Sources of Hip pain
Dr. Daniel Kaplan is an Assistant Professor of Orthopedic Surgery at NYU Langone Medical Center in Manhattan and Brooklyn. He is a Sports Medicine and Shoulder fellowship-trained orthopedic surgeon who specializes in the treatment of complex shoulder, hip, knee and elbow injuries using minimally invasive arthroscopic and... more
As a hip surgeon, I routinely see patients complaining of, “hip pain”. What most patients don't realize, is hip pain comes in several different varieties, and the type and location typically can help us understand the real problem.
Pain in the back of the hip and the thigh, particularly if it radiates down the side of the leg or is associated with numbness or tingling it's usually due to a nerve in the back being squeezed. This is called lumbar radiculopathy and is a common source of posterior hip and back pain. This may be due to a herniated or “slipped” disc Or arthritis in the back.
Pain on the side of the hip may also be due to radicular pain from the back, again particularly if it radiates down the leg. However, pain may also be due to something called trochanteric Bursitis, which is inflammation of a fluid filled sac or “bursa” on the outside of your hip which protects your hip muscles from your hip bone. If this Bursa gets inflamed it can become quite painful to the touch it may make it difficult to sleep on that side. Pain on the side of the hip can also be due to a tear of one of your muscles called your gluteus medius or minimus, collectively called your abductors. This can make it difficult for you to walk upstairs and may lead to imbalance.
Pain in the front of your hip is more typically associated with joint pain. In younger patients, this may be due to a tear of your hip labrum or due to abnormal bone morphology which leads to repeated impact called femoroacetabular impingement. In older patients this may be due to arthritis. Anterior groin pain may also be from irritation of your hip flexor or, “psoas” tendon.
Lastly, pain between your hips, just below your belly button might be from a core muscle injury also known as, “sports hernia”. This is when your abdominal muscles are partially torn from an imbalance of your abdominal versus your leg muscles.
Hip pain is common and this is treatable, but before we can help address the pain, we must first understand what the underlying problem is. Identifying the location of pain is a great clue to help you and your provider narrow down the possibilities and target treatment based on your pathology.
