Hip pain

• Please note
• To the diagnostic

Synonyms in a broader sense

Hip arthrosis, impingement of the hip joint, trochanteric bursitis, Meralgia paresthetica

introduction

Hip joint pain can have different causes. Of importance in finding the correct diagnosis of hip pain are:

• Age
• gender
• Accident event?
• Type and quality of pain (piercing, dull, etc..)
• Development of pain (slowly, suddenly etc..)
• Painful occurrence (at rest, after / during exercise)
• Pain location (inside, outside etc.)
• external aspects (Swelling, redness, etc.)
• and much more
• Pain

In the following descriptions of diseases we will try to address as many characteristics as possible that make up a certain clinical picture.

Unfortunately there are a lot of deviations from the norm, so the assumed self-diagnosis does not necessarily have to be correct. But we hope through our Self-diagnostic just to be able to help the patient on the internet organ or symptom related look for a disease.

Ultimately, however, only a specialist examination and, if necessary, imaging procedures (X-ray image, MRI etc.) to the right one Diagnosis of hip pain to lead.

Please note

In no case does the “self” diagnostic agent replace a visit to your trusted doctor! We also make no claim to the completeness of the differential diagnoses presented (alternative causes). We assume no liability for the correctness of the self-diagnosis you have made! We strictly reject any form of self-therapy without consulting your doctor!

Hip joint anatomy

Hip anatomy

1. hip joint
2. Femoral head
3. large rolling mound (Greater trochanter)
4. Thighbones (Femur)
5. Femoral neck
6. Pelvic bones / ischium (Sciatic tuberosity)

Appointment with a hip expert?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

• Lumedis - your orthopedic surgeon
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

To the diagnostic

Using our “Self” diagnostic agent is simple. Follow the respective link provided, where the location and description of the symptoms best match your symptoms. Pay attention to the point of the hip joint where the pain is greatest.

Where are your complaints?

Hip joint medical terms

For the exact anatomical assignment, we refer to the Anatomy Lexicon our page.

• dorsal - back
• ventral - front
• lateral - outside, on the side
• medial - Inside

Hip osteoarthritis

• Synonyms:
  Hip arthrosis, hip joint arthrosis, wear and tear of the hip joint, coxarthrosis, coxarthrosis
• Place of greatest pain:
  In most cases, the greatest pain in hip osteoarthritis is in the groin. However, buttock pain and knee pain can also occur.
• Pathology / cause:
  Cartilage damage. The cause of the cartilage damage is different. In most cases, the cause is not clear. In these cases one speaks of an ideopathic osteoarthritis.
  Other causes can be hip dysplasia, femoral head necrosis or impingement of the hip joint.
• Age:
  Increasing incidence with age.
• Gender:
  Women> men
• Accident:
  Less often, also due to accidents, after fractures in the hip area (e.g. hip socket fracture = acetabular fracture).
• Type of pain:
  dull, pulling
• Pain development:
  Mostly continuous increase in pain over the years. Acute increase in symptoms after physical exertion or minor accidents.
• Pain occurrence:
  Pain usually occurs after exercise. As the disease progresses, pain at rest and at night can occur.
• External aspects:
  Even with advanced hip arthrosis (coxarthrosis), no external changes can be detected.
• Further information:
  You can find more information on this topic at: Hip osteoarthritis

Trochanteric bursitis

• Synonyms:
  Bursitis of the hip, inflammation Bursa of the great rolling mound.
• Place of greatest pain:
  The greatest pain is just above the greater trochanter (large hillock of the thigh bone (Femur)) - More information can be found here: Greater trochanter pain
• Pathology / cause:
  The cause of the bursa irritation is rubbing of the tendon plate (fascia lata) of the outer thigh over the greater trochanter.
  This can be triggered Bursitis due to heavy stress on the external Thigh muscles, tendon snapping of the tendon plate, or a difference in leg length.
• Age:
  Trochanteric bursitis can occur in all age groups.
• Gender:
  Women> men
• Accident:
  No
• Type of pain:
  Stinging, pulling
• Pain development:
  Acute increase in symptoms after physical exertion or minor accidents.
• Pain occurrence:
  Pain usually occurs after exercise. As the disease progresses, pain at rest and at night can occur.
• External aspects:
  Usually none, if it is pronounced Bursa Thickening above the large rolling mound (Greater trochanter).

