The most common causes of hip pain that we address in our office:
Piriformis Syndrome: A condition of the piriformis muscle in the buttock region, piriformis syndrome is identified by spasms and pain in the upper leg area. The piriformis muscle can also constrict the nearby sciatic nerve to engender sciatica – a term that describes symptoms of discomfort that originate in the lower back to travel through the buttock and down one or both legs. Although piriformis syndrome is a common diagnosis in healthcare, the exact causes of an overly tight and/or spasming piriformis is often overlooked. In many cases, the actual problem is an adhesion (a tightening and sticking condition) between the sciatic nerve and the smaller hip muscles that are near the piriformis. When subjected to prolonged postures and general overuse, the muscles at the back of the hip will begin to entrap and squeeze the sciatic nerve. A sciatic nerve entrapment is a very serious condition that can cause hamstring tightness, aching, numbness, burning, and tingling in the lower extremities. If this entrapment and its attendant adhesion issues aren’t addressed, piriformis syndrome will persist.
Hip Impingement: Also known as femoral acetabular impingement (FAI), hip impingement is a general term that covers all irritation of the hip joint tendons that arises as a result of chronic and repetitive compression. This occurs due to excessive, abnormal bone growth in the hips ball and socket joint. Hip impingement can cause considerable pain and a range of restricted movement issues. These symptoms typically grow at a slow rate over an extended period of time. The pain associated with hip impingement is generally localized in the groin by can also radiate along the side of the thigh and in the buttocks. Most often, the reason that hip tendons become irritated is that they are overused to the point of adhesion. Adhesion in the hip muscles makes them weaker and less flexible, which in turn stresses the hip muscle tendons.
IT Band Syndrome: Iliotibial band syndrome (or IT band syndrome) is one of the most prevalent overuse injuries among runners. This condition arises when the iliotibial band, a ligament that attaches to the shin from the outside of the thigh at the hip, becomes tight and/or inflamed. The IT band is particularly important because it helps to stabilize and operate the knee joint. Although it can be extremely problematic, the IT band is always a victim and never the primary cause of pain. With overuse, the hamstring muscles will develop the knotting and sticking effects of adhesion. The hamstring muscles sit in an ideal position to stabilize the back of the knee, but after they become overused, the IT band must increasingly help to stabilize the knee. Since the IT band is on the wrong side of the leg, it is not in an advantageous position to provide this stability. Thus, the knee joint will become irritated and inflamed from the ravages of overuse.
Osteoarthritis: The most common form of arthritis, osteoarthritis occurs as the protective joint cartilage wears down over time. Although it is widely regarded as a natural part of the aging process, it is often aggravated by other conditions. For example, as muscle adhesion develops from overuse, it can stress cartilage as joints fail to support loads properly. A degenerative bone-building condition, osteoarthritis worsens when patients experience a limited range of motion. The halted motion of a joint causes an uneven placement of forces within it, and the body responds by building up the bone on the part of the joint that is loaded. This leads directly to cartilage degeneration and chronic joint pain. Restoring range of motion can significantly slow down the progression of osteoarthritis. Common symptoms of osteoarthritis include pain, tenderness, stiffness, loss of flexibility, and a grating sensation, which is often the result of bone spurs.
Hip Bursitis: Bursas are tiny fluid-filled sacs that provide cushion and function as gliding surfaces to reduce friction between tissues of the body. When the bursa in the hip joint becomes inflamed, it leads to a condition called hip bursitis. A classic indicator of overuse of the muscles that attach to the hip, this inflammation can arise as a result of injury, infection, or an underlying rheumatic condition. Most often, the damage that engenders hip bursitis is due to adhesion, or a drastic tightening and/or glue-like sticking, in the buttock and hip muscles. Bursitis is generally defined by localized pain, tenderness, and/or swelling. These symptoms tend to become aggravated by any movement of tissue in the affected area.