Hip Pain Treatment

What Causes Hip Pain?

Hip pain, which includes any pain occurring in the hip joint, thigh or groin, can result from a wide variety of issues. Injuries, chronic conditions, reduced blood flow, and simple aging can all cause pain in and around the hip. Hip pain can also signal an underlying problem in the lower spine. This type of discomfort might be accompanied by stiffness or a limited range of motion, and may worsen with activity or when lying on the affected side. Common hip pain causes and conditions include fractures, dislocations, arthritis, bursitis, tendinitis, and sciatica.

Hip Pain Caused by Injury or Trauma to the Hip

Hip fractures are common among older people, especially women and people with osteoporosis, a condition that decreases bone density. Hip fractures cause pain when pressure is put on the leg or when the leg is lifted or straightened. Often, the toes on the same side as the injured hip turn outward.

Avascular necrosis (AVN) of the hip occurs when reduced blood supply causes the death of the hip’s bone tissue. AVN can result from an injury to the hip or from fatty deposits in blood vessels; it can also be caused by certain conditions like sickle cell anemia or Gaucher’s disease. Most common among people between 30 and 60 years old, AVN causes pain within the joints of the hip or in the thigh, groin, or buttocks. When a person first develops this condition, the pain may be mild or occur only when weight is put on the hip; over time, the pain will be present even when lying down.

Bursitis, Arthritis and Tendinitis of the Hip

Bursitis results from inflammation or irritation of the bursae, the fluid-filled sacs surrounding the joints that cushion the bones during movement. Bursitis is most common in the shoulder and elbow, but the condition can also affect the hip, causing stiffness, aching, and tenderness.

Arthritis of the hip, including osteoarthritis and rheumatoid arthritis, results from deterioration of the cartilage within the hip joints that is often caused by age, inflammation, or traumatic injury. Osteoarthritis is most common among women and older people, as well as in people whose work puts regular stress on the hips. Arthritis can cause stiffness, tenderness and pain in the hip, inner thigh, and buttocks. Some people also feel an internal grating sensation when they walk. When related bone spurs develop, the pain can be quite severe.

Hip tendinitis occurs when the tendons of the hip are inflamed, most often due to increased stress over time from repetitive motion. Runners are particularly prone to iliotibial (IT) band syndrome, a common form of tendinitis that causes tightness and pain in the outside of the hip. IT band pain may extend downward to the outside of the knee.

Pinched Nerves

The sciatic nerve branches outward from the lower spine through the buttocks and hips, and down the backs of the legs. Sciatica occurs when a portion of this nerve becomes inflamed due to compression, often as the result of a herniated disk or a bone spur in the lower spine. Sciatica causes pain in the back of the hip, the buttock, or the back of the leg, and can sometimes cause numbness or tingling in the leg. Ranging from mild and achy to sharp or even excruciating, sciatic pain can even feel like an electric jolt within the hip or the back of the thigh.
Since the sciatic nerve runs alongside or through the piriformis muscle, which is located in the buttocks, sciatica can sometimes be triggered by piriformis syndrome. Occurring when the piriformis muscle spasms, this disorder causes buttock pain that can radiate to the lower back or down the backs of the thighs.

Other Hip Pain Causes and Conditions

Kyphosis, an exaggerated forward rounding of the back, can result from osteoporosis or a malformation of the spine. While mild kyphosis typically doesn’t cause problems, more serious cases cause back and hip stiffness and pain.

Whatever the reason for your hip pain, you are likely looking for a way to diminish your discomfort. You can count on the experts at Balcones Pain for compassionate care, a thorough evaluation and an individualized treatment plan, so that pain does not interfere with the things you love doing.

How is Hip Pain Treated?

Treatments for hip pain depend on the underlying cause or condition. At Balcones Pain Consultants, we are experts at determining the most effective treatment or combination of therapies for reducing or eliminating pain in the hip. Hip pain treatments can range from conservative therapies like massage or physical therapy, to more aggressive options, including medication, transcutaneous electrical nerve stimulation, joint and bursa injections, epidural steroid injections, and surgery.

