Hip pain – the most common degenerative, inflammatory, and neurological causes

Hip pain is a common ailment affecting both older adults and physically active individuals. It most often results from degenerative hip joint disease, bursitis, or overuse, but it can also be related to pathology in the lumbar spine. Proper diagnosis determines the effectiveness of treatment.

• The most common cause in individuals over 50 is coxarthrosis.
• Bursitis causes pain in the lateral part of the hip.
• Femoroacetabular impingement often affects young and active individuals.
• Sciatica can mimic hip joint discomfort.
• Rehabilitation is the foundation of conservative treatment.

See also: Muscle cramps – electrolyte, circulatory, and overload causes.

Is degenerative hip joint disease (coxarthrosis) the most common cause of hip pain?

Hip pain in older adults most often results from degenerative hip joint disease (coxarthrosis).

The degenerative process leads to gradual damage to the articular cartilage, narrowing of the joint space, and limited mobility. Symptoms include joint stiffness, reduced range of motion, and limping.

Discomfort worsens during walking and when rising from a seated position.

Do bursitis and femoroacetabular impingement cause pain in younger individuals?

Hip pain in physically active individuals is often associated with greater trochanteric bursitis.

Bursitis causes pain in the lateral part of the hip, which intensifies with pressure and when lying on the side. Swelling of the joint may accompany it.

Femoroacetabular impingement involves abnormal contact between the femoral head and the acetabulum, leading to damage to the labrum and pain during movement.

Can sciatica cause symptoms in the hip area?

Hip pain may originate from the lumbar spine.

Sciatica, resulting from pressure on the nerve roots, causes radiating pain to the buttock and the back of the thigh. Symptoms may be confused with pathology of the hip joint itself.

Clinical examination and imaging diagnostics are helpful in differentiation.

What does treatment and rehabilitation look like?

Hip pain is mostly treated conservatively.

Rehabilitation includes exercises to strengthen the muscles stabilizing the joint and improving the range of motion. Weight reduction decreases the load on the joint surfaces.

In symptomatic treatment, non-steroidal anti-inflammatory drugs (NSAIDs) are used for short-term pain therapy.

In the case of injuries, such as muscle tears, a period of unloading is necessary, followed by a gradual return to activity.

Supporting elements include:

• Regular low-impact activity.
• Stretching exercises.
• Posture control.

Q&A

Does hip pain always indicate degeneration?
No, it can have inflammatory, post-traumatic, or neurological origins.

Is limping a reason for consultation?
Yes, especially if it persists for more than a few weeks.

Is rehabilitation effective?
In many cases, it significantly reduces pain and improves joint function.

When is surgical treatment considered?
When conservative treatment does not bring improvement, and pain limits daily functioning.

Sources:

1. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet.
2. NICE Guidelines. Osteoarthritis management.
3. Griffin DR et al. Femoroacetabular impingement. Lancet.
4. Chou R et al. Diagnosis and treatment of low back pain. Annals of Internal Medicine.
5. American Academy of Orthopaedic Surgeons Guidelines. Hip osteoarthritis.