Coxa saltans

• Synonyms:
  Jumping hip, snapping hip, English: snapping hip
• Place of greatest pain:
  The greatest pain is just above the greater trochanter (large hillock of the thigh bone (Femur)).
• Pathology / cause:
  The cause of the Coxa saltans is also a rubbing of the tendon plate (fascia lata, Iliotibial band) of the outer thigh over the greater trochanter (large rolling hillock -> in the figure above the arrow points to it).
  This snap can be triggered by flexing the hip joint. The tendon plate must slide from the back to the front over the greater trochanter (large rolling hillock). This can lead to a temporary stuck behind the rolling mound and then - when sufficient tension has built up - to a snap over the trochanter, which is sometimes also audible
  Causes can be a Leg length difference, anatomical variants on rolling hills, but also muscular training.
  A Coxa saltans occurs frequently with a trochanteric bursitis (see above).
• Age:
  Prefers younger women
• Gender:
  Women> men
• Accident:
  No
• Type of pain:
  Stinging, pulling
• Pain development:
  Acute increase in symptoms after exercise.
• Pain occurrence:
  Pain usually occurs after exercise. As the disease progresses, pain at rest and at night can occur.
• External aspects:
  Usually no, possibly leg length difference
• therapy:
  conservative:
  
  • Leg length compensation
  • Stretch of the iliotibial band
  • Injections, possibly with cortisone
  operational:
  • Removal of the bone at the greater trochanter (large rolling hillock)
  • Extension of the iliotibial band (Z-plasty)

Meralgia paresthetica

• Synonyms:
  Nerve compression of the lateral femoral cutaneous nerve
• Place of greatest pain:
  Burning pains in the outer upper thigh. The pain is exacerbated by standing, walking or lying down for long periods of time. Flexing the hip joint will ease the pain.
• Pathology / cause:
  A constriction of the lateral femoral cutaneous nerve under the inguinal ligament leads to a functional disorder of the nerve. This dysfunction triggers a discomfort in the area of ​​the outer thigh.
  This disease can be caused by wearing pants that are too tight, but also by being overweight (obesity). This condition is known as meralagia paresthetica.
• Age:
  Mostly younger patients due to clothing.
• Gender:
  Women> men
• Accident:
  No
• Type of pain:
  burning
• Pain development:
  Entrapment (compression) of the lateral cuataneus femoris nerve under the inguinal ligament (Inguinal ligament)
• Pain occurrence:
  Pain usually occurs after exercise or after wearing pants that are too tight.
• External aspects:
  No

Femoral head necrosis

• Synonyms:
  HKN, circulatory disorder of the femoral head
• Place of greatest pain:
  The greatest pain is in the groin area. In contrast to hip arthrosis, the symptoms usually develop in a short period of time, depending on the extent of the circulatory disorder.
• Pathology / cause:
  In most cases, the cause of an HCN is unclear.
  Causes of femoral head necrosis alcoholism, diabetes mellitus, radiation in this area or congenital blood diseases such as B. be the sickle cell anemia. But femoral head necrosis can also develop on the basis of hip arthrosis.
• Age:
  Depending on the cause mentioned above. In most cases, the risk increases with age.
• Gender:
  Men> women, in 50% of the cases also on both sides.
• Accident:
  No
• Type of pain:
  stabbing, pulling
• Pain development:
  The localized circulatory disorders of the femoral head lead to the destruction of bone tissue. This process is accompanied by severe pain.
• Pain occurrence:
  Since the circulatory disorders of the femoral head suddenly set in, there is a short-term increase in complaints / pain.
• External aspects:
  Even with advanced femoral head necrosis, no external changes can be detected.
• Further information:
  

