What Causes Hip Pain

Hip Pain & Muscle Wasting

Muscle wasting is the most common of all factors in hip pain and plays a significant role in the majority of hip pain cases.  Our muscles weaken prematurely when we live in an urban environment; as they seldom get the type of workout they were evolved for. We did not evolve to walk on hard flat surfaces all the time.The vast majority of hip pain sufferers have muscle wasting in their glutes. Steadily strengthening the glutes and hip stabilisers over time is a vital piece of the hip pain jigsaw for most hip pain patients.

Hip Pain & Scar Tissue

Scar tissue is a far more common cause of hip pain than most people realise. Scar tissue from old injuries that weren’t properly rehabilitated is a major cause of hip pain. Scar tissue can form in relation to injury, but it can also build up gradually due to alignment and gait issues.. The presence of scar tissue can cause irritation of the soft tissues around the hip and contribute to chronic hip pain. Happily scar tissue can be broken down in most cases using shockwave therapy and Graston Technique.

Hip Pain & Gait Problems

Even the most sedentary of us take millions of steps per year on hard surfaces like concrete, tarmac & paving. The forces generated when your heel strikes concrete are more significant than you think. If your arches are particularly high or particularly flat the strain of walking on hard ground in fashionable footwear is magnified many times. Not only are these kinds of foot issues a major cause of knee pain, ankle pain, foot pain and hip pain, they are also a major cause of hip pain. At Featherston St. Pain Clinic we use cutting edge sensors and machine learning algorithms to identify gait issues that need to be worked on, just sayin!

Hip Pain & Bursitis

Bursitis is inflammation of a fluid sack that reduces friction in the body. You may have heard bursitis referred to as a ‘cause of hip pain’. It’s important to interpret this carefully given that bursitis itself is a reaction to some form of ‘underlying strain’ that is occurring in the hip. Whatever is causing that underlying strain is the true ‘cause’ of the hip pain, and it is the reason the bursa has become inflamed. We frequently see people in our clinic who suffer from hip bursitis because they have extremely weak gluteal muscles for example. The weak glutes allow awkward repetitive hip movements when they walk and run,  the bursa becomes inflamed and causes hip pain.

Hip Pain & Sedentary Work

There is no escaping from the fact that we evolved to be far more active organisms than most of us now are. . The amount of movement involved in child rearing, nest building, water gathering, foraging, hunting & evading vicious packs of honey baggers is what we were made for ….. and now we ‘write code’. Our bodies are adapted to move. Prolonged sitting or even standing at work for more than 30 hours a week can lead to hip pain; by slowly but surely weakening the stabilising muscles, tightening the fascia and compressing the joint. 

Hip Pain & ‘Poor Technique’

Poor execution of movement in sports and exercise can place unnatural strain on joints and soft tissues and cause hip pain. Improper training methods are a major cause of pain and injury. Lifting heavy weights without good technique is the obvious one.  An extremely common cause of hip pain is distance running on hard surfaces like tarmac with poor form. Running on hard ground without correct technique & leg strength can place significant strain on the hip’s tissues. Using technology to identify movement imbalances is an excellent start point to improving technique and reducing this type of hip pain

Hip Pain & Lifestyle

There are many lifestyle choices that can harm our tissues badly enough to cause hip pain.. A great example would be the classic ‘supporting a child on your hip while doing things around the house’ on a daily basis. Another example would be the patient who plays video games for 12 hours a day and doesn’t exercise.  Being forced into unnatural mobility scenarios by life is perfectly normal and healthy; it’s when these movements are excessively repetitive that they can become a cause of hip pain.

Hip Pain & Stress  

Many people attending their chosen healthcare providers office with bad hip pain have some kind of increased stress going on in the background. Occupational, financial and relationship stressors are triggers for chronic hip pain in a percentage of cases. It is important to distinguish ‘trigger’ from ‘cause’ here because if you have a healthy hip it is not likely that stress will  trigger bad pain. If however, you suffer from stress or unresolved trauma they can trigger latent hip issues into stubborn  pain. Regardless of whether stress is playing a part in your hip pain it should still respond well to pain management tools and technologies.

