Cause of Chronic Hip Pain

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Hip Pain

Published: 04 December 2015

Suffering from chronic hip pain? Well, let’s stand back a little and ask “What is chronic hip pain?”

Here is a simple definition:

Chronic hip pain is a pain in your hip that has lasted longer than six weeks.

I find that this definition is the most useful starting point - as six weeks is generally the transition point between an acute and a chronic pain presentation.

Although the causes of chronic hip pain are many and varied the most common causes that I see on a weekly basis are:

1. Osteoarthritis - is where the hip joint is worn away in parts. The hip joint is a ball and socket joint. A healthy hip joint has a smooth socket and the ball glides around the socket easily allowing you to move your hip without pain.

If your hip is arthritic, then the surface of the socket becomes uneven. As a result, movement is impaired and eventually the surface will become inflamed causing arthritic hip pain. Diagnosis of osteo-arthritic hip pain is made by x-ray imaging. Treatment involves mobilisation of the joint followed by mobility and strength exercises. If the wear and tear is very severe a hip replacement may be needed. However, my advice is to try Physiotherapy first and if that fails then seek a surgical opinion.

1. Bursitis - is where a cushion of fluid in your hip joint becomes inflamed and painful. In order to stop bone rubbing on bone between the ball and socket of your hip, there is a cushion of fluid between them.

Sometimes this cushion gets inflamed due to poor movement techniques or as a sign of early stages of wear and tear. This inflammation causes pain. Treatment of bursitis in the hip involves rest, anti-inflamatories and occasionally steroids. Once the pain has gone the cause of its onset must be addressed through movement and posture correction techniques. This will avoid a relapse or a worsening of the arthritis.

1. Iliotibial band syndrome - is where a band of tissue on the outside of your thigh becomes inflamed and sore. This is due to tightness in the band and its surrounding muscles which can result in the band being repetitively strained. Over time causes inflammation and pain.

2. Flat feet - this is where your feet are flatter than they should be! Orthotic correction and strength exercises work well for this complaint.

3. Piriformis syndrome - is where your piriformis muscle in your buttock gets tight and inflamed causing pain. Treatment involves releasing the muscle, and strengthening the surrounding muscles to prevent it from re-occurring. If a nerve is involved then manual therapy will be required.

4. Referral pain from the lower back - is where a nerve in your back is impinged or trapped causing a referral of pain into the hip. Treatment needs to be directed to the lower back in this case.

Overall chronic hip pain can be avoided if early intervention is provided following correct diagnosis.