  You can also find more information on this topic at: Femoral head necrosis

Hip dysplasia

• Synonyms:
  Dysfunction of the acetabulum, dysplasia of the acetabulum
• Place of greatest pain:
  Hip dysplasia in itself is painless. The symptoms typical of osteoarthritis mentioned above only occur with the development of hip osteoarthritis.
• Pathology / cause:
  Hip dysplasia is a genetic maturation disorder of the hip socket (acetabulum) or the acetabulum. The cause of this disease is unclear; certain types of location in the womb can promote the development of dysplasia.
• Age:
  Depending on the severity of the hip dysplasia, this malformation can lead to hip arthrosis sooner or later.

• Gender:
  

  Women> men

• Accident:
  No
• Type of pain:
  see hip osteoarthritis
• Pain development:
  Acute increase in symptoms after physical exertion or minor accidents.
• Pain occurrence:
  Pain usually occurs after exercise. As the disease progresses, pain at rest and at night can occur.
• External aspects:
  Even with advanced hip dysplasia, no external changes can be detected.
• Further information:
  

  You can also find more information on this topic at

  Hip dysplasia.

Impingement of the hip joint

• Synonyms:
  Hip bottleneck syndrome
• Place of greatest pain:
  As a rule, the impingement syndrome of the hip joint is painfully perceived in the groin.
• Pathology / cause:
  The cause of an impingement syndrome is an anatomical variant of the femoral head or the acetabulum.
  With certain movements, the femoral head (especially with strong flexion) can hit the socket roof.
  This attack causes pain.
• Age:
  Impingement syndrome affects middle-aged patients before hip osteoarthritis has set in.
• Gender:
  Women = men
• Accident:
  No
• Type of pain:
  stabbing, pulling
• Pain development:
  Acute increase in symptoms after physical exertion or making strong flexing movements in the affected hip joint.
• Pain occurrence:
  Pain usually occurs after exercise. Hip osteoarthritis can develop as the disease progresses.
• External aspects:
  No changes are visible externally.

Piriformis Syndrome

• Synonyms:
  Tendon attachment irritation, tendon attachment inflammation of the hip rotator.
• Place of greatest pain:
  The greatest pain is in the deep muscles of the glutes.
• Pathology / cause:
  Due to incorrect loading of the Piriformis muscle a muscle of the hip joint externally rotated, it can lead to a chronic overload of the muscle (musculus piriformis) with permanent induration and visual appendages Sacrum (Os coccygis) and on the great roll mound (trochanter major).
• Age:
  A priformis syndrome can basically affect any age group. How From clinical experience, younger women and patients often suffer from this disease after implantation of a hip prosthesis.
• Gender:
  Women> men
• Accident:
  No
• Type of pain:
  stabbing, pulling
• Pain development:
  Acute increase in symptoms after exercise or Internal rotation.
• Pain occurrence:
  Pain usually occurs after exercise. Sometimes even at rest.
• External aspects:
  No
• Treatment:
  especially conservative methods, such as one Physiotherapy especially for piriformis syndrome
• Further information:
  For more information on this topic, see Piriformis Syndrome and Symptoms of Piriformis Syndrome.

Pain on the outside of the hip

Burning painthat are located on the outside of the hip or thigh are often caused by Nerve irritation caused. Different nerves like that Sciatic nerve, of the Femoral nerve or the Obturator nerve (as well as some skin nerves) can be responsible for discomfort on the outside of the hip. These nerves can either be attached to the Spine be narrowed or in its course by swollen tissue or Muscles be pressed in. Common causes for such nerve irritation are External pressure, Obesity, Adipose tissue, Muscle training or clothing that is too tight.

