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Other conditions causing hip pain
Although arthritis of the hip is the most common cause of hip pain there are a number of other possible causes:
Spinal problems: Problems with the spine give rise to pain both in the back and the leg. On occasions the leg pain may be much worse than the back pain, in which case it may appear that the symptoms are arising from the hip.
Spinal problems will usually be managed with physiotherapy.
Trochanteric bursitis: The buttock muscles insert into the femur at a point known as the greater trochanter (often called the 'hip bone'). This area may become inflamed in much the same way as the elbow becomes inflamed in tennis elbow. The symptoms are of pain felt on the outside of the hip, which is made worse by exercise and by lying on the affected side.
Treatment with steroid injections and physiotherapy is normally successful. Sometimes surgery to remove the inflamed bursa is necessary.
Psoas tendonitis / bursitis: Similar but less common than trochanteric bursitis psoas bursitis is characterized by pain on the inside of the hip. It is often exacerbated by flexing the hip.
Non-surgical treatment is normally successful.
Groin strain: Common in footballers groin strain is often a result of damage to the adductor muscles that insert into the pelvis in the region of the groin.
Rest followed by physiotherapy is normally successful in treating this condition. Only rarely is surgery (Gilmore's procedure) indicated.
Impingement / labral tears: In younger patients hip pain may arise from the joint capsule; this may either be due to pinching of the capsule or a tear at the point of its attachment to the pelvis.
Diagnosis is normally made by means of an MR arthrogram.
Steroid injections and physiotherapy are often helpful, but sometimes surgery (hip arthroscopy) may be required.
|© J M Britton 2007|