FOCUS ON HEALTH      

By Virginia Nsitem

Have you experienced hip pain getting out of your car or up from a seat? Does lying on your side at night cause hip pain? Do you find yourself walking with a limp or having to take rest breaks when shopping or taking a long walk because of hip pain? If you answered yes to any of these questions, you are not alone. This article will discuss common causes of hip pain and how to relieve your pain and discomfort.

The bones, muscles, and nerves of the hip joint:

The hip joint is formed from the head of the femur (thigh bone) and the socket of the pelvis. The hip joint connects the spine to the legs. There are strong ligaments that surround the hip joint and form a capsule. The capsule contains fluids that lubricate the hip joint. The muscles of the hip help flex, extend, rotate, and move the hips from side to side. There are sacs called bursa that provide “cushioning” at the hip joint. Nerves from the low back supply the muscles of the hip and provide sensation to the hip, buttock, and thigh region.

Five common causes of hip pain:

1. Hip joint osteoarthritis: This condition is a wear and tear injury of the hip joint, and develops gradually over time. Typical symptoms of hip osteoarthritis include:

• Pain is described as achy and stiff
• Pain is worse after moderate activity and better after rest
• Pain is worse in the morning, and eases after “warming up the joint”
• Limited movements of the hip and leg, walking with a limp, pain getting up from your seat
• Crackling noises in the hip

You may not be able to reverse hip arthritis, but you can slow down the progression with proper rehabilitation.

2. Hip bursitis: The bursa is a fluid-filled sacs that cushions the tendons, ligaments and muscles of the hip joint. Bursitis is the inflammation of the bursa. This condition can be caused by trauma to the hip (a slip and fall accident or a fall in sports), a repetitive stress injury (long walks or hikes, or jogging), or muscle and tendon injuries. Typical symptoms of hip bursitis include:

• Pain with walking or running
• Tenderness and swelling at the hip joint
• Hip that feels “weak”
• Pain lying down on the sore hip
• Pain getting out of a bed or a chair

3. Hip muscle, ligament, and tendon injury: The hip joint is surrounded by large muscles that provide movement and stability. The hip muscles commonly involved in hip injuries are the hamstrings (back of the thigh), quadriceps (front of the thigh), groin (inner thigh), gluteals (buttock), and hip flexor muscles. Overuse/repetitive use or trauma can lead to injury of the muscles, ligaments, or tendons of the hip. A groin pull is an example of a hip muscle injury. Typical symptoms of soft tissue injuries to the hip include:

• Difficulty walking, running, jumping, and climbing stairs
• Difficulty rising from a seated position
• Walking with a limp
• Muscle spasms

4. Low back injuries: Low back muscle or disc injuries can refer pain to the hip joint.

5. Nerve injuries: Two major nerves associated with the hip are the sciatic nerve and the femoral nerve. Injury to these nerves can cause pain or numbness around the hip. Injury can occur from trauma to the hip, pelvis, and low back. Nerve problems can also occur from seatbelt injuries in a car accident, or even wearing tight clothing or belts at the hip.

Is there a cure for hip pain?

Chiropractors specialize in diagnosing, treating, and rehabilitating injuries of the muscles, joints and nerves.  The first step to relieving your hip pain is understanding the cause of the problem. Your chiropractor or health care provider can provide you with a diagnosis after conducting an examination, and reviewing possible ultrasound studies, x-rays, CT scans, or MRI studies. Your rehabilitation program may vary, depending on your diagnosis. Your chiropractor or health care provider can also identify other serious causes of hip pain that may require urgent attention.

1. Chiropractic techniques: Manual therapies are used to improve tightness of the muscles and ligaments, and movement of the joints. Laser therapy is a useful tool to reduce pain and allow the patient to start the exercise portion of the rehabilitation. Cold therapy (ice) can be helpful in the initial stages of inflammation to reduce the pain and swelling.
2. Exercise modification: You may need to replace intense activities such as running, aerobics, and contact sports with low intensity activities such as swimming, biking, and yoga.
3. Lifestyle changes: Just as stretching, strengthening, and exercise is important, do not forget to rest the joint and allow it to recover from your daily activities. Monitoring your weight is also important as a few extra pounds can cause an increase in hip joint pain.
4. Massage therapy and Acupuncture: Studies have shown that these techniques are helpful for providing a pain-relieving effect throughout the body, an anti-inflammatory effect, and a general sense of improved well-being.
5. Footwear: Proper footwear and proper foot mechanics can help reduce the intensity of hip pain. Custom foot orthotics or over-the-counter foot can provide extra cushioning support for your shoes which will reduce stress on the hip joints. If you have chronic hip pain and are limping, you may be prescribed a cane or walker.

Stop the Pain … Before the Pain Stops You!

(Dr. Virginia Nsitem is a chiropractor specializing in laser therapy for muscle, joint, and nerve injuries, and is a Fellow of the Royal College of Chiropractic Sports Sciences in Canada. She may be reached at (905) 275-4993, or by email at totalhealth@bellnet.ca )