The hip consists of two main parts: The ball at the top of the thighbone fits into a rounded socket in the pelvis. Ligaments -- bands of tissue -- connect the ball to the socket, and cartilage cushions the bone surfaces from rubbing against each other. Synovial membrane, a thin layer of tissue, covers the remaining surfaces and produces lubricating fluid to further reduce friction.
Injury and certain conditions can cause damage to the hip that, over time, causes chronic pain and limited mobility in one or both hips. The most common causes of chronic hip pain can often be treated conservatively with rest, non-steroidal anti-inflammatory drugs and physical therapy. Severe damage may require surgery to replace the joint.
Arthritis
The most common cause of chronic hip pain is arthritis, according to the American Academy of Orthopaedic Surgeons. Osteoarthritis wears away the cartilage that cushions the bones in the hip, causing pain and stiffness in the hip when the bones rub together. Rheumatoid arthritis is an autoimmune disease that, among other effects, can damage the cartilage in the hip by causing inflammation. Traumatic arthritis, a possible result of injury or fracture of the hip, damages the cartilage in the hip and causes pain and stiffness over time. Total hip replacement may be necessary if the pain and disability become severe.
Bursitis
Bursitis is a painful inflammation of the fluid-filled pads -- bursae -- that cushion the bones, tendons and muscles around the joints. Bursitis is most common in the hips, shoulders and elbows due to the frequent motions of these joints. Symptoms include stiffness, achiness, swelling, redness and increased pain on palpation or movement. Conservative treatment, including rest, non-steroidal anti-inflammatory drugs and physical therapy, is usually successful.
Tendinitis
Tendons--fibrous bands that join muscles to bones--can become irritated, inflamed and swollen due to injury, overuse, aging or diabetes. Hip pain may become worse with activity, and the skin over the hip may be warm and red. Conservative treatment, including rest, non-steroidal anti-inflammatory drugs and physical therapy, usually helps to reduce pain and inflammation.
Sciatica
Pressure on the sciatic nerve in the leg, usually caused by a herniated disk in the lumbar area of the spinal column, can cause pain in the hip as well as pain, weakness, numbness or tingling in the leg. Symptoms may be mild at first and get worse at night, or when the patient coughs, sneezes, laughs, bends backward, walks more than a few yards, or stands or sits for long periods. If conservative treatment--rest, non-steroidal anti-inflammatory drugs and physical therapy--does not alleviate the symptoms, surgery may be required to relieve the pressure on the nerve.
Hip Labral Tear
When the ridge of cartilage around the hip joint -- the hip labrum -- is torn, the patient may complain of pain in the hip or groin; a locking, clicking or catching sensation in the hip joint; or stiffness and limited range of motion. This injury can be caused by overuse of the joint, osteoarthritis or trauma. Pain that continues after four weeks of conservative treatment--rest, non-steroidal anti-inflammatory drugs and physical therapy--may require surgical intervention.
