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Non-Arthritic Hip Conditions

Hip pain is often thought to be a part of the natural aging process. This may be due in part to the prevalence of hip osteoarthritis, or “wear and tear” arthritis, that can occur as early as a patient’s 20s and continue to worsen with age. It most commonly begins in a patient’s 40s and 50s and affects most people by age 80.

While joint pain is commonly associated with degenerative, age-related arthritis, the fact of the matter is that hip pain is not limited to arthritis nor is it limited by age. Hip pain can occur at any age and as the result of a number of conditions.

Hip pain is never normal. Even a dull ache or an episode of inflexibility can be a sign of a more serious medical condition. The sooner you are diagnosed by an orthopaedist, the sooner you can start down the road to recovery. Here is a list of non-arthritic hip conditions that you can discuss with a hip specialist.

Hip Sprains / Strains

A sprain or strain refers to the stretching or tearing of soft issue. Specifically, a sprain refers to an injured ligament while a strain refers to an injured muscle or tendon.

A hip sprain or strain results from a direct and forceful impact to the hip, repetitive use of the joint, or stretching the hip beyond the range of motion that it is intended to tolerate. Both sprains and strains are classified according to their severity:

  • Grade I – The ligament, muscle, or tendon features mild stretching and microscopic tears, but the hip continues to function normally.
  • Grade II – The ligament, muscle, or tendon is partially torn, leading to periodic giving out of the hip while standing or walking.
  • Grade III – The ligament, muscle, or tendon is completely torn or ruptured. The hip can no longer bear weight.

In the majority of cases, a hip sprain or strain may begin as a small tear that gradually worsens with prolonged use of the joint.

Symptoms of Hip Sprains / Strains

  • Pain in the hip that results from sudden movement
  • Pain in the hip that increases with activity
  • Pain in the hip when moving your leg backwards
  • Tenderness in the hip
  • Swelling and bruising in the hip

Treatment for Hip Sprains / Strains

Mild and moderate sprains and strains (grade I and grade II) often resolve on their own within three to six weeks. RICE (rest, ice, compression, and elevation) can help relieve pain, reduce swelling, and expedite the healing process. RICE can also be used to treat other mild orthopaedic injuries, including knee injuries. Read Comprehensive Recovery Protocol: Knee Injuries for more information.

Severe sprains and strains (grade III) typically require surgery followed by a rehabilitation program. The length of time that an individual need in order to recover depends on several factors, including the type of procedure they received, their participation in a rehabilitation program, and their overall health prior to their injury.

Hip Fractures

A hip fracture is a break in the bones and cartilage that compose the hip joint. Most hip fractures are caused by falls—such as slipping on ice—although the type of direct, traumatic blows to the hip that occur within a number of sports can also cause bones to break. While the severity of a fracture will depend on the extent of the break, hip fractures commonly cause pain and immobility. If left untreated, a hip fracture can lead to additional conditions and possibly life-threatening complications.

It’s worth noting that not all fractures are caused by physical trauma. Osteoporosis is a disease that weakens bones, causing them to break more easily. For individuals with severely weakened bones, a hip fracture may result from simply standing and twisting. Osteoporosis typically develops after age 30, when the body starts breaking down bone faster than it replaces it. Dietary deficiencies and family history of the disease also play a role in the development of osteoporosis.

While a fracture in itself is a non-arthritic condition, a break in a bone can lead to post-traumatic arthritis. Post-traumatic arthritis is a specific form of osteoarthritis. It is estimated that up to 15% of individuals diagnosed with the disease may have developed it as the result of an injury. In other words, the impact of a fracture can last long after the bone has healed. Even a relatively minor fall needs to be taken seriously and discussed with an orthopaedist.

