Hip Problems, Age 12 and Older
Hip Problems, Age 12 and Older
Hip pain can make it hard to walk, go up and down stairs, squat,
or sleep on the side that hurts. A clicking or snapping feeling or sound around
your hip joint (snapping hip) may bother you or cause you to worry.
But if your hip is not painful, in many cases the click or snap is nothing to
worry about. Home treatment may be all that is needed for minor hip
To better understand hip problems, it may be helpful to
know how the
hip works. It is the largest ball-and-socket joint in
the body. The thighbone (femur) fits tightly into a cup-shaped socket
(acetabulum) in the pelvis. The hip joint is tighter and more stable than the
shoulder joint but it does not move as freely. The hip joint is held together
by muscles in the buttock, groin, and spine; tendons; ligaments; and a joint
capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint
and let the tendons and muscles glide and move smoothly. The largest nerve in
the body (sciatic nerve) passes through the pelvis into the leg.
Hip problems may develop from overuse,
bone changes with age, tumors, infection, changes in the blood supply, or a
problem that was present from birth (congenital). Oddly enough, a person who
has a hip problem often feels pain in the knee or thigh instead of the hip. The type of hip pain you have may help your
doctor 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
- 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
- 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
Pelvic, groin, thigh, or knee pain (referred pain) may be
present along with a sore, painful, or tender hip. Hip pain can have many
- 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
- Pain that is
worse in the morning and improves during the day may be caused by bones rubbing together , such as with
rheumatoid arthritis, or
- 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.
Treatment for a hip problem depends on the location,
type, and severity of the problem, as well as your age, general health, and
activities (such as work, sports, hobbies). Treatment may include first aid
measures; application of a brace, cast, harness, or traction; physical therapy;
medicines; or surgery.
Check your symptoms to
decide if and when you should see a doctor.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
H. Michael O'Connor, MD - Emergency Medicine
August 2, 2012
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