Soft Tissue Related Pain
Hip Flexor, Iliopsoas or psoas strain, tendinitis, tendinopathy or impingement
Pain in the front of the hip may also be related to soft tissues . Soft tissues are non-bony structures that connect, support, or surround other structures and include:
- the muscles, which allow you to move
- the tendons, which connect your muscles to the bone
- the bursae small, flat pockets of fluid that help all these things slide and glide against one another, reducing friction. There are bursae are all around the body in places where different structures may rub against one another, for example where a tendon runs around a bone.
- the fascia stretchy, thin, white fibrous tissue. All our muscles are enveloped in fascia, like stretchy stockings that help transfer energy from muscle and movement. Fascia also forms sheaths or tunnels for safe passage of blood vessels and nerves and wraps and supports all our bodily organs.
A number of other longer, more superficial hip flexor muscles run from the pelvis and down into the thigh and connect below the knee the Sartorius, Rectus Femoris and Tensor Fascia Lata muscles . These muscles help the iliopsoas muscle with lifting the thigh, but their effect also extends across the knee.
Hip Flexor or Iliopsoas Related Pain
Tears or strains may occur within the hip flexor muscles where the muscles and tendons join or within the tendons. Traumatic injury resulting in rapid onset of pain is usually associated with sporting actions such as:
What Causes Hip Pain After Sitting
Your posture ultimately reflects the way that you train your muscles to hold your bones and joints together in good alignment. This combination of muscle strength and muscle length on both sides of a joint affects whether or not it is in an âoptimalâ position.
Sitting places the hips into a flexed position, which changes the length of the hip flexors and the other surrounding hip muscles relative to when youâre standing upright. This seated position affects all sides of the hip joint.
The hip flexors at the front of the hip become shorter, creating an anterior pelvic tilt, resulting in an over-arch in the low back. The glutes and hamstrings, which connect to the back of the hip and pelvis, become stretched out and longer .
In this anterior pelvic tilt, your hips move differently in their ball-and-socket joint, leading to an internal rotation of the femur . The adductor and groin muscles, which connect to the inside of the femur and groin, become shorter and tighter. The abductor muscles on the outside of the hip then become longer.
With the amount of sitting that the average human being does on a daily basis, the hip muscles become accustomed to being in this position. As this pattern is repeated over the course of days, weeks, months, and years…your hip muscles will eventually tighten up.
Essentially, there are 2 simultaneous games of tug of war being played between the front and back sides of the hip and also the inner and outer sides of the hip.
Early And Correct Diagnosis Is Key
When seeing a physician for hip or lower back pain, imaging such as x-rays and MRIs are usually conducted at the sight of the symptoms. Yet, these studies can sometimes show abnormalities that are not actually the root cause of the pain. Let me share a quick example.
A fifty-year-old gentleman had severe pain in the outside of his hip. He saw a physician and had an x-ray of the hip area performed. It was determined that he had mild arthritis in the hip, but the arthritis should not have caused the extensive symptoms he was enduring.
So, he started physical therapy for a period of time and saw no improvement. He then received a cortisone shot in the hip, and that didnt work either. His treatment plan moved on to a stem cell injection with platelet rich plasma in the hip, which also offered no improvement to his symptoms.
This mans symptoms started in April and proceeded to get worse and worse to the point that he was in a wheelchair when he came to the OrthoVirginia office in August. I looked over his symptoms and decided to have a MRI performed on his lower back, even though he had absolutely zero pain coming from his lumbar spine.
It turned out that the L3 and L4 nerves in his back were being compressed, and the symptoms were appearing in his hip. A minimally invasive surgery was performed, and his pain was gone immediately.
Read Also: How To Treat Hip Arthritis Without Surgery
Treatment Options For Hip Pain
Treatment for hip pain depends on the diagnosis, but pain that’s caused by overuse or sports injuries is often treated with heat, rest, and over-the-counter anti-inflammatory medication. To prevent injuries, it is important to stretch before exercising and wear appropriate clothing, especially good shoes when running, Dr. Philippon says.
If certain activities or overuse are causing hip pain, stop those that aggravate the discomfort and talk to your doctor. Excess weight can put pressure on the hip joint, so losing the pounds can provide relief and help you avoid further problems. Some causes of hip pain, such as fractures or hernias, may need surgical repairs. If your hip pain persists, talk to your doctor about the possible causes and treatments.
Left Side Pain Above Hip: Symptoms Causes And Treatments
Jenny Hills, Nutritionist and Medical Writer Health
Left side pain above the hip can be caused by problems with your hip bone, pelvis, or organs in your lower left abdomen. Pain above the left hip can feel like a persistent dull ache or a burning sensation that comes and goes. Or, pain at the left hip bone can result in sharp, shooting pains in your lower back and down your left leg. Sometimes, pain from other organs in your abdomen can radiate to your left side and can feel as if your left hip is sore.
