Hip pain or tenderness

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Hip pain or tenderness

The type of hip pain you have may help your health professional determine the cause of your pain.

• Pain when resting does not increase with motion or standing. This type of pain is usually caused by a less severe problem, unless the pain does not go away or awakens you from sleep.
• Pain with movement increases when you move the hip or leg but does not increase when you stand or bear weight. This type of pain is most often caused by a muscle injury, inflammation, or infection.
• Pain with weight-bearing increases when you stand or walk and may cause you to limp. This type of pain usually means you have a problem with the hip joint itself. Pain that is severe enough to prevent any weight-bearing is more likely to mean a serious bone or joint problem.

Pelvic, groin, thigh, or knee pain (referred pain) may be present along with a sore, painful, or tender hip. Hip pain can have many causes.

• Pain is often present after an injury, such as from a fall, blow, or twisting movement. You may not remember a specific injury, especially if your symptoms began gradually or during everyday activities.
  • Overuse injuries occur from repeating the same activity. The repeated activity, such as running or bicycling long distances, stresses the hip joint and may cause irritation and inflammation. Examples of overuse injuries include irritation of the large sac that separates the hipbones from the muscles and tendons of the thighs and buttocks (trochanteric bursitis), irritation of the tendons in the hip (tendinitis), muscle strain, and hairline cracks (stress fracture) in the neck of the femur.
  • A sudden (acute) injury may occur from a fall on the hip, a direct blow to the hip or knee, or abnormal twisting or bending of the leg. Examples of acute injuries that may cause hip pain include a broken hip (hip fracture ) or pelvis (pelvic fracture), avulsion fracture, dislocated hip, sprained hip, muscle strain in the groin or buttock, or severe bruising (contusion).
• Snapping pain on the outside of the hip and sometimes the knee may be caused by iliotibial band syndrome.
• Pain in the hip, thigh, or knee of an older child or teen may be caused by conditions such as slipped capital femoral epiphysis, in which the upper end of the thighbone (femur) slips at the growth plate (epiphysis), or Legg-Calve-Perthes disease.
• Pain that is worse in the morning and improves during the day may be caused by osteoarthritis, rheumatoid arthritis, or lupus.
• Pain may be a sign of inflammation of the large sac that separates the hipbones from the muscles and tendons of the thighs and buttocks (trochanteric bursitis).
• Pain can occur with signs of infection in a joint (septic arthritis), bursa (septic bursitis), or bone (osteomyelitis).
• Pain and stiffening in the hip may be caused by lack of blood flow to the hip joint (avascular necrosis). Pain in the knee may also be present.
• Pain that shoots down the leg from the hip or lower back may be caused by an irritated or pinched nerve (sciatica).
• Pain with weight-bearing that gradually worsens over several months may be caused by transient osteoporosis. This is more common in middle-aged men but also can affect women in the later part of pregnancy (third trimester). Osteoporosis related to pregnancy usually goes away on its own within 12 months of delivery.
• Some types of bone cancer (osteosarcomas) and the spread of cancer to the bone (metastatic disease) can cause bone pain.

Credits

Last updated:	September 20, 2008
Author:	Jan Nissl, RN, BS
Reviewed By:	William M. Green, MD - Emergency Medicine, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer