Hip Pain Causes and Symptoms

A painful hip is hard to ignore. Not only can it sideline hip pain sufferers from normal daily function and impact recreational activities, but it can also plague sleep or relaxation. Hip pain can be caused by a variety of conditions and injuries. See below for a list of the most common causes of hip pain and a brief description of how it affects the hip.

• Trauma: A fall or other sudden impact on your hip joint can cause a bone fracture or a strain or tear in the muscle, tendons, ligament or cartilage surrounding the joint.
  • Hip pointer: A hip pointer is a bruise to the iliac crest, where the hip bone forms the top and front of your pelvis. A fall or direct impact (typically in contact sports) may have injured the bone and surrounding muscles and tissues, causing pain upon walking, laughing, coughing or even breathing deeply.
• Osteonecrosis (avascular necrosis): Osteonecrosis describes the death of bone tissue due to an inadequate blood supply. A traumatic injury to your hip joint, certain medications, particularly steroids, chemotherapy drugs or overuse of alcohol can all cause this condition. While often painless at the onset, osteonecrosis begins to cause frequent and then chronic pain when pressure is placed on the hip joint.
• Sciatica: Pain in the buttocks may be caused by the irritation or pinching of the sciatic nerve which originates in the lower back, branches out at the buttocks and then extends down to the feet. If you have sciatica, the root problem is not in your hip joint but in the lower spine.
• Hip Bursitis: The bursa sacs that surround the hip joint have the vital role of producing synovial fluid to keep the joint lubricated. When they become inflamed due to injury or infection, the hip joint may swell, causing a dull or pulsing ache.
• Snapping Hip Syndrome: True to its name, snapping hip involves the rubbing of tissues over another, which produces a snapping sound or sensation. The snap is heard when a part of a tendon or muscle moves abnormally across one of the bones that form the hip joint. Usually benign, snapping hip syndrome can sometimes lead to irritation of the tissue, similar to that of a friction blister of your heel in your shoe.
• Rheumatoid arthritis (RA) is an autoimmune disease with episodes and remissions that can afflict the young and cause joint inflammation, pain and stiffness. Although the term arthritis is the same, the mechanism by which the cartilage is broken down is much different. RA needs to be treated with medication to avoid rapid joint deterioration.
• Muscle strains and tendonopathy: The hip is supported by numerous muscles and tendons (the tissue that connects muscle to bone), which can become damaged or injured during activity or exercise. The most common areas of concern are the groin, gluteal region, and hip flexor (the muscles that bend your hip forward). Pain can be sharp and severe when you try to use your muscles, even for simple tasks like crossing and uncrossing your legs.
• Fracture: Hip fractures can be the result of a substantial trauma, a weakened state of the bone structure (as seen in osteoporosis or bone density conditions, or over use/stress on the bone. Most fractures in the hip occur on the femoral neck, which is the connection bridge of the ball and the thigh bone. A fracture can cause a cause very sudden, severe hip pain, and requires immediate medical attention.
• Dislocation: A hip dislocation occurs when the head of the femur (the ball) slides out of position in the socket, partially or completely. It is an extremely traumatic event in most cases, and fairly uncommon in daily living. High impact experiences, such as motor vehicle accidents, are most commonly the cause in a normal hip. However, in abnormally shaped hips, in weak or unstable hips, or in those with a prior dislocation (even those having prior hip replacement) there is a higher risk of dislocation. It is typically a very painful and emergent case, which requires immediate medical attention. Recurrent mild dislocations also warrant a medical examination to find the cause and explore treatment.
• Hip labral tear: A hip labral tear is an injury to the ring of cartilage that lines the socket (acetabulum) of the hip joint. A labral tear can cause clicking, or catching, during movements of the hip, but most commonly feels like a “pinch” when trying to cross your legs or sit for long periods of time. The labral tear affects the stability of the joint and can lead to early breakdown of the joint surface cartilage.
  • Femoroacetabular impingement, arthritis, sports injuries and repetitive motion are all common culprits in labral hip tears. Experiencing sharp, intense groin pain when pivoting can be a red flag that it’s time to see an orthopedic specialist, as it may signal a tear in the labrum.
• Femoroacetabular impingement (FAI): FAI is the term given to the impingement or contact typically in the hip joint of teens and young adults. FAI is a movement condition that is commonly matched with labral tears and groin pain in younger individuals without joint arthritis. It can involve abnormal bony shapes and joint irritation as the bones of the joint rub and cause friction during daily tasks.
• Fibromyalgia: Fibromyalgia is a chronic pain disorder, affecting women with greater frequency than men. While its origins are still shrouded in mystery, there are “tender points” at various places throughout the body, including the high and low areas of the buttocks, that are used to diagnose the condition. If you experience hip pain that is heightened when you apply external pressure to these points, fibromyalgia is a possible culprit.  
• Hip dysplasia: If a person’s hip socket is shallow or not the right shape to fully support the femoral head (the ball in the socket), they may have a condition known as hip dysplasia. The hip joint is less stable and prone to dislocation, wear and tear (osteo)arthritis and labral cartilage tears.  

One of the most common causes of hip pain in adults is osteoarthritis (OA), a disease that tears or wears away the cartilage protecting the hip joint. The rubbing of bone against bone, plus the formation of bone spurs (projections along the edge of a bone) and joint mice (tiny bits of cartilage and bone that break off and remain in the joint), can cause discomfort, swelling and stiffness.

Osteoarthritis can result from injury or aging, combined with other factors such as an inherited or acquired propensity to develop the disease, obesity and diseases that have a secondary, arthritic, effect on the joints.

Arthritis Symptoms

Arthritis of the hip joint typically causes stiffness and pain, though a sudden onset of an episode can cause swelling and a sensation of warmth in the joint as well. Specific signs to look for:

• Pain in the joint that tends to worsen at the end of the day
• Stiffness after long periods of inactivity
• Tenderness and swelling in the joint
• Deformity of the joint in later stages of the disease

Each year, Memorial Hermann Joint Center physicians perform more than 3,000 hip and knee joint replacement procedures, more than are performed at any other hospital system in the Greater Houston area. 

If you're experiencing symptoms of hip pain and are seeking relief, Memorial Hermann Joint Centers can help. Our orthopedists see patients with everything from minor knee pain that requires rest and self-care, to those with chronic, serious knee pain, requiring a targeting non-surgical or surgical treatment plan.