Hip Pain Treatment

The hip is a strong and stable ball and socket joint with very powerful muscles that control and support it. This allows for lots of mobility as well as the ability to generate large forces. We observe this amazing capacity in ballet, and land-based sports such as football, netball and athletics.

The health of the hip joint and surrounding structures is maintained through regular movement and by maintaining the strength of the hip muscles, as well as caring for your general physical and psychological health.  This includes regular physical activity, maintaining healthy body weight, having good sleep habits, managing stress and mood.

Hip pain is a term that relates to pain around the buttock, outside of hip and or the groin regions. It can sometimes refer down the leg and is often associated with back pain.

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hip pain

How common is hip pain?

Hip pain is very common and can occur at any age, although it is more common in very active people and in women around menopause. Hip pain, especially when it is persistent can be very disabling, negatively impacting on engagement in activities of daily living such as dressing, sleep, sexual intimacy, physical activity and work. This can in turn hugely impact on a person’s psychological and physical well-being.

Pain around the hip may be related to sensitive tendons, hip muscles, bursa or the hip joint structures. Very rarely is it related to damaged structures unless there has been a traumatic injury.

Common diagnostic labels for hip pain include: gluteal tendinopathy, trochanteric bursitis, labral tears, piriformis syndrome and hip osteoarthritis. Hip pain usually presents with pain when loading the hip such as standing, walking, squatting, stairs and running, and it commonly disrupts sleep especially when lying on the side.

What are the risk factors?

Previous traumatic injury to the hip region, over-activity (especially weight bearing sports that involves sudden changes of direction), inactivity, muscle weakness of the hip muscles, carrying excessive belly fat and depressed mood, are all known risk factors for hip pain.

These factors can result in inflammation and sensitivity of various structures of the hip.

Myths about hip pain

✖    Pain in the hip usually means something is damaged and a scan is needed

✖    Hip pain that has been there for years means it must be arthritis

✖    Exercise that hurts the hip should be avoided

✖    Pain during movement and exercise means harm is being done to the hip

✖    Noises around the hip are a sign of problems

✖    A tendon tear or a labral tear means a surgical repair is needed

✖    Hip osteoarthritis means a hip replacement is inevitable

✖    Once a person has had surgery, there is no need for physiotherapy

Based on all this information we will then explain to you in simple language, where the pain is coming from, the factors that are contributing to your pain, and discuss the best treatments options available to you.

Facts about hip pain

✔    Hip structures are very strong and difficult to damage

✔    Lots of findings on scans such as labral tears, gluteal tears and ostoarthritis are common in people without pain

✔    Graduated movement and exercise is safe for the hip and doesn’t cause damage, even if it is painful. Movement helps keep the hip structures healthy

✔    Weight loss for people who are over-weight can significantly reduce hip pain, by reducing inflammation in the body and the load on the joint

✔    Guarding and protecting the hip is unhelpful unless you have had a traumatic injury

✔    Learning to relax and move painful hip structures helps reduce pain in the long run

✔    Noises that occur around the hip are common and DO NOT mean your hip is damaged

✔    Education, strengthening exercises and adopting a healthy lifestyle can reduce hip pain for people with gluteal tendinopathy, bursitis, labral tears and osteoarthritis. This can prevent the need for surgery for many people

✔    If you have had surgery, getting strong, mobile, confident, active and healthy is important for long term improvement

Approaching hip pain

The great news is that there are lots of effective treatments that our physiotherapists at Body Logic Physiotherapy can offer people with hip pain.

Assessment of hip pain

We first undertake a comprehensive history in order to hear your story, how the pain began and how it impacts on all aspects of your life. We screen for serious causes of hip pain. We then perform a comprehensive examination of your hip and surrounding structures.

This includes assessment of: the sensitivity of the structures to touch, move and load; the mobility of the hip and the ability to relax the hip muscles; the strength and endurance of the hip muscles. We are most interested in the postures and activities that you find restricting. We will also screen your back and lower limb.

Treatment of hip pain

Based on all this information we will then explain to you in simple language, where the pain is coming from, the factors that are contributing to your pain, and discuss the best treatments options available to you.

If your pain is acute (sudden onset), the key is to help you to get comfortable and moving as this helps with recovery. We will also identify the factors that caused the hip pain and make a plan to prevent it in the future.

If your pain is persistent (longer than 6-12 weeks), we will work out a plan with you to help you take control of your pain and get back to living based on your goals.

Treatment often involves learning to relax tense muscles, regaining joint mobility if restricted, a graduated strengthening exercise program, and a plan to get you physically active based on your preference. It’s really important to get you fit, confident and strong as this results in pain relief and increased functional capacity. Addressing other factors such as sleep, mood, stress, dietary factors, if relevant, may also be important. We work with other health professionals where needed, to ensure your care is coordinated.

We will identify your goals and ensure the treatment plan is directed towards these.

At Body Logic Physiotherapy we are not interested in ongoing “band-aid treatments”. We know that the best way to manage hip pain is to help you understand why you have pain, having a treatment plan to address the factors that contribute to your pain, and get you back in control, moving, active and living again.

For some people this process may take 2-3 sessions, however for long term problems this may take up to 7-10 sessions over a 3-4 month period. We also offer supervised exercise rehabilitation classes and one-to-one sessions to support this process if needed.

A great example of treatment for knee pain at Body Logic Physiotherapy is the GLA:D program. GLA:D is an evidence-based program for people with hip and knee osteoarthritis pain and symptoms.  GLA:D educates people about their pain and involves a 6 week progressive rehabilitation program.  This approach has been shown to positively reduce pain, and the need for medication or surgery, whilst improving functional capacity.

Additional Resources

What do you need to know about overall joint health? https://bodylogic.physio/resources/understanding-pain/what-should-you-know-about-joint-health/