rheumatoid arthritis

The hip is an important joint that you use every day as you walk, run, and jump. Because of this, our hips are especially prone to injury and pain at any stage of life.

At MedStar Health, our hip doctors specialize in diagnosing and treating a wide range of conditions resulting in hip pain, whether it’s from a sports injury, trauma, or joint inflammation.

Symptoms

No two injuries are alike, so it’s important to seek care if you have any of the following hip symptoms:

  • A joint that appears deformed
  • A limp or lurch to the side with walking
  • Difficulty moving your leg or hip
  • Difficulty bearing weight on the affected leg
  • Intense pain or pain that wakes you from sleeping, especially in the groin/thigh
  • Signs of infection, such as local pain, fever, chills, and sweats
  • Thigh and buttock swelling
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Conditions and Treatments

Learn about some of the most common causes of hip pain below.

Hip arthritis

Arthritis is a common hip condition that occurs when the tissue surrounding your joints becomes inflamed. This causes pain, swelling, and damage to the joint, making it hard to do everyday activities.

There are different types that affect the hip.

Osteoarthritis

Osteoarthritis occurs when the cartilage between the bones at joints wears away as part of the natural aging process. It can occur in any joint in the body. Most often, it develops in weight-bearing joints, such as the hip and knee.

Hip osteoarthritis develops slowly and the pain it causes worsens over time. Certain factors may make you more likely to develop the disease, including:

  • Advancing age
  • Family history of osteoarthritis
  • Previous injury to the hip joint
  • Obesity

Inflammatory arthritis

Some types of inflammatory arthritis, including rheumatoid arthritis, may result in dull, aching hip pain. Rheumatoid arthritis is not hereditary. However, researchers believe some people may have a gene that can be triggered by an infection or environmental factor. When this happens, it prompts the immune system to respond by producing a chemical that attacks and destroys the joint surface.

Unlike osteoarthritis, stiffness or pain from inflammatory arthritis may improve with activity. However, since there is no cure, you should see a hip doctor if your pain affects your everyday life.

Post-traumatic arthritis

Post-traumatic arthritis is a form of osteoarthritis that develops after you experience an injury to the hip. It can develop years after your injury occurs.

Arthritis gradually worsens over time. The sooner you start treatment, the more likely it is that you can lessen its impact on your life. Although there is no cure without surgery, there are many treatment options to help you manage pain and stay active. However, your doctor may recommend surgery if your pain from hip arthritis causes disability and is not relieved with non-surgical treatment.

Sports-related Hip Pain

Hip injuries and pain are common among athletes, from runners to basketball players. At MedStar Health, our experienced surgeons provide high-quality care for hip joint pain and injuries, using physical therapy and other conservative treatment options, as well as advanced surgeries, when necessary. Our team performs thousands of surgeries each year, and we pride ourselves on offering the least invasive options to allow our patients to recover quickly from surgery and return to their active lives faster. Our specialists will always encourage non-surgical options when possible and recommend surgery only when needed.

What are the causes?

It can be caused by a variety of hip conditions and injuries, many of which occur as the result of playing a sport. The most common injuries that result in hip pain include:

  • Acetabular labral tears

  • Hip impingement syndrome

  • CAM lesions

  • Muscle strains

  • Stress fractures

  • Dislocation


Hip Pain

Hip pain is common in active individuals and athletes. The hip joint is prone to injury in both repetitive motion and high impact activities.

The surgeons of MedStar Health, who specialize in the treatment of hip pain, have a comprehensive and precise understanding of the causes of hip pain. While there are many causes, hip impingement is becoming an increasingly recognized problem in the athletic and highly active populations. The good news is that there are new and improved methods of treatment.


Hip Impingement

Our surgeons commonly diagnose hip impingement, also known as femoral acetabular impingement or FAI, in young, active individuals who are performing repetitive hip movements. However, it is an overuse injury and can be present at all ages and activity levels.

This condition is caused by abnormal contact between the ball of the femur and the socket. The abnormal contact can be a result of excessive bone around the socket, the femur, or a combination of both.

The excess bone creates a joint that is no longer spherical. This abnormal shape can cause injury to the cartilage as well as the labral soft tissue (cartilage). The damage caused may lead to increased pain and arthritis in the hip joint or hip labrum if left untreated.

How is it diagnosed?

If you experience hip pain that is severe or does not go away, it is important to speak with a specialist. MedStar Health is home to experts in a wide range of hip conditions who have years of experience diagnosing and treating pain. Your initial exam with one of our physicians will likely include the following:

  • *Medical history evaluation –*Your physician will discuss your medical history with you and any relevant prior hip problems
  • *Physical exam –*Your doctor will evaluate the affected hip and may ask you questions about where you are feeling pain or discomfort or how the injury first occurred
  • Imaging tests – Your orthopedist will also likely conduct imaging studies to rule out bone fractures and accurately diagnose your condition

Treatment

  • Ice to decrease swelling
  • Pain medications
  • Avoiding activities that cause pain or pressure on the hip
  • Anti-inflammatory medications to reduce swelling
  • Physical therapy

If conservative treatments are unsuccessful, or if your hip condition is severe or recurring, our physicians at MedStar Health may recommend hip arthroscopy.