Pain on the left side above the hip bone in the front can often affect women more than men. For example, ovary pain or endometriosis can cause sharp aches in the lower left abdomen and left hip. However, both men and women can experience left side hip pain if they have inflammation in the pelvic bone, digestive issues, kidney stones, or an abdominal hernia.
In order to treat pain on the left side of the body above the hip you need to address the underlying problem. For example, a course of physical therapy can help to relieve a pressed nerve or release pressure from a painful hip joint. If kidney stones are causing agonizing pains in the left abdomen above the hip, diluted apple cider vinegar can help to dissolve the stones. However, whatever the reason for left side hip pain, a hot or cold compress can bring temporary relief.
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Symptoms Of Left Side Pain Above The Hip
Doctors from the Mayo Clinic say that hip pain is a common problem which can cause a wide variety of symptoms. Sometimes the location of the pain is in the actual hip bone and can feel like groin pain. Or, the deep aches and discomfort could be in your left back or buttock.2
Because left side hip pain can come from a number of sources, describing the intensity of hip or back pain and what else hurts on your left side can help to identify the cause. Dr. Benjamin Wedro on eMedicineHealth says that other symptoms of hip pain can include:3
- Sharp, stabbing hip bone pain that shoots down the left leg to the knee
- Numbness or tingling in your left leg if your left sciatic nerve is affected
- Burning sensation in the hip along with pain when moving your leg if inflammation or damage has occurred
- Limping because of soreness when walking
- Tenderness or discomfort in the lower abdomen just above the left hip bone
- Lower back pain that spreads to your hip
- Excruciating pain from kidney stones that affect your middle back, lower abdomen, and groin
Why Does My Hip Pain After Sitting Go Away After Walking
If you are experiencing hip pain after sitting, you may find that the pain reduces after you get up and walk around for a couple of minutes. This is likely due to the increased blood flow and activation felt in the muscles surrounding your hips that helps create more movement in the joint. Take this as a sign that you should get up and move more frequently.
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What Is Your Opinion On Acupuncture If Surgery Is Not An Option
Back pain often has low success rates when it comes to surgery compared to buttocks pain that has high success rates. So if surgery is not an option for you, I think the answer is yes try everything else.
Everything else can range from physical therapy to acupuncture to chiropractic care to stem cell therapy. I have had patients respond to every version of therapy, and I have had patients respond to none of these options.
I would absolutely recommend trying acupuncture to see how much relief that provides you.
Tight Hamstrings After Sitting
Ever get the feeling that your hamstrings are tight after sitting? Thereâs a good chance theyâre involved in the same game of tug-of-war with the tight hip flexors that makes it feel like the hamstrings are short and tight, when they truly are not . The same idea can apply when feeling tightness in your gluteus maximus, especially down closer to your sitting bones.
Similarly, the game of tug-of-war can impact the deeper hip rotators such as the piriformis muscle. This is because the much larger glute muscles, which have been lengthened beyond what is optimal, now have a harder time contracting and have developed weakness due to being overstretched by sitting for long periods.
Because the much smaller piriformis muscle is now required to perform more of the work that the glutes arenât doing, it can lead to the muscle being overworked, fatigued, and tight. As the sciatic nerve runs beneath this muscle, a tight piriformis may compress the nerve and cause sciatica pain when standing up after sitting.
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The Asis And The Quadriceps Muscles
The anterior superior iliac spine is located on the iliac bone on both sides of the hip its the bony projection you can feel at the front of the hips. In addition, the quadriceps muscles in the thigh attach here. This would be the next layer of concern when searching for the cause of pain at the front of the hip.
If there is a problem with the quadriceps muscles, these muscles and the ASIS will feel tender when pressure is applied.
Causes Of Hip Pain In Women
When a female patient comes to Dr. Siegrist complaining of hip pain, she considers the patient’s age, build, and activity level. If the patient is a thin 20-year-old runner or a heavy, sedentary 80-year-old grandmother, the possibilities at the top of my list will be different, she says.
Among the most common causes of hip pain in women are:
1. Arthritis Chronic hip pain in women is often due to arthritis, particularly osteoarthritis, the wear-and-tear kind that affects many people as they age. The ball-and-socket joint starts to wear out, Siegrist says. Arthritis pain is often felt in the front of your thigh or in the groin, because of stiffness or swelling in the joint.
2. Hip fractures Hip fractures are common in older women, especially those with osteoporosis . Symptoms of a hip fracture include pain when you straighten, lift, or stand on your leg. Also, the toes on your injured side will appear to turn out, a sign that can aid your doctors preliminary diagnosis.
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Pain On The Side Of Your Hip Is More Likely From Tendinitis Tight Muscles Or Another Condition
Hip bursitis an inflammation between your thighbone and nearby tendons is commonly diagnosed when patients have pain on the outer side of the hip. However, several other conditions can cause similar pain, and require different treatments. “Doctors often assume that pain on the outer side of the hip is due to bursitis. But 90% of the time, it’s not bursitis,” says Dr. Lauren Elson, a physiatrist with Harvard-affiliated Massachusetts General Hospital.