If the pain is on the outside of the hip, it is more likely dull or boring feels and feels improved with movement and warmth, this is an indication that the pain is originating in the hip muscles. Tense muscles often cause pain that can be precisely localized and is limited to certain points (the tendon attachments of the muscles).

It is important that most hip pain on the outside of the hip is not pain of the hip joint itself, but mostly through tight hip muscles and from connective tissue caused. Only with long-term tension can painful hip joint damage occur.

But causes of hip pain outside the musculoskeletal system should also be considered. This can also be the case with the peripheral aortic pelvic arterial occlusive disease sharp muscle pain in the hips, thighs and buttocks. The cause of this vascular disease is vascular calcification (arteriosclerosis), which leads to an undersupply of tissue and thus causes pain.

Pain in the groin

There are a variety of explanations and causes for groin pain. Because, on the one hand, that is located close to the bar hip joint with bones, cartilage, ligaments, muscles, tendons, and bursa, all of which can also cause pain in the groin. You can also go to the other too Nerve bottlenecks, Spinal and pelvic diseases, such as internal organs in the groin area (intestines and genital organs) cause discomfort in the groin area. The pain in the groin can appear as a sharp, stabbing pain, but also as a Drag in the bar, as a feeling of pressure or as a bump or Hernia in the groin (Protrusion of the abdominal wall).

Pain sensations in the groin can also go through Misaligned feet, Leg length differences or Posture errors to be triggered. Such disturbances are mostly only ´´functional´´ and can be reversed. A leg length difference of more than two centimeters, for example, leads to an equinus foot position of the shorter leg and on the longer side to greater flexion in the hip and knee. This causes many problems and discomforts in the lower half of the body up to the groin. For this reason, differences in leg length should be given early on through orthopedic aids such as heel heights and the like. be compensated to prevent chronic pain in the area of ​​the quiet or pelvis.

Pain that is localized in the depth of the groin and initially only occurs after prolonged exercise such as climbing stairs or cycling and then increasingly when bending the hip joint can be caused by the so-called Impingement the hip. This leads to entrapment or a bump of joint parts of the hip with the thigh bone. Hip impingement often affects young men between the ages of 20 and 30. The risk that the hip joint wears out prematurely due to entrapment and a arthrosis arises is increased.

Chronic pain in the groin area can be a typical sign of hip arthrosis (joint wear). In addition, osteoarthritis causes start-up pain in the morning, hip pain especially after exercise, pain at rest (e.g. at night), pain when turning the leg around its own axis and increasing stiffness.

Thigh pain

Hip pain can also manifest itself in the thigh. This is the case with, among others

• tendinitis of the hip (Trochanteric endinosis)
  In this inflammation, the tendon attachments to the protruding bone on the outside of the thigh, the large roll mound (Greater trochanter), inflamed. Often the trochanteric endinosis occurs in conjunction with a bursitis (Trochanteric bursitis) or a snap hip.
• or tendinitis in the groin.

Both inflammations can be caused by excessive or improper stress.

Neurological causes must also be considered in the case of pain in the thigh area. When neuralgia is called Meralgia paresthetica is the lateral thigh cutaneous nerve (Lateral femoral cutaneous nerve) becomes inflamed and causes burning pain on the upper outside of the thigh. Uncomfortable tingling and numbness can be other symptoms. The inflammation can occur because the nerve is constricted and thus irritated. A narrowing can e.g. be favored by wearing very tight pants.

When the sciatic nerve constricts, however, the pain typically radiates downward on the back of the thigh.

If children complain of thigh pain, it may also be due to hip problems. At a young age, a so-called "hip runny nose" (Coxitis fugax), which provokes severe pain in the groin and front thigh, which sometimes also radiate to the knee. Coxitis fugax is a temporary inflammation of the hip joint with joint effusion that usually disappears after 2 weeks. Both sides of the hips can also be affected with a runny nose. It can be the result of a viral infection of the respiratory tract or, more rarely, a gastrointestinal infection. In addition, diseases that affect the bone or its structure can make themselves felt as pain in the thigh. These include osteoporosis (bone loss), osteomalacia (softening of the bones due to vitamin D deficiency) and Paget's disease (deformation of the bones).