Hip Pain & Cartilage Tears

The hip joint bears a huge amount of weight and needs thick cartilage structures to absorb shock. Due to the amount of repetitive loading these cartilage structures endure they are prone to damage. The most common cartilage structure that sustains damage in the hip is the labrum. Labrum tears are thankfully not too common, but they do occur. Some labral tears require surgical intervention but thankfully many others respond just as well to rehabilitation that involves support and strengthening of the hips supporting muscle.

Hip Pain & Osteoarthritis

In many ways osteoarthritis is just a normal part of the aging process. Everyone over the age of 60 has some osteoarthritis in their body, but interestingly only a percentage of these joints ever end up hurting. While there can be a connection between a person’s hip pain and osteoarthritis there is often none.  It is a complete myth that all arthritic hips hurt, Some hip pain is caused by osteoarthritis, the vast majority of hip pains are not caused by osteoarthritis. Even when osteoarthritis is present in a joint it doesn’t necessarily mean that it will need replacing. Lots of good news about hip arthritis!!

Hip Pain & Inflammatory Arthritis

Inflammatory arthritic conditions are body-wide conditions with the capacity to cause joint pain and hip pain. These types of arthritic conditions include rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. These forms of arthritis are not common causes of hip pain but they do nonetheless show up. We still know very little about the full complexity and subtlety of many of these auto-immune type conditions, many of which may be more to do with the health of the gut than anything else. If your hip pain is being caused by an inflammatory arthritis it’s likely that you will have pain in other areas and have been feeling unwell in other ways. Blood tests and x- rays can usually identify inflammatory arthritic issues pretty quickly if they are present. Happily this is not a common cause of hip pain and most are caused by movement issues.

Hip Pain & Bone Disease

On occasions hip pain can be caused by disease within one or more of the ‘hip bones’. In older people with osteoporosis bone can become seriously weakened and become susceptible to fractures. Other ways a bone can become weakened by disease include cancer, kidney disease and endocrine disease; if the bone is sufficiently affected any of these can turn into hip pain. Often these types of issues will not make themselves known until they have caused a bone fracture. 

Thankfully it is not that likely that your hip pain is being caused by a disease process. If however you are sweating profusely –  getting a lot of pain at night –  losing weight without any change of diet or exercise – feeling increasingly unwell in combination with hip pain, get yourself checked out ASAP. 

Hip Pain & Major Injuries

It probably goes without saying that significant injuries to the hip and it’s associated tissues can cause bad hip pain. True injuries to the hip are not that common and usually only occur under more extreme accidents. Probably the most common are femoral neck fractures in contact sports and vehicle accidents. If you badly injure your hip in a sporting context or in a serious accident you will almost certainly know all about it in the form of serious amounts of pain. Hospitals do an excellent job screening for these types of injuries so very few of them slip through the net these days. 

Hip Pain & Infections

Bone infections are a less common cause of hip pain that nonetheless should be considered. Infection should be investigated if there is a ‘hot spot’ around the hip or if you have other symptoms of infection like fever. There are basically 2 kinds of bone infection. There is a slow creeping kind that can behave a lot like normal hip pain and is often misdiagnosed as a result, and there is also a far more aggressive kind of acute infection that makes people very sore and very sick very fast. There are numerous possible causes of a bone infection in the hip, all of which warrant a serious medical investigation.

Hip Pain & Internal Organs

There are many complex connections within the human body, more than the minds of the genius level experts can comprehend. One area in which there is a great deal of complex connectivity is within the sensory part of the nervous system. You can have pain in your neck and feel it as a headache (cervicogenic headache). You can have pain in your back and feel it in your leg (sciatica). You can also have pain in an internal organ and feel it in your hip. Digestive organs and reproductive organs can generate ‘referred’ hip pain. Thankfully this isn’t too common.

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