Pain in the hip is a common complaint that can be caused by a wide range of problems. Symptoms are frequently worse with prolonged walking and going from a sitting to standing position. The first issue is to determine if the hip comes from the hip joint (the ball and socket joint) or referred pain from the ‘lateral hip’ including muscles, ligaments, tendons and other soft tissues. Some patients even have lumbar or buttock pain that can refer pain to the hip or groin. Injuries including chronic bursitis involving the greater trochanter (the bony region on the side of your hip that causes pain if you lay on one side) or the ischial bursa (the ‘butt bone’). Labral tears, hip dislocations, and prior fractures are also possible causes.
In many patients, the pain is referred from the upper nerves from the lower back due to a pinched or inflamed nerve, bad disc, or joint inflammation. There are some nerves that can be compressed in the pelvis or the top of the thigh. An xray, MRI, ultrasound, NCS/EMG, or CT may be necessary to further evaluate the true source of pain.
If the pain is referred from the back, nonsurgical treatment options include trigger point injections, epidurals, selective nerve blocks, joint injections, and physical therapy. If the discomfort is secondary to a problem with the hip joint itself, nonsurgical treatment options include non-steroidal anti-inflammatories, compound transdermal medications, bracing, neuomodulation treatments, custom bracing, vitamin supplementation, cold therapy, initial corticosteroid injections, growth factor injections, cryopreserved stem cell injections, botox therapy, and platelet rich plasma injections.