Hip pain can be a result of a number of causes, most of which are related to degenerative processes, injury, or inflammation of the muscles and tendons located in the hip area. In most cases pain is felt in the groin, but it can also be experienced down the thigh, descending to the knee and sometimes all the way to the ankle. This is because of conjoined nerve pathways. In some cases it can be felt in the buttock and rarely in the back.

Patients usually describe pain intensifying during activities which load the joint such as walking or standing for prolong periods. They experience difficulties in dressing, especially while putting on shoes and socks. Sleep can often be disturbed too.

Sensations such as “catching” or “snapping” of the hip during specific movements are also described. This is connected to the damage of the labrum or the articular cartilage of the joint. There may have been a history of previous injury or trauma.

Any painful condition of the hip typically manifests through limping during walk.

Hip Anatomy

The hip joint is the largest and most stable of the joints in the body. It is a ball and socket type joint. The ball is called the “head” of the femur. The socket is formed by the bones of the pelvis and is called the “acetabulum”.

The head of the femur and the acetabulum are covered by articular cartilage. It is white and shiny material which has a rubbery consistency. It provides an extremely smooth joint surfaces which allows sliding against one another and absorbing shock without causing any damage. Joint is filled with “synovial” fluid which provides nourishment and lubrication to the hip joint.

The joint is surrounded by a strong tissue called a joint capsule. Capsule is reinforced by ligaments which prevent the head of the femur from coming out of the acetabulum. They also provide stability to the hip joint.

Tendons are structures that connect muscles to bone. Hip joint is surrounded by many muscles. They provide wide range of movements in the hip joint when the leg is moved.

The hamstring muscles (at the back of the leg) and the gluteus maximus (the “butt muscle”) move the leg backwards at the hip. The hip flexors, such as iliopsoas, move the leg forward at the hip. The groin muscles move leg toward the midline of the body. The abductor group, with gluteus medius as main muscle, move the leg away from the body. They also stabilize the hip joint during weight bearing activities.

Bursa is a small sac of fluid which decreases friction between tendons, muscles and bones. The main bursa of the hip joint is the subtrochanteric bursa. It can become painfull because of direct injury or overuse.