Understanding the hip joint
The hip is one of the most stable joints in the body and is responsible for supporting the trunk and absorbing forces from the spine and lower limbs, enabling movement.
The hip is a ball and socket joint, with the ball (head of the femur) articulating on the cup (acetabulum of the pelvis). Like all joints in the body, both the ball and socket have protective layers of cartilage to help the joint shock absorb and glide smoothly during movement. It is held together by a strong capsule that is reinforced by powerful ligaments. There are also large muscles overlying the joint that connect the lower back and hip.
Due to its deep socket and stable architecture, the joint is difficult to dislocate or fracture unless through trauma like a car accident or if you have a bone condition like Osteoporosis. More commonly, hip pain can arise from a sudden increase in activity i.e. walking or running or periods of inactivity. The source of the pain might be caused by irritation or impingement of the front of the hip, or tendon pain on the outside of the hip. Less common, the joint itself can be painful secondary to joint changes such as osteoarthritis. The back joints can also sometimes refer to the hip, which is why it is important to be assessed to accurately work out what is causing the pain.
Diagnosis of your hip pain
With a good understanding of the cause and structure involved in your hip pain, you can then get the right treatment and management plan for your condition.
Hip pain can be diagnosed by taking a thorough history of your recent activity and lifestyle, a review of your medical history, and a thorough physical examination.
Imaging can sometimes be useful to rule out any structural damage following injury or serious pathology. It can also be useful if your symptoms are not responding to conservative management. Examples of imaging are X-rays or MRIs.
How to manage your hip pain
If you have acutely hurt your hip or it has suddenly become painful, sometimes short-term relief is needed such as pain medication, topical non-steroidal gels, ice or heat treatment or modification of your activity levels. If the pain persists, then seeking input from a Physiotherapist is advised.
How can Physiotherapy help hip pain?
A Physiotherapist will take a detailed case history to understand the cause and contributing factors to your Hip pain.
Often the physio will assess your back to ensure it is not involved in your hip pain picture. A passive assessment of the hip joints combined with a movement screen to identify any biomechanical factors contributing to your symptoms. This may involve a combination of simple hip movements or looking at the functional tasks you are struggling with, i.e. walking.
The Physiotherapist will then explain what they see and advise on the diagnosis and factors contributing to your pain picture.
Depending on your presentation and expectations of the appointment, the Physiotherapist will advise on any relevant short-term relief options such as optimising pain relief medication, and manual therapy techniques i.e. soft tissue release, and joint mobilisations. These hands-on techniques provide short-term relief and can sometimes help to dampen down the secondary responses to pain such as muscle tightness.
The Physio will also suggest self-management advice i.e. how to modify your activities, simple movement strategies, or an exercise program to address any movement deficits. In some cases, the Physiotherapist may feel onward referral is necessary i.e. back to GP or a specialist. This will always be a shared decision-making process and often there is a lot you can be doing in the meantime.
