Hip problems are pretty common. The cause may be obvious, like an injury that comes on suddenly while playing sports. Sometimes the cause is not as clear and you will need to be checked out by a doctor.
Hip problems are common and can be an occupational hazard of getting older, although may affect younger people too. They are usually due to a problem with the hip joint. Joints are junctions between two bones.
In the UK alone, 8.5 million people live with joint pain, and hips are prime candidates. Pain in your hip can also come from your lower spine or from any of the structures near your hip joint. Your doctor will check this out.
What does the hip joint look like?
Your hip joint is known as a 'ball-and-socket' joint. The ball (head) of your thigh bone (femur) fits into the socket of your pelvic bone to make your hip joint. This socket is called the acetabulum. The adjoining bone ends are covered in a tough, smooth material called cartilage, which lets the bones glide smoothly over each other. The joint is surrounded by a strong but flexible capsule. It helps to give stability to the joint and also produces a fluid called synovial fluid to give lubrication and help joint movement. Ligaments across the joints keep it all stable.
Causes of hip problems in adults
- Osteoarthritis is the most common cause of hip problems. Your joints go through constant wear and tear, and keep repairing themselves. Sometimes, the repair process can't keep up with the damage and osteoarthritis develops. Wear and tear increases with age and weight. Injury or deformity of your joints - from a break, a joint infection or other damage - also makes you more prone to osteoarthritis. Women suffer more often than men, and it can sometimes run in families. Hip osteoarthritis causes pain (usually felt in the groin) and stiffness. This can affect your ability to walk and may eventually mean that you would benefit from a hip replacement. See separate leaflet called Hip Replacement.
- Greater trochanteric pain syndrome is another very common cause of hip pain. It is particularly common in middle-aged women but can also affect younger people, especially runners and footballers. Unlike hip joint pain, when the pain is usually felt in the groin, greater trochanteric pain syndrome gives you pain on the outside of the top of your thigh. See separate leaflet called Greater Trochanteric Pain Syndrome (Trochanteric Bursitis).
- Hip fracture is another term for a broken hip. It is a very common fracture in older people. It usually happens after a fall. Having had a hip fracture is the most common reason for being admitted as an emergency to a bone (orthopaedic) ward. This is because it is usually necessary to have an operation to fix a hip fracture. Hip fractures are most likely in someone who has a condition called osteoporosis, which makes the bones weaker and more likely to break. See separate leaflet called Hip Fracture.
- Femoroacetabular impingement (FAI) happens because of slight abnormalities in the shape of the 'ball-and-socket'. The movement between the bones can then cause damage to the cartilage on the surfaces and to the other tissues around the edge of the hip joint. It is not known how common FAI is but it is increasingly thought to be a common cause of hip problems, particularly in young adults.
- Rheumatoid arthritis is the second most common kind of arthritis. It's an autoimmune disease - your body's immune system attacks itself. Often many joints are affected at the same time, but in the early stages it tends to cause hand and foot problems and doesn't often cause hip problems.
- Septic arthritis is an infection in a joint. It is a rare cause of a hip problem but is serious and needs urgent treatment. It can affect people of any age. See separate leaflet called Septic Arthritis.
Causes of hip problems in children
- Even newborn babies can have problems with their hips. This is why all newborns are examined by a doctor or midwife to check their hips. What they are looking for is a painless condition called developmental dysplasia of the hip (DDH). DDH makes the hip joint unstable so that it can dislocate (something that very rarely happens to the hip joint otherwise). It is important to pick this up and treat it, as if it isn't treated the joint won't develop normally. See separate leaflet called Developmental Dysplasia of the Hip.
- Older children, particularly boys, though girls may be affected, can develop a problem with the blood vessels to the hip joint. This is called Perthes' disease. It mainly affects children aged over 4 years but younger than 13 years. Often the first symptom is that the child develops a limp. The hip is not always painful. See separate leaflet called Perthes' Disease.
- Older children can also develop a problem called slipped capital femoral epiphysis. This hip problem affects a slightly older age group than Perthes' disease. It usually causes a problem around the age of 11, 12 or 13 years. The main symptoms are pain around the hip or knee, and limping. See separate leaflet called Slipped Capital Femoral Epiphysis.
- Septic arthritis (see above) can also affect children.
How are hip problems diagnosed?
Your doctor should be able to make a diagnosis on the basis of your symptoms and examining you. You may need any of the following tests depending on what your doctor suspects to be the cause of your hip problem:
- X-ray of your hip. Knee or spine X-ray may also be requested. Note: X-ray changes don't always match the severity of your symptoms and therefore aren't always helpful.
- Blood tests.
- Magnetic resonance imaging (MRI) scan.
- Computerised tomography (CT) scan.
- Rarely a bone scan may be suggested.
Treatment for a hip problem will depend on what the cause is thought to be. Some problems will settle without any treatment and others might need urgent treatment. For example a broken hip is often treated by an urgent hip replacement. You will find more information in the leaflets on the individual conditions.
Further reading and references
Wall PD, Brown JS, Parsons N, et al; Surgery for treating hip impingement (femoroacetabular impingement). Cochrane Database Syst Rev. 2014 Sep 8(9):CD010796. doi: 10.1002/14651858.CD010796.pub2.
Hi ShaunI am ten years post a Perthes-related total hip replacement! It really has been a godsend for me :D Briefly- I had Perthes diagnosed aged 8, but they caught it late so hip ball was pretty...Guest
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.