Are you interested in this topic? Read more about this in our next article: Pain in the thigh and hip

Pain in the buttocks

A very common localization of hip pain is in the area of ​​the buttocks. The pain usually comes from the Outside of the hip and pull into the buttocks. These complaints are usually caused by the gluteal muscles that make up the large rolling mound (Greater trochanter) connect to the pelvis. These muscles tighten the leg in a rotational position. If the pain in the buttocks is noticeable, not only the muscle attachments but the entire muscle are usually tense. Such tension is usually caused by unfavorable postures or monotonous movements in everyday life. Muscle-related pain in the buttocks occurs particularly when doing jobs that involve a lot of sitting or standing. Sometimes palpable hardenings form in the tight gluteal muscles, which are also known as contraction nodes or muscle tension.

The most common cause of acute pain in the hip to buttock area is blockages Sacrum and iliac joint (Sacroiliac joint, SI joint). The pain can radiate into the leg, is more noticeable after sitting and is also intensified when lifting the affected leg or when straightening up from a stooped position.

It can also lead to the so-called Piriformis Syndrome in which the pear-shaped piriformis muscle (inner hip muscle) leads to a narrowing of the sciatic nerve or one of its nerve branches when it crosses from the pelvis to the thigh. Of the Piriformis muscle can shorten and thicken in the event of improper use; it is responsible for splaying, stretching and external rotation of the thigh. This causes pain that extends deep into the buttocks and often radiates to the thighs, hips or back. Most of the time, only one side of the body is affected, and climbing stairs or lying on the affected side is very painful. The symptoms can be exacerbated by sitting for a long time.

The therapy options for hip pain that extend into the buttocks range from pain reliever medication (e.g. Paracetamol or others NSAIDs), Local injections of anesthetic agents, psychotherapy (for psychological trigger factors) up to physiotherapy, Massages and suitable relaxation exercises for the tense muscles.

Hip pain after jogging

After jogging, excessive strain, incorrect footwear or previous damage can lead to pain in the hip area. In most cases, this is an indication that the workout is being carried out too one-sidedly or that the hips are incorrectly loaded or overloaded while jogging. An uneven surface when running also harbors the same risk of the uneven distribution of weight on the hip joint. For this reason, taking care of yourself and avoiding chronic overstimulation is usually the right approach to tackling hip pain after jogging. Running training should be adapted to the pain and pain-aggravating movements should be avoided. Depending on the location and cause of the hip pain, physiotherapy and, in rare cases, pain-relieving and anti-inflammatory drugs can be useful.

In addition, shortened muscles (muscle imbalances) and not sufficiently stretched hip muscles before jogging can put wrong strain on the hips when moving and thus lead to pain. In addition, many athletes take on themselves with great ambition and provoke sports injuries such as strains or tears in the hip muscles through excessive training - the result is pain. Typically, it also happens that stress fractures (fatigue fractures) result from permanent overload. These are microfractures in the skeleton, in which the surrounding periosteum is also inflamed. In many cases, the resulting pain is accompanied by a restriction in movement of the hip joint. Not only while jogging but also after exercise, many feel an uncomfortable pain in the hip. This is often a sign that your own stress level has been exceeded. Here everyone has individually different load limits.

Read more on the subject below: Inflammation of the periosteum of the hip

Pain in the hip area after jogging usually comes from the attachment of tense muscles on the outside of the thigh. Painful hip joint damage only occurs when there is long-lasting tension in the hip and thigh muscles.

