Hip Pain

How to Manage and Fix Your Hip Pain, for Good! 

Hip pain is one of the most common non-spinal issues we see here at Stoke Chiro Spinal Health. And hip pain is no joke! Due the hip’s role in stabilisation when both standing, and walking, hip pain can be a major obstacle to your mobility and comfort, affecting your daily life and ability to do the things you love.  

So, whether it's a lingering discomfort that won’t go away, or an acute, annoying twinge when you move, it's time to find the solution.  In this article, we'll dive into the common causes of hip pain and explore effective solutions for self-management, as well as when it may be best to get a professional opinion. 

Common Causes of Hip Pain 

Hip pain affects most of us at some point in our lives. A complex, mobile joint (when it’s working well anyway!), its role is to allow the leg to swing forward and back when walking or running, to move outward and inwards when climbing, and to stabilise when standing and moving. 

Any joint with this level of complexity is always going to be at risk of dysfunction due to our modern, sedentary lives. Hours of sitting leads to a reduction in hip motion, and decreased activation of the gluteal muscles which are essential for stabilisation of the hips and spine. 

Prolonged dysfunction can lead to one, or a combination of the conditions below: 

• Osteoarthritis: Pretty much every person reading this will know of somebody who either is suffering or has suffered from arthritis of the hip. Hip arthritis is super common. Over time, due to excessive stress and strain, the cartilage in your hip joints can wear down, eventually leading to bone-on-bone rubbing between the femur (leg bone) and hip joint. In its early stages, the pain caused by this rubbing can be managed and mobility maintained as best as possible by using a combination of exercises, hands on mobilisations and soft tissue work. If managed well, many cases of hip arthritis will never progress to needing surgery. However, some cases inevitably go on to need hip replacement surgery. Your doctor, chiropractor, or osteopath can help you investigate the severity of your condition by ordering x-rays and help you arrange a referral to an orthopaedic consultant for an opinion as to whether surgery is your best option at that stage. If surgery is required, typically the prognosis following a hip replacement is good in most cases, and our in-house rehabilitation team is ready to help you strengthen with a post-surgical exercise plan to ensure you optimise your recovery if required. 

• Hip Bursitis: Hip bursitis is the name given to inflammation of the fluid sac in your hip which acts as a lubricant between the moving tissues to ensure frictionless motion. If the bursa becomes inflamed due to abnormal mechanics of the hip, this can lead to pain which is most commonly felt on the outside of the hip in an area called the Greater Trochanter of the Femur. Symptoms of bursitis also include stiffness, and sometimes, visible swelling of the outside of the hip. Treatment depends on the underlying cause, but manual therapy and dry needling techniques, plus exercises can be effective in treating hip bursitis. Sometimes, of the inflammation is too great, a steroid injection may be needed to decrease pain and inflammation. And in rare cases, the bursa may need to be surgically removed for a full resolution of the problem, 

• Tendonitis (acute) and tendinopathy (chronic): Like with other joints in the body, excessive stress and strain on the tendons surrounding the hip can cause them to become inflamed (either in the short or longer term, hence acute and chronic) and resulting in pain. Typically, the action plan here would be similar to that of hip bursitis, with an emphasis on strengthening the muscles which stabilise the hip. 

• Hip Labral Tears: The labrum is the name given to the ring of cartilage which follows the outside rim of the hip socket. Its job is to provide cushion to the hip joint, and to assist in holding the head of the femur (ball) into the hip joint (socket). Labral tears can cause a sharp, catching type pain on movement which is felt in the hip or groin. They can also cause stiffness and locking in the hip. Labral tears are more common in active people such as dancers and athletes. Mild tears can be managed with exercises and hands on treatment, however more serious tears will need to be surgically repaired. If a labral tear is suspected, you will be sent for an MRI to assess the amount of damage before a course of action is recommended based on your specific situation. 

• Hip Fractures: A fracture or break in the hip bone can be extremely painful and requires immediate medical attention due to the amount of blood vessels present in this area. More common in the elderly resulting from falling over, fractures of the hip can also be caused by blunt trauma, though this is less common in younger people. 

• Muscle Strain: Modern humans are highly prone to stiffness and tension in our muscles. This is especially common in the hips due to our sedentary lifestyles. When the muscles are tight and short, sudden movements, overexertion, or an inadequate warm-up before sports participation can result in strain in the hip muscles- resulting in pain. 

• Congenital deformity: In some cases (between 1-3 per thousand to be precise!), a baby can be born with a deformity of one, or both their hips. This is called hip dysplasia. Thankfully, in the UK, doctors check for this as part of the newborn physical screening examination within 72 hours of birth, and again 6-8 weeks later. If the doctor thinks there may be an issue, an ultrasound image is performed on the hip(s) in question when the baby is between 4 and 6 weeks old. Risk factors for hip dysplasia include family history and babies born in breach position. If dysplasia is identified, the baby is most often treated using something called a Pavlik Harness, or surgery can be performed if the severity warrants it. Most babies born with hip dysplasia go on to have few or no issues in later life when an intervention is made early enough. However, more mild cases may be missed and result in issues such as pain, stiffness, or premature wear later in life. 