Avascular necrosis of the hip

Avascular necrosis of the hip occurs when a part of the bone dies after losing its blood supply. The lack of blood may cause the surface of the bone to collapse, and arthritis will develop. Causes may include:

  • Excessive alcohol consumption
  • Injury to the hip
  • Some diseases
  • Trauma
  • Use of corticosteroids

Symptoms vary depending on the cause, but pain in the hip is common. Although nonsurgical treatment options can relieve pain and slow the progression of the disease, surgery may be your most effective treatment option.

Hip abductor tear

The abductor muscles are located on the side of the hip. These muscles move the leg away from the midline of the body and support the pelvis during weight-bearing activities.

Hip abductor tears usually occur during the following activities:

  • Changing direction quickly
  • Overstretching the muscle, such as in martial arts high kicks
  • Rapid leg movements against resistance, such as kicking a ball
  • Sprinting

Abductor tears can also occur as a chronic degenerative process, especially in the setting of a diseased abductor tendon.

These tears can cause severe, chronic pain and weakness and may not respond to non-surgical treatment. However, many of these tears can be repaired by arthroscopic hip surgery.

Hip bursitis

Bursitis is inflammation or irritation of a bursa, a small sac of fluid that serves as a cushion between joints, muscles, and tendons. There is a bursa located on the inside of your hip (iliopsoas bursa) and a bursa on the outside of the thighbone, (trochanteric bursa). When one of these becomes inflamed, it may result in hip bursitis.

Hip bursitis is most common in women and middle-aged adults. You may be at an increased risk for hip bursitis if you have or have had any of the following:

  • Bone spurs or calcium deposits
  • Hip injury
  • Overuse of the hip (Repetitive movement such as bicycling or climbing for a long period)
  • Previous surgery
  • Rheumatoid arthritis
  • Spine disease
  • Weakness of hip abductor muscles

Most people experience relief for hip pain caused by bursitis through non-surgical treatments, including physical therapy, activity modification, anti-inflammatory medication, or a steroid injection. Your hip doctor may also be able to drain the fluid. In rare cases, your doctor may recommend hip arthroscopy, a type of hip surgery to remove the inflamed bursa.

Hip impingement

Hip impingement occurs when there is excessive bone around the joint socket and/or ball of the thighbone (femur). When that happens, it causes an abnormal shape that impacts the joint's ability to move smoothly. This can damage the surrounding cartilage, causing increased pain in the hip and, possibly, hip arthritis.

Symptoms may also include:

  • A feeling of the hip catching or locking during movement
  • Decreased range of motion with hip rotation
  • Discomfort in the hip while sitting or standing
  • Pain in the groin with activity

Also known as femoral acetabular impingement or FAI, hip impingement most commonly occurs in young athletes. However, it can occur at all ages and activity levels.

A hip doctor will use imaging tools, such as X-ray and MRI, to diagnose hip impingement. Nonsurgical treatment options may include rest, physical therapy, and/or steroid injections. If symptoms don’t improve, your doctor may recommend minimally invasive hip surgery called hip arthroscopy.

Hip fracture

A hip fracture is a break in the upper quarter of the thighbone (femur) that occurs after a fall or direct blow to the hip. In other cases, a fracture may occur gradually as a result of a stress injury. You may be at a higher risk for a stress fracture if you are aging or:

  • Take certain medications, including sleep medications and sedatives
  • Have a chronic medical condition that leads to fragile bones
  • Have a history of tobacco or alcohol
  • Lack essential nutrients in your diet, including calcium and Vitamin D

A hip fracture can limit your ability to move around independently, so it’s important to seek treatment. In most cases, a hip fracture will require hip surgery.

Labral tears

The labrum is a structure in the hip that surrounds the pelvic socket and provides some stability to the joint. More importantly, it helps maintain normal fluid in the joint. A tear in the labrum can be caused by injury or overuse. It can lead to pain and catching of the joint.

While many labral tears can be treated by physical therapy or steroid injections in the joint, some cases may require surgery to reattach the tissue to the socket.

Damage to an existing hip replacement

For a total hip replacement to function effectively, the implant or prosthesis must remain firmly attached to the bone. Over time, however, an implant may loosen from the underlying bone, causing pain in the hip.

It’s not always clear what causes the hip prosthesis to loosen, but factors that may contribute include:

  • High-impact activities
  • Obesity
  • Wear of the plastic spacer between the metal parts of the implant
  • Infection

If you undergo hip replacement surgery at a young age, you may outlive the life expectancy of your artificial hip. As a result, you may be at a higher risk of needing hip revision surgery due to loosening or “wear and tear.”