The Diagnosis: Is It Your Hip?
When you tell your doctor your hip hurts, the first thing she should do is confirm that your hip is actually the problem. Women might say they have hip pain, but what they may mean is that they have pain in the side of the upper thigh or upper buttock, or they may be experiencing lower back pain, says Stephanie E. Siegrist, MD, an orthopedic surgeon in Rochester, New York, and a spokeswoman for the American Academy of Orthopaedic Surgeons. Hip pain is often felt in the groin or on the outside of the hip directly over where the hip joint (a ball-and-socket joint) is located.
Causes of Hip Pain in Women
When a female patient comes to Dr. Siegrist complaining of hip pain, she considers the patient's age, build, and activity level. If the patient is a thin 20-year-old runner or a heavy, sedentary 80-year-old grandmother, “the possibilities at the top of my list will be different,” she says.
Among the most common causes of hip pain in women are:
1. Arthritis Chronic hip pain in women is often due to arthritis, particularly osteoarthritis, the wear-and-tear kind that affects many people as they age. “The ball-and-socket joint starts to wear out,” Siegrist says. Arthritis pain is often felt in the front of your thigh or in the groin, because of stiffness or swelling in the joint.
2. Hip fractures Hip fractures are common in older women, especially those with osteoporosis (decreased bone density). Symptoms of a hip fracture include pain when you straighten, lift, or stand on your leg. Also, the toes on your injured side will appear to turn out, a sign that can aid your doctor’s preliminary diagnosis.
3. Tendinitis and bursitis Many tendons around the hip connect the muscles to the joint. These tendons can easily become inflamed if you overuse them or participate in strenuous activities. One of the most common causes of tendinitis at the hip joint, especially in runners, is iliotibial band syndrome — the iliotibial band is the thick span of tissue that runs from the outer rim of your pelvis to the outside of your knee.
Another common cause of hip pain in women is bursitis, says Marc Philippon, MD, an orthopedic surgeon in Vail, Colorado. Fluid-filled sacs called bursae cushion the bony part of the hip that is close to the surface. Like the tendons, these sacs can become inflamed from irritation or overuse and cause pain whenever you move the hip joint.
4. Hernia In the groin area, femoral and inguinal hernias — sometimes referred to as sports hernias — can cause anterior (frontal) hip pain in women. Pregnant women can be susceptible to inguinal hernias because of the added pressure on the wall of their abdomen.
5. Gynecological and back issues “Hip pain in women can have gynecological causes,” Siegrist says. “It’s important not to just assume that the pain is caused by arthritis, bursitis, or tendinitis. Depending on your age and other health issues, the pain in your hip could be coming from some other system.”
Endometriosis (when the uterus lining grows somewhere else) can cause pelvic tenderness, which some women describe as hip pain. Pain from the back and spine also can be felt around the buttocks and hip, Siegrist says. Sciatica, a pinched nerve, typically affects one side of the body and can cause pain in the back of the right or left hip — the pain from sciatica can start in your lower back and travel down to your buttocks and legs.
Treatment Options for Hip Pain
Treatment for hip pain depends on the diagnosis, but pain that's caused by overuse or sports injuries is often treated with heat, rest, and over-the-counter anti-inflammatory medication. To prevent injuries, it is important to stretch before exercising and wear appropriate clothing, especially good shoes when running, Dr. Philippon says.
If certain activities or overuse are causing hip pain, stop those that aggravate the discomfort and talk to your doctor. Excess weight can put pressure on the hip joint, so losing the pounds can provide relief and help you avoid further problems. Some causes of hip pain, such as fractures or hernias, may need surgical repairs. If your hip pain persists, talk to your doctor about the possible causes and treatments.