Hip Pain FAQs

Pain in and around the hip joint has a vast myriad of potential causes.  They range from the musculoskeletal in nature (e.g. hip arthritis, greater trochanteric bursitis, iliopsoas impingement) to the intra-abdominal (e.g. sportsman’s hernia, inguinal hernia, athletic pubalgia) to the less clear-cut or multifactorial (e.g. complex regional pain syndrome, fibromyalgia).

Although each of the aforementioned conditions will cause a form of hip pain, the hip pain will be slightly different depending on the cause and these differences will be identified by your healthcare practitioner and will help them achieve a definitive diagnosis of the underlying cause of your hip pain.

Pain in and around the hip can present in great number of different ways, and each identifiable cause of hip pain has a unique presentation and characteristic quality to the pain itself.  For example, hip osteoarthritis pain tends to present as a dull ache that is exacerbated with weightbearing, iliopsoas impingement tends to present as a sore burning sensation that is worsened with resisted hip flexion and an inguinal hernia will present with pain around the hip that is worsened with a Valsalva maneuver.

That being said there are number of conditions that will present with hip pain of very similar nature, for example pain from osteoarthritis can often be confused with pain from femoroacetabular impingement or any other intra-articular cause of hip pain.

Although pain in the hip is generally felt in and around the hip joint, its specific location can give away key clues to the underlying cause of the hip pain.  For example, greater trochanteric pain will worsen with specific palpation of the area directly overlying the greater trochanter. Hernia type pain will be felt more so in groin than the lateral deep aspects of the hip.  Hip pain can even be felt in the buttock area – this is  a common presentation of osteoarthritis.

Any sustained hip pain that lasts longer than a few days and is refractory to conservative management such as over-the-counter analgesics and rest, stretching or continued exercise should be brought to attention of a medical professional.  Although a good amount of hip pain will respond well to over-the-counter analgesics such as Tylenol and nonsteroidal anti-inflammatory drugs, these may temporarily relieve the pain but  on cessation of these medications, the pain may very well return.

Depending on the cause of the hip pain, these may actually be ineffective (for example using anti-inflammatories and Tylenol to treat an inguinal hernia will be largely ineffective. Although it may provide some pain relief, this will be likely incomplete and very temporary). Our specialist orthopedic surgeons would be happy to consult with you regarding any hip pain that you may have been experiencing and will help to reach a definitive diagnosis which is key to successfully treating your hip pain.

One of the most common scenarios a surgeon will see is a patient who presents with pain in the hip and attribute this pain to arthritis of the hip, but on consultation with our specialist orthopedic surgeons and review of plain film radiographs, the patient lacks any radiographic evidence of arthritis in the hips at all, however, assessment of the lower back reveals significant arthritis in this area.

This is a common presentation for many people who experience hip pain that is actually coming from the lower back.  Depending on the extent of the involvement of the lower back and the specific symptoms the patient presents, they may warrant a referral to a spine specialist, but in most cases a course of sustained and effective physical therapy often provides these patients with the muscular training that they require in order to improve their arthritis pain originating from their lumbar spine.

Many patients choose to visit their regular family physician with hip pain complaints and this is perfectly reasonable, as is presenting to a physiotherapist or chiropractor.  However, our specialist orthopedic surgeons have years of experience treating hip specific problems and are best qualified to assist you in achieving a definitive diagnosis for the cause of your hip pain.

Once we have made this diagnosis, we will be more than happy to discuss with you the treatment options and whether this includes surgery or nonsurgical options such as physical therapy, nonsteroidal anti-inflammatory medications, gait aids and injections.