Hip Joint Pain: Causes, Symptoms, and Treatment Options

(Hip joint issues suspected due to stretching)

Hello, doctor.
Around July 2019, I first experienced pain in the area where my left thigh connects to my buttock while walking, which sometimes radiated to the front of my thigh, but I didn't have much lower back pain.
When the pain was severe, even slight movements, such as sneezing or lying flat to sleep, became very difficult.
I have not had an X-ray, but I underwent over a month of acupuncture treatment initially aimed at sciatica, which was ineffective.
Later, muscle strain and femoral issues were ruled out.
I found that attempting simple stretches in bed would actually exacerbate the pain.
In 2019, I played badminton one to two times a week at moderate to high intensity; occasionally my thigh would hurt, but it did not affect my ability to walk.
During a month of rest, I did not engage in any exercise.
Additionally, during my university years, I lived in a place with very steep roads and frequently hiked for several years.
I have also had some issues with slouching and poor posture, and I occasionally practiced yoga.
After a few months, as the pain gradually lessened, I returned to playing badminton, and after my last game, I found that even the lingering pain had disappeared.
However, in the past month, I stopped all exercise and only did simple stretches.
After one stretch, I experienced abnormal pain in my hip joint, and since then, the next day, I began to feel the same pain as before, making it difficult to walk and sleep normally.
Currently, the pain has persisted for two weeks, and I can hear joint sounds.
I would like to ask the doctor what type of hip joint issue this might be.
If an X-ray shows no abnormalities, how should I manage the pain? Thank you.

Anna, 20~29 year old female. Ask Date: 2020/03/13

Dr. Wang Shouji reply Orthopedics

Hello, sciatica at your age is often associated with trauma or sports injuries.
If there is no numbness or pain in the lower limbs, it is less likely to be a sciatica issue.
If there is a noticeable pain point at the upper buttocks near the femoral joint, then piriformis syndrome should be considered.
X-rays are not useful for diagnosing soft tissue injuries, sciatica, or piriformis syndrome, and it may be necessary to arrange for an MRI to confirm the diagnosis.
Changhua Hospital cares about your health.
Dr.
Wang Shou-ji.

Reply Date: 2020/03/13

More Info

Hip joint pain can arise from a variety of causes, and understanding the underlying issues is crucial for effective treatment. Based on your description, it seems you have been experiencing pain in the hip area for several years, with episodes of increased discomfort following physical activity, particularly after playing badminton and engaging in stretching exercises.

Possible Causes of Hip Joint Pain
1. Muscle Strain or Ligament Injury: Given your history of high-intensity activities like badminton and the mention of occasional pain during movement, it's possible that you may have experienced a muscle strain or ligament injury. These types of injuries can lead to inflammation and pain in the hip region.

2. Hip Bursitis: This condition involves inflammation of the bursae, which are small fluid-filled sacs that cushion the hip joint. Bursitis can cause pain on the outer side of the hip and may be exacerbated by certain movements or positions.

3. Snapping Hip Syndrome: This is characterized by a snapping sensation or sound in the hip, which can occur when tendons or muscles move over bony structures in the hip. It can be painless or associated with discomfort, particularly during certain activities.

4. Osteoarthritis: Although you mentioned that you have not had X-rays taken, osteoarthritis is a common cause of hip pain, especially in individuals with a history of joint stress or improper posture. It involves the degeneration of cartilage in the joint, leading to pain and stiffness.

5. Labral Tear: The labrum is a ring of cartilage that surrounds the hip joint. A tear can result from acute injury or repetitive motions, leading to pain and instability in the joint.

Symptoms to Monitor
- Pain Location: You mentioned pain radiating from the hip to the thigh, which can indicate issues with the hip joint or surrounding muscles.

- Mobility Limitations: Difficulty in movement, especially during activities like sneezing or lying down, suggests that the pain may be significant and could be related to joint or muscular issues.

- Audible Sounds: The presence of clicking or popping sounds in the hip joint can be indicative of snapping hip syndrome or other mechanical issues within the joint.

Recommended Diagnostic Steps
1. X-ray Imaging: Since you have not yet had X-rays, this is a crucial step. X-rays can help identify any bony abnormalities, signs of arthritis, or other structural issues in the hip joint.

2. MRI: If X-rays do not reveal any significant issues but pain persists, an MRI may be warranted to assess soft tissue structures, including muscles, tendons, and the labrum.

Treatment Options
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the hip, improve flexibility, and address any postural issues. A physical therapist can tailor exercises to your specific needs and monitor your progress.

2. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) can be effective in managing pain and reducing inflammation. Always consult with a healthcare provider before starting any medication.

3. Activity Modification: It may be beneficial to temporarily reduce high-impact activities that exacerbate your pain. Instead, focus on low-impact exercises such as swimming or cycling, which can help maintain fitness without stressing the hip joint.

4. Injections: If conservative treatments fail, corticosteroid injections into the hip joint may provide relief from inflammation and pain.

5. Surgical Options: In cases where conservative management does not yield results and significant structural issues are identified, surgical intervention may be necessary. This could involve repairing a labral tear or addressing other structural abnormalities.

Conclusion
Given your symptoms and history, it is essential to consult with an orthopedic specialist who can conduct a thorough evaluation and recommend appropriate imaging studies. Understanding the specific cause of your hip pain will guide effective treatment strategies, allowing you to return to your desired activities, including badminton and other forms of exercise. Remember, early intervention is key to preventing further complications and ensuring a full recovery.

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