Incorrect strain, misalignment in the joint, overuse or a previous trauma can also inflame a bursa while jogging (Trochanteric burstitis), as the tissue around the large rolling mound (Greater trochanter, a protruding bone on the thigh bone) is very prone to inflammation. The bursa located in the hip is supposed to prevent friction between the thigh bone and the tendons running there. In the case of bursitis, the pain occurs particularly after loading or moving the leg and is noticeable through direct pressure and deep pain on the side of the hip. The occurrence of bursitis can be observed in particular with re-exertion, so that untrained joggers are often affected.

In coxarthrosis (hip joint arthrosis), the articular cartilage is so worn out that the bony parts of the joint rub against each other during movement and thus lead to pronounced pain.

Rheumatism and gout can also cause discomfort in the hip region when jogging.

In rare cases, sharp pain in the hip that occurs after jogging can also indicate diseases of the hip joint (e.g. hip dysplasia). More often, such complaints are caused by blockages in the sacrum joint (the joint between the sacrum and the pelvic bone). Such blockages can be diagnosed and treated with physiotherapy or chiropractic.

In order to avoid pain during or after jogging, it is particularly important to choose the right amount. A running unit adapted to your personal fitness level and sufficient stretching of the muscles can prevent unwanted pain. Those who continue to have problems jogging should consider doing less hip-stressing sports such as swimming or cycling.

also read: Hip pain when jogging

Pain at night

There are a number of hip diseases that present themselves as pain, especially when you are at rest or when you are lying down at night. This is a big problem because the body should recover precisely in this resting phase. If the relaxation phase at night is no longer due to pain-related insomnia, this also has an impact on the quality of life and the person concerned is less productive. Correct diagnosis by the doctor and good therapy not only reduce existing complaints, but also help the patient back into a normal daily rhythm.

One cause of hip pain at night is coxarthrosis. In this disease, improper loading leads to wear and tear in the hip joint. The cartilage in particular, which is responsible for the smooth running of the joint, is severely affected by wear. However, pain at rest in the hip area often only appears in the late stages of coxarthrosis. The damage to the cartilage or the bone is then noticeable when lying down and in the vast majority of cases at night.

Inflammations are also particularly noticeable at rest. If the hip joint is inflamed, known as coxitis, those affected have pain symptoms at night.

Likewise, nocturnal pain can indicate a bursitis.

Rheumatism or gout can also be triggers.

In particular, if you have hip pain at night, you should also think about pain caused by nerves. Nerves could be constricted, causing pain. Particularly when lying down, the complaints with nerve involvement become symptomatic.

If the pain radiates from the back towards the buttocks and hips, a herniated disc in the lumbar spine or discomfort in the sacrum cannot be ruled out.

Read more on the topic: Hip pain at night - what's behind it?

Hip pain in pregnancy

A pregnancy means for that pool and the hip a great burden. This can lead to a so-called in some cases Symphysis loosening which can cause severe pain in the hip area. On the anterior side of the pelvis is the pubic symphysis, which is also Pubic symphysis is called. During pregnancy, the body makes the hormone Relaxin which makes the ligaments in the pelvis softer and more flexible (and therefore more stretchable). With the ligaments now loose, one side of the pelvis may have more leeway than the other when moving the legs or walking, causing pain in the hip. The complaints often occur in the groin and pubic area.

Pain in the hip area that occurs during pregnancy is usually more pronounced with certain movements such as climbing stairs or turning over in bed. They can also increase at night and when you are resting.

In very rare cases there is not only a loosening of the pubic symphysis but even a so-called Symphysis diastaste. This leads to an unusually large distance between the pelvic bones because the pubic symphysis is very loosened. If painful symphysis diastasis occurs during pregnancy, the symptoms can be caused by a orthopedic support belt for the pelvis to be alleviated. The heavy stress on the hip during pregnancy can be reduced by various therapy options such as acupuncture, Chiropractic or Osteopathy be reduced. As a rule, the hip pain disappears quickly after the child is born, and only in rare cases does the pain persist for more than a year.

also read: Hip pain in pregnancy