Chronic Knee and Hip Pain

Chronic Knee and Hip Pain

Hip Pain

The hip joint is the body’s largest ball and socket joint, designed to withstand repetitive motions and significant wear and tear. Whenever you use the hip, such as walking or running, a protective layer of cartilage helps prevent friction between the ball and the socket. Over time, this cartilage can become damaged. The surrounding muscles and tendons can become damaged as well. If there is a fall or other injury, the hip could fracture. Any of these incidents can lead to hip pain.

Symptoms

Some of the symptoms indicative of hip pathology include:

-thigh pain

-inside hip joint pain

-groin pain

-outer hip pain

-buttock pain

At times, other areas of the body have pain that can radiate to the hip including back pain or hernias. Often times, hip pain will increase with activity, particularly in the setting of arthritis. The pain is typically associated with decreased range of motion in addition to a limp.

Diagnosis

X-rays

X-rays are often the best way of finding out what’s wrong with the hip as they clearly show the condition of the bones. They’re very good at looking for arthritis in the hip, but they may also show problems in your pelvis which could explain your pain. They’re not as useful for looking at the soft tissues around the joint.

CT scans

A CT scan can often be very helpful to work out if the hip joint has an unusual shape. There are conditions where the socket of the hip can be very shallow, and a CT scan often helps to show this up.

MRI scans

MRI scans are useful for looking at the muscles and tendons around the hip. They’re particularly helpful for diagnosing avascular necrosis.

If your doctor thinks you have a torn acetabular labrum, they may suggest you have an MR arthrogram. A small amount of contrast is injected into the hip joint before an MRI or CT scan is performed. This allows the capsule, the articular surface of the bones and the surface of the cartilage to be examined.

Blood tests

If your doctor thinks your pain is caused by an infection or rheumatoid arthritis, blood tests can often help.  If your pain is intractable, present at night or there is associated swelling, redness, or warmth around the joint, call your health care provider immediately.

Treatment

If the cause of your hip pain is a muscle or tendon strain, osteoarthritis or tendonitis, over the counter medication such as Tylenol or a non-steroidal anti-inflammatory can help reduce the inflammation. With arthritis, exercising the hip joint with low impact exercises including stretching and resistance training can help reduce pain and improve joint mobility. Physical therapy can also help increase your range of motion. Swimming is an excellent non-impact exercise as well.

At times, a hip injection is recommended to relieve pain and inflammation in the hip joint and can also aide in the diagnosis of hip pain. For this procedure, a needle is inserted into the hip joint with the assistance of real-time x-ray to ensure proper needle placement in the joint. Once the needle is in the correct location, steroid medicine is injected in the joint. There may be reduced pain after the injection due to the numbing medication, but the pain can sometimes after this wears off. The steroid should take effect within 2-7 days and the hip should feel less painful. Some people may need more than one injection and how long the shot lasts varies from person to person depending on the cause of the pain. For some, it can last weeks to months.

If hip osteoarthritis becomes so severe that conservative treatment options are ineffective, a total hip replacement may be considered.