Hip Problems, Age 12 and Older

Topic Overview

Hip pain can make it hard to walk, go up and down stairs, squat, or sleep on the side that hurts. A clicking or snapping feeling or sound around your hip joint (snapping hip) may bother you or cause you to worry. But if your hip is not painful, in many cases the click or snap is nothing to worry about. Home treatment may be all that is needed for minor hip symptoms.

To better understand hip problems, it may be helpful to know how the hip works. It is the largest ball-and-socket joint in the body. The thighbone (femur) fits tightly into a cup-shaped socket (acetabulum) in the pelvis. The hip joint is tighter and more stable than the shoulder joint but it does not move as freely. The hip joint is held together by muscles in the buttock, groin, and spine; tendons; ligaments; and a joint capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint and let the tendons and muscles glide and move smoothly. The largest nerve in the body (sciatic nerve) passes through the pelvis into the leg.

Hip problems

Hip problems may develop from overuse, bone changes with age, tumors, infection, changes in the blood supply, or a problem that was present from birth (congenital). Oddly enough, a person who has a hip problem often feels pain in the knee or thigh instead of the hip. The type of hip pain you have may help your doctor determine the cause of your pain.

• Pain when resting does not increase with motion or standing. This type of pain is usually caused by a less severe problem, unless the pain does not go away or awakens you from sleep.
• Pain with movement increases when you move the hip or leg but does not increase when you stand or bear weight. This type of pain is most often caused by a muscle injury, inflammation, or infection.
• Pain with weight-bearing increases when you stand or walk and may cause you to limp. This type of pain usually means you have a problem with the hip joint itself. Pain that is severe enough to prevent any weight-bearing is more likely to mean a serious bone or joint problem.

Pelvic, groin, thigh, or knee pain (referred pain) may be present along with a sore, painful, or tender hip. Hip pain can have many causes.

• Snapping pain on the outside of the hip and sometimes the knee may be caused by iliotibial band syndrome.
• Pain in the hip, thigh, or knee of an older child or teen may be caused by conditions such as slipped capital femoral epiphysis, in which the upper end of the thighbone (femur) slips at the growth plate (epiphysis), or Legg-Calve-Perthes disease.
• Pain that is worse in the morning and improves during the day may be caused by bones rubbing together, such as with osteoarthritis, rheumatoid arthritis, or lupus.
• Pain may be a sign of inflammation of the large sac that separates the hipbones from the muscles and tendons of the thighs and buttocks (trochanteric bursitis).
• Pain can occur with signs of infection in a joint (septic arthritis), bursa (septic bursitis), or bone (osteomyelitis).
• Pain and stiffening in the hip may be caused by lack of blood flow to the hip joint (avascular necrosis). Pain in the knee may also be present.
• Pain that shoots down the leg from the hip or lower back may be caused by an irritated or pinched nerve (sciatica).
• Pain with weight-bearing that gradually worsens over several months may be caused by transient osteoporosis. This is more common in middle-aged men but also can affect women in the later part of pregnancy (third trimester). Osteoporosis related to pregnancy usually goes away on its own within 12 months of delivery.
• Some types of bone cancer (osteosarcomas) and the spread of cancer to the bone (metastatic disease) can cause bone pain.

Treatment for a hip problem depends on the location, type, and severity of the problem, as well as your age, general health, and activities (such as work, sports, hobbies). Treatment may include first aid measures; application of a brace, cast, harness, or traction; physical therapy; medicines; or surgery.