Hip and Thigh Pain

The hip is a ball-and-socket joint, surrounded by large muscles. The ball, the round head of the femur (thigh bone), is set deeply in the acetabulum, a deep socket or cavity in the pelvis. The joint is very stable. 

Causes

The majority of long-term hip problems are associated with aging, disease (such as arthritis) and fractures. But pain in the hip and thigh also can be caused by injury to muscles, tendons or bursas, usually from a fall, a blow or overuse.

Groin Pull

A groin pull can be caused by a quick change in direction while you're moving. It often occurs in sports such as hockey, tennis and basketball. A groin pull can result in pain, tenderness and stiffness deep in the groin, making activity difficult.

Pulled Hamstring

A pulled hamstring is an injury to the group of muscles at the back of the thigh that attach at the pelvis and just behind the knee. Pulls or tears can occur from a sudden forceful move, such as sprinting to steal a base. Hamstring injuries most often occur in the center of the muscle, but the hamstring also can tear from the pelvic bone, just under the buttocks. Hamstring pulls and tears cause pain in the back of the thigh, limited motion and sometimes bruising or a lot of swelling.

Bursitis

Bursas are fluid filled sacs that help prevent friction in or around a joint. They can become inflamed and painful (bursitis). Bursitis in the hip usually involves the hip socket and causes tenderness, pain in the lateral hip, thigh and possibly knee, and swelling on the outer part of the hip, where some of the large buttock muscles attach. Bursitis in the hip can be caused by activities such as speed-walking, aerobic dance or carrying a baby on your hip. It also can be caused by conditions that alter the normal tilt of the pelvis, such as having one leg shorter than the other.

Charley Horse

Charley horse is a painful muscle injury caused by bruising of the thigh. The typical cramping of a charley horse can be accompanied by pain, swelling, stiffness and skin discoloration. Use the RICE method right after any significant blow to the thigh. Continue icing for several days to help with pain and swelling. After a few days, start doing gentle stretching exercises. Heat may help, but don't apply heat until at least three days after the injury.

Piriformis Syndrome

Piriformis syndrome is an irritation of the piriformis muscle, one of the smaller muscles lying under the large muscles of the buttocks. Irritation can occur if you sit or stand for long periods or repeat certain motions. When the piriformis muscle tightens and spasms, pressure may be placed on the sciatic nerve that serves the leg. The irritation, called piriformis syndrome, can cause pain, numbness and tingling from the buttocks down the back of the leg to the foot.

The symptoms of this condition are often confused with those of disc disease in the spine. One way to tell if the problem is piriformis syndrome is to lie on your stomach with your knees together and bent, so your feet are in the air. Gently let your feet spread apart sideways. If you feel a pain in your buttocks as your feet move apart, your problem is probably piriformis syndrome.

Self-Care Steps

For Groin or Hamstring Pulls or Tears:

• Use the RICE method and pain medications.

• Depending on the damage to the muscle tissue, you may need crutches for a few days.

For Bursitis:

• Use the RICE method and pain medications.

• Avoid the activity that started the inflammation.

For a Charley Horse:

• Apply ice to the whole muscle, or as much of it as you can, right after the injury.

• Rest the area. Don't try to move it in spite of the pain.

• Use the RICE method and use pain medications.

• See a doctor if not better in seven to 10 days.

For Piriformis Syndrome:

• While sitting, cross left leg so ankle rests on top of right knee. Gently press on inside of left knee until stretch is felt deep in hip. Intensify stretch by leaning forward. Switch legs.

  

Special Concerns for Children

Children can have the same hip and thigh problems as adults, but there are several problems unique to children that can affect the bones of the hip and thighs. Because children are still growing, these problems require medical attention to prevent long-term problems.

Legg-Calve-Perthes Disease

Legg-Calve-Perthes disease is a breakdown of the ball of the femur, which is the long thigh bone that fits in the hip joint. Loss of blood supply to the hip causes part of the top of the bone to die and deteriorate. This condition occurs most frequently in young children typically ranging from age 4 to 10 years but may occur in slightly younger or older children.

Symptoms can include limping, pain in the groin area or inner thigh, and knee pain. Rest usually relieves the pain; activity makes it worse. The hip may be stiff, and the thigh may be weak.

Unless the hip is inflamed or the doctor recommends a brace to keep the femoral head in the socket, a child with Legg-Calve-Perthes disease can play normally. The deterioration caused by the disease usually heals completely and does not recur. In some cases, a child with Legg-Calve-Perthes disease may need require rest, a brace and occasionally surgery to make sure the new bone on the femoral head grows properly.

Slipped Capital Femoral Epiphysis

In slipped capital femoral epiphysis, there is slippage at the epiphysis, and the femoral neck slips upward and backward relative to the femoral head. This condition usually occurs in children between the ages of 9 and 16 during periods of rapid growth and when puberty begins. It is more common in boys. The slip can happen over several months (slipped capital femoral epiphysis) or suddenly, following a fall or other injury to the hip (acute traumatic separation of the femoral epiphysis). Symptoms can include limping, pain in the groin area or inner thigh, and knee pain. Rest usually relieves the pain; activity makes it worse. The hip may be stiff, and the thigh may be weak. 

Treatment for slipped capital femoral epiphysis is surgery. It is usually very effective, but is needed right away. Left untreated, the condition can lead to arthritis in early adulthood. The outlook is good for slipped capital femoral epiphysis. The traumatic separation has a worse outlook, with more long-term problems.

Synovitis

Synovitis is the inflammation of any joint. The cause is unknown. In children, synovitis of the hip happens most often between the ages of 2 and 5. Children usually wake up with a limp, with or without pain. Your doctor may recommend that the child rest in bed. Symptoms usually last three to 14 days. You need to watch your child's temperature. If a fever develops, your child needs to see a doctor.