What Causes Hip Pain and Why

April 26, 2024 4:21 pm

Categorised in: ,

What Causes Hip Pain and Why Does It Radiate Down Your Leg?

Hip pain comes in many forms. Similar to shoulder pain, knee pain, and back pain, there’s no one-size-fits-all treatment for it. You can get hip pain when you sit or run. It can manifest in your buttocks, at your hip joint, or in the front near your groin.

Sometimes different types of hip pain overlap with one another, like hip flexor pain with snapping hip syndrome. And sometimes pelvic pain, such as endometriosis and pelvic inflammatory disease, can have similar symptoms that overlap with other types of hip pain.

This makes diagnosis tough and treatments could be a trial-and-error process, which can be costly and painful—physically and emotionally. Instead of blaming a “tight” muscle, a pinched nerve, osteoarthritis, and a ton of other factors that may cause hip pain, let’s take an in-depth look at some of the common causes.

What causes hip pain?
Different types of hip pain can produce similar symptoms. To pinpoint exactly what you may have, your healthcare professional will likely rule out more common and serious conditions while reviewing your health and lifestyle history.
Some types of hip pain stem from the hip joint where inflammation occurs, or it could be an irritated nerve deep in your buttocks. In some cases, hip pain can travel down to your leg and foot (or vice versa) where the symptoms manifest, which can be mistaken for another cause of pain.

As Massage therapists we are taught to do a subjective history of the patient. With that information we break hip pain down based on where the patient points to their pain, where they describe their pain, and what structures are in that area or referred to that area.

Osteoarthritis is the most common source of pain. Anterior hip impingement and labral could be a cause of front hip pain, and that type of pain can radiate down to the knee. Degenerative changes in the hip joints are very common, it is just a matter if they are causing pain or not.

Gluteal tendinopathy
Gluteal tendinopathy is a broad term that includes pain and inflammation of the tendons of the gluteus medius and minimus. It often occurs in older people, particularly in occupations that require sitting for long periods of time.
Pain from gluteal tendinopathy usually occurs in the lateral hip area by the greater trochanter of the femur. Similar to hip arthritis, gluteal tendinopathy can start as a subtle, nagging pain that gradually worsens over time.

Piriformis syndrome
The symptoms of piriformis syndrome are similar to sciatica. Unlike sciatica, this condition is often not associated with spinal problems. Patients with piriformis syndrome typically report deep pain in the buttocks that may radiate down into the back thigh.

While many case of this condition tend to be from the irritation of the sciatic nerve against the piriformis muscle, not every case may stem from this cause because some people may have different branching of the sciatic nerve in relation to the piriformis and other gluteal muscles.

Hip flexor pain
Compared to other types of hip pain, there is less research about hip flexor pain, which makes it difficult to diagnose and treat. Sometimes the pain is not from the psoas or iliacus but from visceral pain, such as appendicitis and diverticulitis.

Symptoms of hip flexor pain overlap with other types of groin pain, which can be mistaken for pain in the psoas. The psoas muscles lie deep from the skin. Thus, “digging” deep into the muscle can be uncomfortable for many people and may worsen their hip pain.

Sciatica
Sciatica is the radiating pain that tends to “shoot” down the leg and sometimes into the heel of the foot. While it tends to affect one side of the body, sciatica is sometimes caused by the irritation of the sciatic nerve in one side of the hip.

Oftentimes, the piriformis muscle is to blame, but there are multiple causes of sciatica where some of them are less obvious. Sometimes the pain can last for days or weeks, and sometimes it “happens” without warning. But the good news is: sciatica does go away on its own most of the time.
Iliotibial band syndrome

Too much friction between the iliotibial band (IT band) and the lateral knee or the thigh muscles are often blamed for iliotibial band syndrome. This usually happens to those who engage in prolonged repetitive movements in the legs, such as runners and cyclists.

While many massage therapists suggest that the IT band should be massaged and “softened,” pain research and current understanding of the IT band suggest that “deep tissue” work may not be the answer, but there are alternatives to alleviate IT band syndrome. ‘’

Sacroiliac joint pain
Sacroiliac joint pain (SI joint) can often feel like low back pain or an achy hip pain in the upper buttocks. The SI join can become stuck and the muscles surrounding the joint tighten up. Massage can help ease those muscles so the joint will glide better.

Leg-length discrepancy
Leg-length discrepancy is divided into anatomical and functional, where the “anatomical” refers to the physical differences of leg length while “functional” refers to movement patterns that cause the shortening of one limb.
Having an uneven leg length is thought to be a cause of hip pain and back pain. Like most kinds of pain, it often stems from multiple factors rather than just one cause of pain. Pay attention to daily repetitive tasks such as sitting on the couch or how you get into the car for clues to the cause.

What causes hip pain that radiates down the leg?
There are a few different things that can cause pain radiating down the leg. If the pain is mostly in the back of your leg, the first thing to make sure is that the pain isn’t coming from the spine. Get an x-ray to rule out nerve irritation or radiating back pain from the lumbar spine.

Soft tissues around the hip may radiate down the leg. If there’s too much load demand from the glute muscles, that may cause radiating posterior leg pain. Every time you step, it could be hip pain from your gluteus minimus or glute medius.

Another cause may be Stenosis, which is the narrowing of the opening where the nerves come out of the lumbar spine. Hamstring injuries may cause radiating down the leg, but it’s more likely from high-force injury than low-loading activities like walking.

How to relieve hip pain?
Because there are many types of hip pain and symptoms that overlap with other body parts, such as reproductive organs and lower back, there’s no single method that can treat all hip pain.

Besides the typical recommendations, like pain medications, surgery, and physical therapy, there are some contributors of hip pain and other types of joint and muscle pain that are influenced by your environment. How old are your shoes? Do you sit for long periods of time in the car? How do you sleep? Do you always cross one leg over the other?

Massage therapy for hip pain may help alleviate some pain and help you move better in the short-term, but some types of hip pain, as well as the individual differences each person has, may require the therapist to approach each case uniquely and may not be effective on the first try.

Does exercise for hip pain work?
While exercise in general has been shown to help reduce back pain and disability, there’s some evidence that it can help with some types of hip pain. Stretching the hamstrings and strengthening the glutes can often help, especially with Gluteal tendinopathy or SI joint pain.

Hip pain is difficult to diagnosis. It may take several tries to find the cause and determine the right treatment. Pay attention to specifically where the pain is, when you feel it and look for any daily activities that seem to aggravate it so your therapist can make an informed assessment.

Will Massage help with Hip Pain?
Massage therapy might not be your first choice of treatment, and it shouldn’t serve as your primary treatment for hip issues. However, it can be an invaluable tool in relieving inflammation and pain. Targeted, therapeutic massages have two primary benefits: stimulation and relaxation. The best type of massage for hip pain relief is a combination of deep tissue massage, myofascial release, and trigger point therapy. Deep tissue massage helps to reduce inflammation and improve circulation, while myofascial release helps to loosen tight muscles and fascia.

As always, consult with your healthcare provider for the best treatment and your personal guidance.

Body & Soul Massage in Salem Ma offers Therapeutic Massage for Pain Relief. For more information call 978-825-0040 or visit www.bodysoulsalem.com