Symptoms of Hip Fractures

  • Severe pain in the hip or pelvic area
  • Inability to put weight on your hip
  • Difficulty walking
  • Swelling and bruising in the hip
  • One leg that appears shorter than the other

Treatment for Hip Fractures

Most hip fractures often require a joint repair or replacement. If surgery is not appropriate for a patient, an orthopaedist will utilize traction. Traction is a technique that involves pulleys and weights that slowly and gently pull on a fractured body part. The goal of traction is to guide the body part back into the proper position and hold it steady while the body heals.

Hip Bursitis

The hip consists of two major bursae, which are lubricated cushions located between bones and soft tissue. The trochanteric bursa is located on the side of the hip, adjacent to the edges of the femur (thighbone). The ischial bursa is located on the inside of the hip, adjacent to the pelvic bone. Hip bursitis is the inflammation and irritation of either of these two bursae. Inflammation is often caused by trauma or strain. Although less common, inflammation can also be caused by a bacterial infection or other conditions such as gout.

Symptoms of Hip Bursitis

The symptoms of hip bursitis depend on which bursa is affected.

Trochanteric Bursitis:

  • Pain on the outside of the hip and thigh
  • Pain in the hip that increases with activity
  • Pain when lying on the affected side
  • Swelling or stiffness in the hip

Ischial Bursitis:

  • Pain in the upper buttock
  • Pain that increases with activity, particularly climbing up stairs
  • Swelling or stiffness in the hip

Treatment of Hip Bursitis

Like sprains and strains, non-infectious hip bursitis can be treated with rest, ice, compression, and elevation. Moreover, exercise and weight reduction can ease pain and prevent recurrence.

If the inflammation is caused by an infection, your orthopaedist will recommend an antibiotic medication. In other instances, orthopaedist may administer a cortisone injection. Inflamed bursae rarely require surgical removal.

Hip Tendonitis

The hip consists of several different tendons that connect muscles to bones, including the groin, hip flexors, glute tendons and hamstrings. The iliotibial band—which is a thick band of connective tissue that can either be classified as either a tendon, a ligament, or an area of thickened fascia—also runs along the hip and thigh. When these bands are healthy, they move easily when their respective muscle contracts.

Hip tendonitis occurs when one of these tendons become inflamed or irritated. An inflamed hip tendon causes acute pain and tenderness, making it difficult to move the joint. Moreover, using the hip irritates them further, causing more inflammation and pain.

Tendonitis is commonly caused by the overuse of a tendon. Gymnasts, runners and cyclists, in particular, face a higher risk of hip tendonitis due to the repetitive use of their lower bodies. In less extreme circumstances, tendonitis may result from poor posture and body mechanics that put unnecessary stress on tendons. And, although less common, tendonitis can also result from an acute, direct injury to the joint.

Symptoms of Hip Tendonitis

  • Pain in the hip that increases with repetitive motion
  • Swelling or redness around the hip
  • Stiffness and tightness in the hip
  • Limited range of motion in the hip joint

Treatment of Hip Tendonitis

Individuals with hip tendonitis should take a break from activities, especially those that involve the joint. Rest, ice, compression, and elevation can also help reduce symptoms. It is important to remain patient during this time and to avoid pushing the body unnecessarily. Tendons, in general, receive less blood flow consequently making them slow to heal.

Stretching before activities, enhancing the strength and flexibility of hip and leg muscles, good posture, and maintaining a healthy weight will help prevent injury.

Talk to a Hip Specialist

While sprains, strains, fractures, bursitis, and tendonitis are all relatively common, there are a number of non-arthritic conditions that cause hip pain and stiffness. These include labral tears and femoroacetabula impingement (FAI), avascular necrosis, and bone tumors. Only a hip specialist has the expertise to accurately diagnose your condition and provide a treatment plan personalized to you.

Dr. Steve Hamilton at Beacon Orthopaedics and Sports Medicine is one of the most recognized hip specialists in Greater Cincinnati and Northern Kentucky. You can schedule an appointment online to meet with Dr. Hamilton. For your convenience, he is available at Beacon East, Beacon West, or Summits Woods in Ohio or at Beacon’s Northern Kentucky location.