Hip Pain

What is it?

Osteoarthritis is the most common type of arthritis, and is most common in people over the age of 45. It develops gradually over time, and can cause joints to become stiff and painful. One of the main characteristics is thinning of the cartilage which covers the ending of our bones.

Symptoms;

• Groin pain is common and sometimes accompanied by pain around the side and front of your thigh, buttock or down to your knee
• Pain and stiffness are often worse in the mornings, or after prolonged sitting
• Symptoms may also seem worse after sustained activity

Diagnosis

Osteoarthritis can often be diagnosed on examination, without the need for imaging such as x-ray. However, when an x-ray is required it is worth remembering that a lot of the changes seen on x-ray will be related to your age, and will not necessarily be the cause of your symptoms i.e. a high proportion of people with signs of osteoarthritis on x-rays will not have any symptoms.

Management

• Exercise – a combination of strengthening and aerobic fitness is proven to help manage osteoarthritis effectively
• Physiotherapy – physiotherapists can often provide a diagnosis, further information about your condition, and an individualised plan for management
• Body weight - If you are overweight, try to lose some weight
• Simple painkillers – your GP or pharmacist can provide advice on suitable options
• Therapies – things that some people may find helpful in addition to the above include mobilisations (e.g. via a physiotherapist), the use of TENS machines, and stretching

Surgery for osteoarthritis

Most people with osteoarthritis do not have it badly enough to need surgery. However, hip replacement surgery has become a standard treatment for severe osteoarthritis. Your GP or physiotherapist can provide advice if this is something you are considering.

How to avoid it?

•Make sure you are not overweight as this will increase the load on your hip joint

•Exercise regularly, and include a combination of weight bearing (e.g. walking) and non-weight bearing (e.g. swimming) activities

•Ensure you have a healthy diet and quit smoking if you are a smoker

 

What is it?

This refers to pain on the outside of your hip or thigh. It can be due to a number of structures, with tendons and bursae (fat pads) thought to be the most common culprits. It is most common in women between the ages of 40 and 60, and can often be linked to a change in activity levels. Symptoms can be aggravated by activities such as climbing stairs, sleeping on the affected side, and running

How to deal with it?

The most important aspect of dealing with this type of pain is identifying what you think might have caused it and starting by reducing that activity.

You can then gradually increase the amount of activity you do whilst following a strengthening programme for the hip; both of which a physiotherapist can help you with.

Symptoms may take a long time to improve, but are likely to resolve with the correct management in the majority of cases.

NB Previous advice such as stretching (which is now thought to compress the tendons or bursae) and steroid injections (which are now linked to weakening of tendons in the long-term) are not usually considered as ‘first-line’ options.

What is it? 

FAI is characterised by pain around the hip and/or groin area.  The underlying cause is often thought to be a fault in the movement of the hip joint, resulting in aggravation of the joint itself and/or the surrounding soft tissues.

Who gets it?

The ball and socket joint which forms the hip comes in many different shapes and sizes. Certain combinations, such as a larger ‘ball’ (head of the femur) or a socket with a deeper lip, are thought to increase the chances of FAI. Some of this is down to genetics, although activities which involve rapid changes of direction (some ball sports) and rotational or twisting movements are also linked to the prevalence of FAI.

Management

Changing or adapting any activities which aggravate your symptoms is often an important part of managing FAI. Guidance on the best way of doing this, and help with a thorough rehabilitation programme can be provided by a physiotherapist.

In certain cases where physiotherapy management has not solved the problem surgery can be considered, where the aim is to alter the bony abnormalities which might be causing the pain via arthroscopy (keyhole surgery).

Click the link for patient information on shared decision making  Shared Decision Making _ OA Hip [pdf] 874KB

Click the link for Information on Hip Pain  Hip Pain exercises [pdf] 986KB

https://www.csp.org.uk/conditions/managing-pain-home/managing-your-hip-pain

https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-oa-of-the-hip/

It is important that you apply the advice and guidance provided above for around 8 weeks by which time we would expect you to notice improvement and in some cases complete recovery. If not, we have a team of trained physios who can help.

Self-refer into our service today

Think you need more urgent or emergency treatment? Follow the below guidance to see if you need to see someone quicker. 

Physiotherapy Triage

Physiotherapy Triage Red flag re-direction of patients to A&E/GP consultation

IMPORTANT 'Cauda Equina Syndrome’ although rare, can cause a permanent change to your bladder and/or bowel function, or foot strength.

IF you are suffering with low back pain and if you have any changes regarding the following since your pain started;

• Bladder or bowel function (i.e., Increasing difficulty when you try to urinate, increasing difficulty when you try to stop or control your flow of urine, loss of sensation when you pass urine, leaking urine or recent need to use pads, inabilityof knowing when your bladder is either full or empty, inability to stop bowel movement or leaking, loss of sensation when you pass a bowel motion)
• Loss of sensation/tingling around genitals, back passage, buttocks or inner thighs • Erectile or ejaculation problems or loss of sensation in genitals during sexual intercourse
• Loss of sensation/ tingling or numbness in both legs
• Weakness in foot (i.e. floppy foot or inability to lift front of foot when walking)

If YES call NHS 111 or go to A&E IMMEDIATELY

If you are suffering with low back pain and if you have any of the following;

• History of cancer
• Unexplained weight loss
• Feeling generally unwell/fever/lack of appetite

Please contact with your GP as soon as possible to discuss if other investigations are required rather than self-referring to physiotherapy.

You can also visit your GP for more information and advice on;

• Women's and men's health including pelvic floor and incontinence
• If you have had a series of falls and want to learn more to help avoid them
• If you have reduced mobility and require a stick or frame
• If you require neurological support for example if you have had a stroke or Parkinson's
• If you are housebound
• If you are under 16 years old