Hip Pain and Arthritis

The hips allow us to run, walk, sit down, bend over and move our legs in many directions. When the hips are a source of pain, everyday life is affected. In the absence of a recent trauma, hip pain in adults is most often caused by some form of arthritis.

The hip connects the torso to the leg, and hip-related pain may not be felt directly at the hip. Instead, pain may be felt in the groin, down the thigh, inner knee, buttock or lower back. Conversely, lower back problems may cause pain to radiate to the hip. Because the pain can be diffuse, hip problems can be a challenge to identify and diagnose.

See Hip Pain That Travels Down the Leg

Despite its reputation as a sign of old age, hip pain is not a normal part of aging that should simply be accepted. Whether the pain is felt as a dull ache, stabbing pain, stiffness or inflexibility, it is advisable to get a diagnosis for the underlying cause of the pain as soon as possible. Early diagnosis allows treatment to begin and steps to be taken to prevent or slow further joint degeneration.

Hip Joint Pain from Arthritis

Hip pain can vary depending on the degree and nature of the joint degeneration, the patient’s physical condition (such as weight and fitness level), and the patient’s individual perception of pain.

That being said, the hip pain associated with osteoarthritis is usually characterized by some combination of the following symptoms:

Hip pain that comes and goes
Arthritic hip pain may come and go and, unlike knee arthritis pain, is often predictable, meaning hip arthritis patients can anticipate what time of day and what activities will result in pain.¹Hawker, G.A., "Experiencing Painful Osteoarthritis: What Have We Learned From Listening?", Medscape Today News, http://www.medscape.com, accessed May 19, 2011. Remember though, that this is a trend and not a rule.

Two distinct types of hip pain
In a clinical study designed to learn how people experience osteoarthritis pain, researchers found that hip osteoarthritis patients generally felt two distinct types of pain: a dull ache and intermittent sharp pain.²Hawker G.A., Stewart L., French M.R., et al. "Understanding the pain experience in hip and knee osteoarthritis: an OARSI/OMERACT initiative." Osteoarthritis and Cartilage, 2008; 16:415–422.

• Ache. A persistent, dull aching is commonly felt in the groin and front of the thigh. Some people may experience a dull ache in the buttock, outside of the hip and/or in the lower back. People with hip arthritis use words like dull, aching, nagging, sore and throbbing to describe this type of pain.
• Intermittent Sharp Pain. Intense, stabbing pain episodes due to hip arthritis are sudden and brief. People describe this hip pain using words such as sharp, stabbing, ice pick, spike or paralyzing.²Hawker G.A., Stewart L., French M.R., et al. "Understanding the pain experience in hip and knee osteoarthritis: an OARSI/OMERACT initiative." Osteoarthritis and Cartilage, 2008; 16:415–422.

Certain things make the hip pain worse

• Prolonged inactivity. People with hip arthritis often complain of pain in the morning when getting out of bed. The pain will often dissipate within 30 minutes of getting out of bed or from a seated position.
• Abduction, external and internal rotation. Spreading the legs or rotating the toes inward or outward can cause hip pain. Lying on the back causes a natural outward rotation of the toes and legs, so sleeping on the back can be uncomfortable. Sexual intercourse can be painful, also.
• Bending over. Deep bending can be difficult to impossible for patients with hip arthritis. Many complain that bending over to put on socks and shoes is challenging.
• Difficulty getting in or out of a car. People suffering from hip joint pain will often complain of a difficulty with driving and need the assistance of their arms to lift the leg and thigh both into and out of the car.
• Prolonged physical activity. Participating in weight-bearing physical activity, including sports, can result in stabbing pain or be followed by an aching pain.

Certain things make the hip pain better

• Rest. The surrounding muscles, tendons and ligaments that support the hip joint can tire, placing more pressure on the joint. Resting the hip can ease this type of pain.
• Gentle/moderate activity. Gentle activity can relieve the pain and stiffness caused by prolonged rest. When the hip joint is used, synovial fluid is secreted, lubricating and delivering nutrients to the joint.
• Medical treatment. Medical treatment for hip pain can include any combination of physical therapy, aqua-therapy, hip injection, oral anti-inflammatory and weight loss to name a few. Hip surgery can often be avoided. It is important to have pain in your back, hips or legs evaluated by a physician so that a proper treatment plan can be made.