Independence from Hip Pain this July: Part 1

Have you been suffering from hip pain for longer than you care to remember. Whether it’s a sharp pinch to the front of your hip when getting up from a chair, exercising, or on stairs to the dull ache that wakes you up in the middle of the night on the side of your hip, hip pain can be a maddenly difficult thing to overcome. What’s more, when you go to your GP or Urgent Care, all they seem to want to do is give you steroids and send you on your way(with a referral for a surgeon of course).  But now there are several natural options for sorting out hip pain naturally that avoids shots, surgery, or dangerous painkillers. In this article-we’ll dive into what’s going on at the hip when we’re dealing with hip pain, talk about some often-missed causes, and then look into what some natural options are for getting back to the active life you deserve. 

Sources of pain in the hip

Before we can really dive into sources of pain at the hip-we’ll have to divide the hip up into 3 main regions. Why? Because often the drivers of discomfort in these areas are entirely different and have completely different needs(some need mobility and stretching, some need strength and control, some need decompression).

Region 1: Hip Joint proper: 

Where and what is it? If you place your right(or left) thumb right where your leg bends at the hip, it is pointing right at the ball and socket joint that makes up your Femoroacetabular joint(aka your hip joint). The socket angles down off your pelvis(see pic to the right). Angling up and in is the head of your thighbone/femur. There’s a suction cup(your hip labrum) that holds it in the socket around the ball part of the femur. Several injuries are associated with the joint itself including hip arthritis, FAI(impingement), as well as a torn labrum. Pain in this area can be either sharp or dull and can stay right there or can radiate down your leg. On top of this are several muscles that attach right around the hip joint that can behave like a hip joint injury but really aren't. These muscles include your hip flexors that attach basically right at the joint line, inner thigh muscles that attach just inside of the hip joint(and can refer pain to the joint area) as well as some of your thigh muscles that start just above the hip joint. Any one of these muscle groups can mimic hip joint pain. In addition, several nerves go through the hip joint region and can be responsible for pain in this area including the femoral and obturator nerve(which can cause pain down the leg and up to the hip joint). What’s more, especially if you’ve had imaging of your hip is that many of the things they find on imaging are found in pain free people(and often interventions like shots are based on imaging findings and may miss the true driver of pain completely). In fact, over 50% of people with labral tears are completely symptom free. 

How to figure out the cause. 

First, before we do anything else, we have to figure out the hip pain’s pattern. Is it worse when I stand up but eases after a bit, does it get worse with distance walked, is it worse after doing certain things like bending over, does it pinch, burn, ache, stab? How long does that symptom last? Does it have a pattern(i.e. Gets better or worse even if it is always there). As a Physio, these are actually the most important questions because they reveal often hidden patterns in the pain that have very little to do with what the MRI says and more about how we can use movement to help you heal. Once we’ve figured that out, we’ve then got to test and make sure this isn’t coming from the low back. Often gentle stretches either backwards or towards the side of the pain can reveal if the back is part of the problem(and part of the solution). Why the spine? Well, in order for you to be able to feel your hip, all the nerves(our danger detectors), have to send messages to and through the spine for further processing. If I’ve got an issue where that nerve comes into the spine, then the nerve can become irritated and make it feel like all my pain is coming from the hip(this is one of the reasons why injections and surgery miss the mark when trying to fix the hip…it was actually the low back that was the problem).  Now, if your hip is better after doing the gentle stretches to the back, you may be on to the actual cause of hip pain(even if you’ve got imaging that says there’s a problem with the hip-we’ll get to that in a bit). What that means is that your hip is being sensitized by the back and that simply treating or doing things like surgery or shots won’t deal with the source of the problem.  Test, don’t guess: Book your complimentary Total Body Diagnostic Test

How to start easing “Hip joint proper” issues

Now that you’ve tried several gentle stretches for your back, retest the painful motion to your hip. Is it better, worse, or the same? If better, it doesn’t mean that there isn’t something going on with your hip along with your spine. It means that first you should see just how much of your hip problem is really your low back in disguise BEFORE treating the hip. If same, this doesn’t mean that the low back isn’t part of the problem, just that the movement you tried may not be right movement, may have not been done right, or may not have been taken as far as it needed to be, or lastly there may be something blocking the test(i.e. Pain, stiffness, etc…).  Is it worse? Believe it or not, this is actually a good thing. It means that the back is still impacting the hip AND that sorting out the RIGHT movement could be the fix for hip pain. 

What to do if the spine isn’t part of the problem: 

This is where it gets tricky and ruling out which structures are not part of the problem comes in. If your pain activates when you pick your leg up off the bed or pick your knee up in standing, we are more likely dealing with muscle/tendon issues while if pain is worse with passive movement, i.e. you have more pain when you passively move your leg, then we may be dealing more with joint based problems. 

At the clinic, one of the ways we test this is to find what movements actually provoke the pain(though we only use gentle movements to explore where it starts-we try really hard ot not fight pain with pain). 

Confused about where to start? Book a call from the comfort of your home or office and  on your schedule with one of our Chronic Pain Specialists. You can schedule your call here.  Need help now? Come by and talk with one of our Doctors of Physical Therapy at no charge. We offer FREE consultations, which give you the opportunity to come in and meet us and see for yourself how we can help you.

Here are just a few of the things you will learn in one of our free consultation:

• What is the underlying cause of your pain? (hopefully nothing too serious!)

• Roughly, how long will it take to fix the problem?

• What to do to help – which doesn’t include painkillers, resting or surgery etc.

• What other, natural, drug free methods are there to speed up recovery alongside treatment?

Our consultations are great for anyone that may be “unsure” if physio is right for them, and they give you the opportunity to ask questions and see for yourself if we can help you.

If you’d like one of our limited free consultation sessions, please click here to schedule your free consultation or CALL us on 850-765-2779 to make a no-obligation enquiry.

About the Author

Dr. Brandon is the owner and a Physio at Body Mechanix Physiotherapy and Fitness. Four of his favorite people call him daddy while he's been married to his other favorite person for 22 years. He enjoys teaching martial arts and is a Mestrando in Capoeira while in the mornings, he can be found working out with the guys in F3 around town.  He's the author of 4 pain relief guides for sciatica, low back, shoulder, and knees and the lead contributor to the Active Tallahassee Blog.