Do you suffer from hip pain? We explore the causes, symptoms, treatment and more.

Causes
Hip pain generally refers to any pain in or around the hip joint. The most common cause of hip pain is injury.

However, the list of causes of hip pain is extensive and includes many rare ailments. For example, Legg-Calve-Perthes disease affects 1 in 1,000 children between the ages of 5 and 10 years and might result in the destruction of the growth plate in the neck of the thighbone.

A few of the more common causes of pain not related to injury include:

• Forms of arthritis – This includes osteoarthritis and rheumatoid arthritis, lupus and gout.
• Bursitis of the hip – Pain sets in slowly over time and is caused by overuse of the joint. Pain is felt on the outside of the hip over the thigh bone, just under the skin.
• Aseptic necrosis – This is caused by a clogged artery at the head of the femur, secondary to excessive alcohol intake and steroid therapy, among many other causes.
• Joint infection – This includes septic arthritis.
• Viral illnesses – Influenza, for example, can cause muscle and joint pain.
• Muscle cramps – These cramps may have no clear cause, and may even be due to dehydration or failing to stretch before exercise.

Symptoms
People often complain that the hip “just hurts”. This is because hip pain is often difficult to describe.

The condition will also not always be felt directly over the hip and it’s not unusual to be felt in the groin, the middle of the thigh and the same-side knee.

Depending on what’s causing the hip pain, discomfort may also felt in the following areas:

• Groin
• Inside of the hip joint
• Buttocks
• Thigh
• Outside of the hip joint

Sometimes pain from other areas of the body, such as the back or groin (from a hernia), can also radiate to the hip.

If it’s caused by arthritis, you might notice that the pain gets worse with activity. There’s usually a reduced range of motion and you could also develop a limp from the persistent pain.

Who’s at risk?
Although hip-related pain and injury are believed to be an ailment of older people, and rightfully so, children and young adults are not immune to it:

• In older people, the most common cause of hip pain is osteoarthritis. This form of arthritis causes the degeneration of joint cartilage surfaces and results in bare areas of bone that rub together. This may cause mild to severe pain.

• When it occurs in young adults, it’s generally caused by hip dysplasia, spondylo-arthropathy (a family of inflammatory rheumatic diseases that causes arthritis), sports-related injuries and trauma, rheumatoid arthritis, and avascular necrosis due to various reasons, including chronic alcoholism or the use of illegal intravenous drugs.

Prevalence
Because hip pain is a symptom of so many ailments, it affects children, the aged, and men and women alike.

In the United States, research shows that self-reported hip pain has increased over the past 30 years. Other international studies have pointed to a prevalence of 25% joint morbidity (hip and knee disease) in people over 60, while men seem to report hip pain less frequently than women.

Australian researchers have found that lower-extremity pain, including hip pain, significantly affects quality of life (physically and mentally), as well as mobility.

Prevention
Various steps can be taken to avoid the risk of hip pain (note that, in many instances, hip pain may be related to factors beyond your control):

• Be mindful of activities where one of your hips is above the other for prolonged periods of time.
• Learn about fall prevention, especially as you get older.
• Read up about osteoporosis prevention.
• Always wear protective gear (hip pads) during contact sports.
• Stretch your hips, lower back and thighs before and after exercise.
• If you experience pain, seek medical assistance as early as possible.

Treatment
Most hip pain can be reduced with the following steps, but it will depend on the severity and the location of pain:

• Resting and icing the area.
• Using over-the-counter medication such as oxycodone hydrochloride or ibuprofen. Ask your pharmacist or doctor to recommend pain medication suited to your specific needs.
• Using a cane, walker or crutches. This may be useful in the short term.

In severe cases, especially among the aged, medical treatment is required and may include:
• Prescription anti-inflammatory medications such as corticosteroids, or disease-modifying anti-rheumatic drugs such as sulfasalazine or methotrexate.
• Therapy to maintain the strength and range of motion of the hip.
• Surgery that involves hip replacement.

When to see a doctor?
See a doctor immediately if:

• You know your hip pain is caused by injury.
• Pain is severe and you can think of no injury or activity that might have caused it.
• Pain persists after two weeks of home treatment.
• Pain is accompanied by an unexplained fever, or becomes more severe or frequent.
• The hip is unable to bear any weight, or if walking is impossible.

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