• Child and Adolescent hip pain: Hip pain in adolescents is a red flag, and always needs to be taken seriously. Thankfully, the most common cause is usually sport or activity related muscle strain. However, at our centre, we are always to hip pain in children and adolescent patients as in rare cases, it could be related to one of two other potential causes which we do occasionally see at our centre.These are: 

1. Legg Calve Perthes Disease: Perthes' disease is a rare condition (it only effects 1 in 9000 children) affecting the hip joint in children aged between 3 and 11. It presents as pain in the groin and happens when the ball part of the ball and socket loses its blood supply, causing it to become misshapen. If a child presents to us complaining of groin pain and a limp after sport or physical activity, we may take x-rays in-house to assess for Perthes Disease. Most children fully recover without needing invasive treatment, but they will be assessed by an orthopaedic specialist every 4-6 months to keep tabs on the progression of the disease. Treatment for Perthes depends on its severity, and may include rehab exercises, manual therapy such as those performed at Stoke Chiro, crutches, plaster or, sometimes, an operation to re-shape the bone around the hip joint. Rest will also be advised, as will avoidance of contact sports to prevent severe injury. 
2. Slipped Capital Femoral Epiphysis (SCFE): Slipped Capital Femoral Epiphysis is the second rare (affecting around 10 in 100,00 children) , but serious hip disorder that predominantly affects adolescents (age of onset is between 9 and 15 years old and it is more common in boys than girls) during their growth spurt. This condition occurs when the ball at the top of the thigh bone (femoral head) slips off the neck of the bone through the growth plate, which can lead to various complications if not diagnosed and treated promptly. Again, SCFE is most commonly found by taking x-rays in adolescents who are experiencing similar symptoms to those discussed in Perthes Disease. Typically, surgery is needed to correct SCFE. The prognosis for SCFE largely depends on the severity of the condition, the time of diagnosis, and the effectiveness of treatment. Early detection and appropriate management are associated with better outcomes. If left untreated or if there are complications, SCFE can lead to chronic pain, osteoarthritis, and hip deformities. 

Key Steps You Can Take to Improve Your Hip Pain 

• Rest and Elevation: For an acute injury, give your hip the rest it needs to recover and elevate it to reduce swelling. Be sure to get the hip moving as quickly as possible though with some light stretching and walking to prevent the hip from seizing up, which can make recovery more challenging in the long run. 

• Hot and Cold Therapy: Apply ice to reduce pain and the initial inflammation immediately, and in the weeks following an injury. Later in the healing process, you can use heat therapy to relax tense muscles and improve blood flow. We tend to find 3 applications of 20 minutes works well for both hot and cold, just make sure you wrap your hot or cold pack in a towel so it’s not in direct contact with your skin to avoid a nasty burn. 

• Gentle Stretching: Incorporate gentle stretching exercises to improve hip flexibility and reduce tension. You can find lots of examples of stretches you can perform for your hips online. Consistency is key with stretching! A little and often approach works best and stretching needs to be repeated for weeks to start seeing benefits, so stick with it! 

• Strengthening Exercises: Engaging in exercises that target the hip muscles can help in the management of hip pain. You can try exercise classes such as the Yoga and Pilates classes we offer at Stoke Chiro for mild issues, though if your condition is more significant, you should book a consultation with one of our experienced Chiropractors or Osteopaths. They will then decide on the best course of action for you, whether that’s hands on treatment, a home exercise plan, a referral to our in-house sports massage or rehabilitation team, further imaging, or a referral for an opinion from one of our recommended orthopaedic consultants.  

• Book a Consultation Appointment with a Member of our Award-Winning Team: If your hip pain persists or worsens over time, it’s always best to consult an experienced professional for their opinion. If the pain is in a child or adolescent, then this should be your absolute first step. They can perform a detailed case history and examination to diagnose the underlying cause of your pain and recommend a suitable treatment plan which may include Chiropractic or Osteopathic care, Rehabilitation, Massage Therapy or a further Orthopaedic Opinion to ensure you get the support you need. 

The Wrap-Up 

Hip pain doesn't have to hinder your life. By understanding the common causes, taking proactive steps to alleviate it, and seeking the right help when needed, you can regain control and enjoy a life with less pain and improved mobility. Our award-winning, 5-Star team are here for you when you need us. Simply call 01782 660744 to book your consultation, or book online today at www.stokechiro.co.uk. We can’t wait to meet you!