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Hip Pain? A Proper Diagnosis is Your First Step to Finding Relief

By Robert Ference, MD, FAAOS, Board Certified-American Board of Orthopedic Surgeons

Hip pain and weakness is most often felt during activities like walking, lifting your leg to step over something, or going downstairs. Many patients live with it for years before seeking treatment. In my experience, most people could have found relief sooner if the source of their hip pain had been diagnosed sooner.

First, let's clear up what makes up your "hip," and then I'll go over the various causes and treatments of hip pain. The hip is one of the body's largest weight-bearing joints. Your hip is where the thigh bone meets the pelvis to form a ball-and-socket joint. The hip joint consists of two main parts: the ball-shaped piece of bone at the top of your thigh bone, and the socket in your pelvis into which the thigh bone fits.

The hip joint is surrounded by large muscles of the thigh, lower back, and buttocks. They all support the hip joint and enable movement. Major nerves and blood vessels also run through the hip. These include the sciatic nerve at the back of the hip and femoral nerve at the front of the hip; and the femoral artery, which begins in the pelvis and passes by the front of the hip and down the thigh.

As you can see, your hip pain has many areas to hide, which is why a thorough exam and x-rays are typically needed to pinpoint the source of pain.

Here are some of the more common causes of hip pain:

Muscle Strain: Considering all the muscles, ligaments and nerves that support and surround the hip joint, an injury or strain to a muscle during activity can be the cause of pain in your hip.

Bursitis (pain outside of the hip joint): The joint capsule is lined with a thin membrane called synovium which produces fluid to lubricate the joint. Fluid-filled sacs called bursae provide cushioning where there is friction between muscle, tendons, and bones. If the sacs become irritated or infected, this is bursitis.

Bursitis symptoms include pain on the outside of the hip that's worse with activities such as standing, walking, or running. Treatments include resting, ice, anti-inflammatory medications, steroid injections, and physical therapy.

Disc Herniation in Back: If one of your spinal cord discs (the fluid filled cushions between the joints of your vertebrae) is bulging (herniated), it can cause a pinched nerve that feels like it is coming from the hip due to referred pain from the back. While often difficult to diagnose, the referred pain can be pinpointed with x-rays and a thorough office exam.

Arthritis of the hip: If a patient tells me that their pain is coming from the groin, buttocks and/or

thigh areas, this is more indicative of an arthritic condition inside the hip joint. Arthritis is identified by an x-ray. Your orthopedic surgeon can tell if you have arthritis when they see cartilage cushioning has worn away between the ball socket and the ball-shaped head of the upper thigh bone.

Conservative treatments to ease arthritis pain in the hip joint include cortisone injections and physical therapy. If your x-rays are indicating you are "bone-on-bone," a total hip replacement may be recommended. Fortunately, we have new and advanced methods of replacing hip joints these days. Robotic technology and computer navigation are making hip joint replacements faster, less invasive and with fewer days in the hospital. In some cases, patients who are healthy can go home the same day as their hip replacement (arthroplasty) procedure. The materials used to replace hip joints are also more durable and reliable than they were even a few years ago.

The Next Steps to Hip Pain Relief

If you have been suffering with hip pain or immobility and are ready to take the next step of finding the cause and treatment options, talk to your orthopedic surgeon or call my office at (248) 626-0135 and request a consultation. The treatments are plentiful and improving every year.


Dr. Robert Ference is an Orthopedic Surgeon based in Farmington Hills, Michigan. He specializes in advanced treatments for hip, knee, shoulder, and other joint pain. To learn more, go to

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