Treating Hip Pain Caused by Bursitis, Tendinitis and Arthritis

Hip pain from bursitis, tendinitis, and arthritis—including osteoarthritis and rheumatoid arthritis—can be managed with NSAIDs (non-steroidal anti-inflammatory drugs) or other pain medications, or with steroid injections into the affected joint to reduce swelling and inflammation. Physical therapy exercises can greatly reduce hip pain due to arthritis, as can proper diet and weight management to reduce pressure on the joints. In some cases, acupuncture treatments may help reduce the pain.

Bone spurs that develop due to arthritis can initially be treated with NSAIDs or other anti-inflammatory pain medications along with physical therapy techniques such as cold packs, stretching, and massage. Corticosteroid injections into the affected joints can also reduce pain from bone spurs. Ultimately, severe, painful bone spurs may require surgical removal.

Kyphosis—an exaggerated forward rounding of the back that can result from a spinal malformation, arthritis, or osteoporosis—typically doesn’t cause pain, but more serious cases cause back and hip stiffness and pain. Hip pain due to kyphosis can be treated with pain medication, exercises, and physical therapy. Nutritional therapies can also help, and in some cases, surgery is recommended.

Hip pain from iliotibial (IT) band syndrome can be relieved by rest, especially if the condition has developed from repetitive motion or overuse, as with long-distance running. NSAIDs, topical anti-inflammatory medications, massage, and special stretching techniques are also helpful in reducing the pain, as are exercises designed to strengthen the core, hip, and buttock muscles.

Treatment for Pinched Nerves

One of the most common causes of hip pain due to a pinched nerve is sciatica. Mild cases of sciatica usually resolve on their own over time and can be treated with rest, massage, heat applications, and NSAIDs for reducing pain and inflammation. If sciatic hip pain is severe, however—if it lasts longer than a week or gets progressively worse instead of better—medical intervention is necessary. Immediate medical attention is needed if sudden, severe pain in the hip, lower back, or leg follows a major injury, such as from a car accident; if you experience numbness or weakness in the hip or leg muscles; or if you’re experiencing pain along with difficulty in controlling your bladder or bowels.

Treating Hip Pain from Injuries, Fractures and Dislocations

Fractures, dislocations, and injuries, including those due to osteoporosis or repetitive motion, are common causes of hip pain. Treating hip pain due to injuries of these types might include a combination of rest, physical therapy, and medications, such as NSAIDs or bisphosphonates. Surgical options for treating hip injuries can include internal repairs using screws, or partial or total hip replacement.

Avascular necrosis (AVN) can develop as the result of a hip injury, or due to other causes or conditions. Treatment for hip pain due to AVN depends on the severity of the condition, and the extent of the bone loss. In its early stages, this condition can be treated with medications like NSAIDs, blood thinners or osteoporosis drugs, along with exercises to improve the hip’s range of motion or electrical stimulation to encourage new bone growth. In its later stages, AVN may require surgical treatment, such as through a bone graft or reshaping or a joint replacement.

Whatever the underlying cause of your hip pain might be, your caring provider at Balcones Pain Consultants will work with you to develop an individualized approach to treating your pain, so you can return safely and pain-free to the activities you love.

Advanced Treatments for Hip Pain Management

Chronic hip pain following an injury might also be treated with joint injections, in which a mixture of anesthetic and steroid medications is injected to relieve pain and reduce inflammation.

Severe or chronic hip pain which does not respond to other treatments, or which significantly impacts your life or activity level, may be treated with more advanced methods. It’s important to let your healthcare provider at Balcones Pain Consultants know about all your symptoms, so that we can help you to return to living life as smoothly and quickly as possible. We will be happy to answer any questions you have about the many treatment options available, including:

• Fluoroscopic Guided Hip Injections
• Fluoroscopic Guided Piriformis Injections
• Intrathecal Pump Implant
• Joint Injection
• PRP for Hip Arthritis
• Spinal Cord Stimulator Implant (Includes Trial Procedure)
• Trigger Point Injections