Hip Pain: Common Causes and Treatment Options

Anatomy of the Hip

The hip joint is a complex ball-and-socket joint where the thigh bone meets the pelvis. As one of the body’s largest weight-bearing joints, the hip is also responsible for the movement of the upper leg.

In order to identify what hip pain can mean and to better understand its conditions and injuries, it’s helpful to learn the anatomy of the hip:

• Articular cartilage covers the weight-bearing bones, allowing for smooth movement of the hip.

• The acetabulum is a circular socket at the top of the pelvis.

• The femoral head, on the upper part of the thigh bone, is the ball of the hip joint and fits into the acetabulum.

Muscles support the joint and allow it to move, including:

• The iliopsoas muscle starts in the lower back and connects to the femur.

• The gluteals are the muscles of the buttocks.

• The adductor muscles are the muscles of the inner thigh.

• Hamstrings run down the back of the thigh and go from the hip to just below the knee.

• There are four quadriceps on the front of the thigh that run from the hip to the knee.

There are also major nerves and blood vessels running through the hip, including the sciatic nerve.

Common Causes of Hip Pain

Arthritis is the most common cause of chronic hip pain and instability. The three most common types of arthritis that affect the hip include osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.

Rheumatoid Arthritis

This autoimmune disease affects the synovial membrane, causing it to become thickened and inflamed. Chronic inflammation damages the cartilage, causing pain and stiffness. Unlike osteoarthritis, however, rheumatoid arthritis originates from an immune system disorder.

Osteoarthritis

This form of arthritis refers to the breakdown of hip cartilage, synovium, and eventually, the hip bones. People 50 years and older are more prone to this wear-and-tear condition in which the joint is gradually eroded. Total hip replacement is an option for people with advanced osteoarthritis.

Post-Traumatic Arthritis

A serious hip injury or fracture can damage the cartilage permanently.

Avascular Necrosis

Similar to post-traumatic arthritis, avascular necrosis is caused by an injury to the hip. A dislocation or fracture may limit blood supply to the femoral head, which eventually leads to a collapse in the surface of the bone.

Childhood Hip Disease

Sometimes infants are born with congenital hip abnormalities that result in arthritis later in life. One example is hip dysplasia, a condition in which the hip socket does not fully cover the ball of the thigh bone.

Treatment Options for Hip Conditions

Core Decompression

Core decompression involves surgical drilling into dead bone near the joint affected by avascular necrosis.The surgeon must drill into the femoral neck to stimulate blood flow, reduce pressure, and slow the deterioration of the hip joint.

Hip Resurfacing

Hip resurfacing and hip replacement are commonly used for patients with advanced arthritis or another condition that has caused severe damage to the joint. Hip resurfacing is less invasive than hip replacement, requiring a trimming of the femoral head (rather than a complete prosthesis replacement).

Hip Arthroscopy

This minimally invasive procedure may be recommended if you have certain painful conditions that do not respond to conservative treatments, such as rest, physical therapy, and injections. Arthroscopy involves the insertion of a small camera into the hip joint, which projects images onto a video monitor. Because the arthroscope (camera) and instruments are so thin, the surgeon can perform tiny incisions during the procedure.

Many patients choose hip resurfacing because less bone is removed and the remaining bone will stay strong and healthy for longer than a hip replacement.

Total Hip Replacement

Over the last two decades, the number of total hip replacements being performed each year has steadily increased in the United States, according to the American Association of Hip and Knee Surgeons. When the hip has worn down significantly due to arthritis, a prosthetic hip can take its place. This surgery, also called hip arthroplasty, involves removing the damaged bone and cartilage.

• The damaged femoral head must be removed and replaced with a metal stem, which is positioned in the hollow of the femur.

• A metal or ceramic ball is placed on the top of the stem, replacing the damaged femoral head.

• The cartilage surface of the socket must be extracted and replaced with a metal socket with screws holding the socket in place.

• A spacer is inserted between the new ball and socket to ensure a smooth surface.

This surgery requires extensive rehabilitation following the procedure to restore movement and strength. Most patients can perform physical therapy exercises without assistance, but the speed of your recovery will depend largely on the consistency of your exercise regimen.

About OrthoNC

The orthopaedic experts perform thousands of surgeries each year. Although joint replacement is a major procedure, we walk patients through every step of the process to make them more comfortable.

What else makes our hip surgeons exceptionally qualified? Here are our top traits:

• Fellowship-trained. Each doctor has undergone advanced subspecialty training within a fellowship program, in addition to their residency training.

• Innovative. We research orthopaedic diseases, develop new treatments, and set surgical standards. Our dedication to innovation is how we are able to give patients the best care possible.

• Patient-centered. When patients trust us with their health, they are in good hands. Our physicians and surgeons are determined to provide education, support, and top-quality care each and every day.