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Hip Injuries & Conditions

Hip Injuries & Conditions

When it comes to pain, your hips don’t lie. Hip pain can have an significant impact on your daily life. So often, people think that hip pain is an evitable part of aging, but it doesn’t have to be. Hip pain can be due to a variety of causes and most are treatable.

From bursitis to osteoarthritis, treatment is available that can get you moving again. If achy hips are slowing you down, keep reading to learn more about common hip conditions and options for treatment.

HIP BURSITIS

Bursae are small, fluid-filled sacs that act as cushions between your bones and soft tissue. The bursae help reduce friction in areas including your shoulders, elbows, hips, and knees. Bursitis occurs when the bursa become inflamed and irritated. Typically, bursitis occurs in the hip and is called either trochanteric bursitis or hip bursitis, depending on its location.

Anyone can be affected by hip bursitis but is more common in middle-aged or elderly people. Women are more likely to have hip bursitis than men or younger people.

The following may contribute to hip bursitis:

  • Overuse – From running, stair climbing, bicycling, or standing for long periods of time
  • Hip injury – From a fall or bump onto your hip.
  • Spine disease – Includes scoliosis, arthritis, and other problems.
  • Uneven leg-length – Can affect how you walk and lead to irritation.
  • Previous hip surgery – Surgery and/or prosthetic implants can cause bursitis.
  • Bone spurs or calcium deposits – Developing within the tendons and causing inflammation.

Symptoms

Bursitis causes pain at the point of the hip that usually extends to the outside of the thigh area. During early stages, the pain is sharp and intense. Later, it becomes more of an ache that spreads across a larger area of the hip.

Bursitis pain is usually worse:

  • At night when lying on the affected hip.
  • When getting up from a chair after being seated for a while.
  • With prolonged walking, stair climbing, or squatting.

Treatments

Your doctor will perform a physical examination and check for tenderness in the area of the point of the hip to diagnose bursitis. He or she may also perform additional tests, such as X-rays, bone scans and magnetic resonance imaging (MRI) to rule out other injuries or conditions.

Many people with hip bursitis can avoid surgery and find pain relief with simple changes, including:

  • Avoiding activities that worsen symptoms
  • Taking non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen.
  • Using a walking cane or crutches when needed.
  • Exercising on your own (as advised by your doctor) or with a physical therapist.
  • Steroid injections

If lifestyle changes or injections don’t help, your doctor may recommend surgery to remove the bursa. Newer, arthroscopic techniques are less invasive with a speedier, less painful recovery.

Surgical Procedures

Hip Arthroscopy, Labral Repair

A hip arthroscopy or “hip scope” is a surgical procedure in which the orthopedic surgeon uses a camera to visualize the internal structure of the hip joint. Through this minimally invasive scope, the surgeon can address multiple aspects of the hip joint. The labrum is the “cartilage cup” that the head of the femur bone sets in and provides stability and cushion. When the rim of this cup is damaged the orthopedic surgeon can work to repair that surface as well as prevent future issues.

Osteoarthritis is a common condition that can occur when the cartilage in the joint gradually wears away over time.  It most frequently develops in hips or other weight-bearing joints. The condition causes pain and stiffness and makes it difficult to perform everyday activities like getting out of a chair or going for a walk.

Anyone can develop osteoarthritis of the hip but middle-aged and older people are at higher risk.  Other factors include:

  • Increasing age
  • Family history of osteoarthritis
  • Previous injury to the hip joint
  • Obesity
  • Improper formation of the hip joint at birth

Symptoms

Hip osteoarthritis most commonly causes pain around the hip joint. Pain and stiffness may be worse after sitting or resting for a while. Other symptoms may include:

  • Pain in your groin or thigh that extends to your buttocks or your knee
  • Stiffness that makes it difficult to walk or bend
  • A grinding noise caused by loose fragments of tissue
  • Decreased range of motion or limp
  • Increased joint pain with rainy weather

Since osteoarthritis develops slowly and gets worse over time, it’s important to seek medical attention in the early stages.

Treatments

You should talk to your doctor about your symptoms. He or she will give you a physical examination and may order diagnostic tests, such as an X-ray, to determine the condition of your hip and the surrounding tissues.

There is no cure for osteoarthritis, but there are things you can do that will help relieve pain and increase mobility, such as:

  • Avoiding activities that aggravate the condition, such as climbing stairs.
  • Switching to lower impact activities, such as swimming.
  • Losing weight to reduce stress on the hip joint.
  • Physical therapy to increase strength and flexibility.
  • Walking supports like a cane, crutches, or a walker.
  • Taking medications if your pain affects your daily routine.

If your hip pain isn’t relieved by lifestyle changes, your doctor may recommend surgery. The surgical procedure will depend on the extent of damage from the osteoarthritis. Surgical options include total hip replacement, hip resurfacing, hip replacement implants, and in rare cases, osteotomy.

Your recovery time and rehabilitation will depend on the kind of surgery you have. You may require physical therapy or need to use a cane, crutches or a walker for a period of time after the surgery.

A break in the upper quarter of the thigh bone (femur) is considered a hip fracture, or broken hip. This condition is most frequently the result of a fall or blow to the side of the hip. Risk factors that weaken the bone and make the hip more susceptible to a fracture include osteoporosis, cancer, or stress injuries. The type of surgery used to treat a hip fracture is primarily based on how the bones and surrounding tissues have been affected and extent of the fracture.

Symptoms

If you’ve fractured your hip, you will feel pain over the outer area of your upper thigh or in the groin. If you attempt movement in your hip, you’ll feel significant discomfort. If the bone is completely broken, the injured leg may appear to be shorter than the other leg.

Your doctor may order an X-ray to determine the extent of the fracture or magnetic resonance imaging (MRI) to check for a hidden fracture not visible in an X-ray.

Treatments

If a patient is too ill for surgery, or is already wheelchair or bed bound, the doctor may recommend nonsurgical treatment. In some instances, if a fracture is considered “stable,” the patient may be able to avoid surgery.

If you are like most candidates for surgery, the majority of surgeons agree it is best to operate sooner rather than later. There are many different kinds of surgical procedures. Your surgeon will determine what is best for you based on the location and extent of your injury.

Depending on the type of surgery and your overall health, you may either return home after surgery or go to a rehabilitation facility for additional assistance to regain mobility. Your doctor will prescribe medication as needed to alleviate pain.

You’ll be encouraged to get out of bed as soon as possible after surgery. Working with a physical therapist, usually for up to three months, will help you regain the ability to walk. Most patients eventually regain much, if not all, of the mobility they had before surgery.

Surgical Procedures

Fracture Care

When a bone is broken is it called a fracture. Orthopedic surgeons can work to realign the broken bones and secure the bones in place. The goal is to restore proper alignment and stabilize the bone ends to allow healing. This can be accomplished through a variety of surgical techniques including open and minimally invasive methods such as plate and screws, “nailing,” or “pinning”.

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