Hip Pain That Travels Down The Leg
Hip pain may sometimes radiate or be referred to the knee or lower in the leg. Pain in the lower limb is usually associated with joint stiffness and makes daily activities hard to perform. Activities such as putting on shoes, standing up after sitting, walking, and/or driving are commonly affected.
Hip pain can occur in the front, side, or back of the hip.1 The nerves from the hip that travel down the leg commonly cause radiating pain in the thigh, knee, and/or lower in the leg.2 Pain may also be referred from muscles or joints. Here are some potential causes of hip pain that travels down the leg.
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Left Side Hip Bone Pain During Pregnancy
Many women who are pregnant find that they have more pain near the left side hip bone. Of course, pregnancy pelvic pain can also affect the right side of the hip.
Doctors from the National Health Service say that pain around the hip bones during pregnancy is called pregnancy-related pelvic girdle pain. This can cause painful symptoms in your hips, lower back, groin, or the top of your thighs. Some reasons for left side hip bone during pregnancy affecting your pelvis can include:20
- The position of your baby
- The weight of the growing baby pushes on the hip bone and stretches abdominal muscles
- The hormone relaxin is released which affects the joints in the pelvis
How Your Hip Works
Your hip is a very stable and strong joint.
Its known as a ball-and-socket joint. This is because the top of the thigh bone is shaped like a ball. This ball sits inside a hollow socket in your pelvis.
Ball-and-socket joints give the most movement of all the different types of joints in the body.
The hip joint is held together by a covering of muscles which are secured to the bones by strong cords called tendons.
These muscles and tendons form a capsule around the joint and support its movements. They help move the joint, supporting your leg and upper body movement.
Inside the capsule is the synovium, which lubricates the joint with synovial fluid and keeps the cartilage healthy. The cartilage sits between the bones of your hip joint to stop them rubbing together and reduces any impact when you walk or move your hip.
With all this support, it is unusual for the hip to become dislocated, even after a high-impact injury.
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What’s Causing The Pain
Dr. Elson says pain in the side of your hip most often results from one of the following conditions:
Tendinitis. This is an inflammation of the tendons that connect the gluteal muscles in your buttocks to the hip bone. “Tendinitis develops because of muscle imbalance. It could be from a lack of activity, crossing your legs, or even sitting on a wallet,” Dr. Elson says.
Overuse injury. When you walk or run, weak hip and buttock muscles can tighten and irritate the iliotibial band a long band of connective tissue that runs from the knee to the hip. It merges with the gluteal muscles to stabilize the leg.
Tight muscles in the buttocks and hip. If the gluteal muscles and IT band are too tight, they pull at the thighbone where they attach, and that causes pain on the side.
Spine problems. “The body isn’t always smart in recognizing where the pain is coming from,” Dr. Elson explains, “and spine arthritis, a pinched nerve, or bones in the spine rubbing together can create pain in the side of your hip.”
Pain In The Back Of The Hip When Standing
Pain in the back of the hip when standing after sitting may be coming from several different muscles: the glutes, hamstrings, and other deep hip rotators. When the hip flexor muscles on the front side of the hip become short and tighten up, it creates an anterior tilt of the pelvis. The glute and hamstring muscles, which attach to the back of the hip and pelvis, become longer than they want to be. While we often think of long muscles as optimal, these muscles have not lengthened in a healthy, active way. Theyâve been yanked into a game of tug-of-war, where the posterior chain muscles may also tighten up to prevent further imbalance.
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Osteonecrosis Of The Femoral Head
This issue, known as ONFH, causes the hip bone to deteriorate and collapse due to a lack of blood to the area. The cartilage that covers the hip bones also deteriorates, resulting in arthritis.
Hip pain is typically the first symptom, and it may accompany a throbbing pain or dull ache in the buttocks and groin. As the condition progresses, it may be difficult to put weight on the hip and any movement may be painful.
This may progression can take several months to a year, and getting an early diagnosis leads to a better outlook.
Internal causes of hip and groin pain may stem from underlying conditions or growths in other regions of the body. The issue may be:
How To Get Relief From Left Side Pain Above The Hip
Putting a hot or cold compress on the painful left hip area can help to relieve the pain and increase joint movement in your left leg.
Dr. Carol DerSarkissian on WebMD advises when to use cold therapy and when to use heat therapy for hip joint pain.
- Cold therapy. Cold helps to reduce inflammation in sore hip joints and can also alleviate pain from a pinched nerve. Cold therapy is good for arthritic conditions and other inflammatory pain in your left hip area.
- Heat therapy. Use heat to help increase circulation to the painful area above your left hip joint. Heat therapy helps to relax muscles and can help ease abdominal cramping, herniated discs, or chronic back pain.
To find out how to make your own heat treatment compresses, please read my article on how to use cold or heat therapy for pain relief.
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