bone tissue due to a loss of blood supply. The disease may affect one or multiple bones. Although osteonecrosis may originate in the hip, affecting the femur, it can affect the knees, shoulders, and ankles as well. Risk factors include long-term use of high-dose steroids and excessive alcohol intake, sickle cell disease, and trauma. Osteonecrosis most commonly occurs between the ages of 40 and 65. Men develop the disease more often than women.
Anterior hip pain is symptomatic of septic hip arthritis, a painful infection in the hip joint. Microorganisms traveling in the bloodstream, a puncture, or injury can introduce bacterial, viral, or fungal elements into the joint. The most common cause of septic arthritis is staph bacteria. In addition to hip pain, septic arthritis often causes fever and swollen, tender joints. Risk factors for septic hip arthritis include advanced age, diabetes, rheumatoid arthritis, recent joint surgery, hip osteoarthritis, and hip or knee prostheses.
Femoral and inguinal hernias or "sports hernias" can cause frontal hip pain. Hernias most often develop in the inner groin and may be due to heavy lifting, straining during bowel movements, excess weight, or chronic coughing and sneezing. The majority of hernias require surgery.
Sciatica refers to irritation or inflammation of the sciatic nerve, the largest single nerve in the human body, which originates in the lower back and terminates just below the buttocks. Sciatic nerve pain travels down the back of the leg and may develop due to lumbar disc herniation, spinal stenosis, piriformis syndrome, or degenerative disc disease. A major symptom of sciatica is anterior hip and buttock pain. Other symptoms may include low back pain that radiates into the foot and toes. Tingling or numbness in the lower extremities and weakness in the leg and foot are also common. Symptoms of sciatica usually occur on only one side of the body.
Slipped capital femoral epiphysis (SCFE) is an uncommon disease of the adolescent hip. The head of the femur slips backward in the hip joint, separating from the main part, causing a fracture of the growth plate. Hip pain is a major symptom of this condition and the left hip is more commonly affected than the right. SCFE is most common in male adolescents with obesity. Other symptoms include knee pain, an intermittent limp, an outwardly turned leg, and decreased range of motion in the hip.
Meralgia parasthetica or Bernhardt-Roth syndrome occurs due to compression of the lateral femoral cutaneous nerve, a large sensory nerve in the thigh. The result is tingling, numbness, and burning in the lateral hip and thigh. Pain may intensify with prolonged walking or standing and be relieved by sitting. Repetitive motions of the legs, pregnancy, weight gain or obesity, wearing tight clothing or tool belts, and recent injuries to the hip may cause nerve entrapment. The condition affects people with diabetes more often than the general population.
Hip pain in women can have gynecological causes. Endometriosis can cause pelvic tenderness and numbness, which some women identify as hip pain. Women may also experience hip pain during menstruation. Pain from the back and spine may also be felt around the buttocks and hip. In general, hip pain affects women more often than men.
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