Hip Joint Pain: Causes, Treatments, and Next Steps

Hip joint swelling and pain?

Hello Doctor: Since high school, I have often experienced swelling and pain in my hip joint due to excessive exercise (at its worst, the pain is so severe that I cannot stand or walk).
Last year, I underwent an X-ray examination at a hospital, and the doctor mentioned that there are calcifications near the joint, which sometimes compress the nerves and cause pain.
A few days ago, while traveling abroad, my old condition flared up again.
After returning home, I visited another hospital, and the doctor said that my symptoms do not entirely resemble those of hip joint pathology.
This time, he extracted about 20cc of serous fluid from the swollen area (however, since there was no bruising on the surface of the swelling, the doctor found it quite strange and suggested that the bleeding might be from a deeper layer).
The doctor advised me to take muscle relaxants for a week and apply heat for 30 minutes daily to see if there is any improvement.
However, it has been three days, and I still experience intermittent swelling and pain.
I would like to ask: 1.
Based on this, could my condition be hip joint pathology? 2.
Since my symptoms have not resolved in the past three days, should I seek another doctor’s opinion, or should I wait a week to see my original doctor again? 3.
I live in Kaohsiung; could you recommend a specialist in this area (and their affiliated hospital) for my consultation? Thank you for your thoughtful response!

Amy, 20~29 year old female. Ask Date: 2001/07/26

Dr. Shi Guozheng reply Orthopedics

To determine the location of hip pain, it is important to identify whether it is in the anterior, lateral, or deep region, as this is significantly related to the diagnosis.
If X-rays are normal, the likelihood of bone pathology is reduced.
It is recommended that if symptoms persist without improvement, further examinations such as ultrasound or MRI should be conducted, as these types of tests are typically available at larger hospitals.

Reply Date: 2001/07/26

More Info

Hip joint pain can be a complex issue, often stemming from various underlying causes, and it can significantly impact your quality of life, especially if you are active or involved in sports. Based on your description, it seems you have been dealing with recurrent hip pain and swelling, which has been exacerbated by physical activity. Here’s a comprehensive overview of potential causes, treatment options, and next steps.

Understanding the Causes
1. Hip Joint Pathologies: Your history of pain and swelling, particularly after physical exertion, suggests that you may be experiencing some form of hip joint pathology. This could include conditions like hip osteoarthritis, labral tears, or bursitis. The presence of calcifications noted in your X-ray could indicate chronic inflammation or degenerative changes in the joint.

2. Synovial Effusion: The extraction of 20cc of fluid from your hip joint indicates synovial effusion, which can occur due to inflammation, infection, or injury. The absence of bruising on the surface suggests that the bleeding is likely from deeper structures, which could be related to trauma or chronic irritation.

3. Nerve Impingement: You mentioned that the pain can sometimes be related to nerve compression, which could be due to structural changes in the hip joint or surrounding soft tissues.

Treatment Options
1. Medications: The muscle relaxants prescribed can help alleviate muscle spasms that may be contributing to your pain. Additionally, non-steroidal anti-inflammatory drugs (NSAIDs) can be beneficial in managing pain and inflammation.

2. Physical Therapy: Engaging in physical therapy can be crucial. A physical therapist can design a rehabilitation program that focuses on strengthening the muscles around the hip, improving flexibility, and enhancing overall joint function. Specific exercises can help stabilize the hip joint and reduce the risk of future injuries.

3. Heat Therapy: As advised, applying heat for 30 minutes daily can help relax muscles and improve blood flow to the affected area, which may aid in recovery.

4. Injections: If conservative treatments do not provide relief, corticosteroid injections into the hip joint may be considered to reduce inflammation and pain.

Next Steps
1. Follow-Up with Your Doctor: Since you have not seen significant improvement after three days, it may be wise to follow up with your original doctor after the week of medication. They may want to reassess your condition and consider further imaging studies, such as an MRI, to get a clearer picture of the underlying issues.

2. Seeking a Specialist: If your symptoms persist or worsen, consulting an orthopedic specialist who focuses on hip disorders may be beneficial. They can provide a more in-depth evaluation and discuss potential surgical options if conservative measures fail.

3. Finding a Specialist in Kaohsiung: While I cannot provide specific names, I recommend checking with local hospitals or medical centers in Kaohsiung that have orthopedic departments. Look for specialists who have experience with hip joint issues, particularly those who are familiar with sports medicine or joint disorders.

Conclusion
Hip joint pain can be multifactorial, and understanding the underlying causes is essential for effective treatment. It’s crucial to communicate openly with your healthcare providers about your symptoms and any changes you experience. By following up with your doctor and possibly seeking a specialist, you can work towards a treatment plan that addresses your specific needs and helps you return to your desired level of activity. Remember, early intervention can often lead to better outcomes, so don’t hesitate to seek further evaluation if your symptoms persist.

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