What Other Symptoms and Signs May Accompany Hip Pain?

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DR. SUNIL RAJAN
Head of Department Apollo Institute of
Orthopaedics, Apollo Hospitals, Indore M.S
Orthopedics, Specialization Joint Replacement
Surgery
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What Other Symptoms and Signs May Accompany Hip
Pain?
Hip pain is often difficult to describe, and
patients may complain that the hip just hurts.
The location, description, intensity of pain,
what makes it better, and what makes it worse
depend upon what structure is involved and the
exact cause of the inflammation and injury.
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Pain from the hip joint may be felt anteriorly
(in front of the hip) as groin pain, laterally
over the greater trochanter (the outer aspect of
the hip), or posteriorly in the buttock.
Sometimes the patient may complain of knee pain
that has been referred from the hip. This is
especially true in children.
Trauma to the hip With a fall, direct blow,
twist, or stretch, the pain is felt almost
immediately.
Overuse injury The onset of pain may be delayed
by minutes or hours as inflamed muscles
surrounding the hip joint go into spasm or joint
surfaces become inflamed, causing fluid
accumulation. Overuse injuries may also cause
cartilage, labrum, or capsule damage, resulting
in inflammation, pain, and limping. Hip labrum
tears may also cause clicking, catching, or a
locking sensation in the hip, in addition to pain
and decreased range of motion.
Pain Most often, pain is felt in the front of
the hip, but the joint is three-dimensional. Pain
may be also felt along the outside part of the
hip or even in the buttock area.
Limp Limping is the body's way of compensating
for pain by trying to minimize the amount of
weight the hip has to support while walking.
Limping is never normal. Limping produces
abnormal stresses on other joints, including the
back, knees, and ankles, and if the limp
persists, these areas may also become inflamed
and cause further symptoms.
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Fracture With a hip fracture, there is an acute
onset of constant pain after the injury that
usually is made worse with almost any movement.
The muscles that attach to the hip cause the
fracture to displace, or move, and the leg may
appear shortened and rotated outward. If no
displacement occurs, the leg may appear normal
but there is pain with any range of motion of the
hip joint and with attempts at weight bearing.
Pelvic fractures may have pain similar to a hip
fracture, but the leg appears normal.
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Sciatica pain Pain from the sciatic nerve tends
to start in the lower back and radiate to the
buttocks and to the front or side of the hip. It
may be described in different ways because of
nerve inflammation. Some typical descriptive
terms used for the pain of sciatica include
sharp, stabbing, or burning. The pain of sciatica
may be made worse with straightening the knee,
which stretches the sciatic nerve and may make it
difficult to stand from a sitting position, or
walk with a full stride. There may be associated
numbness and tingling in the leg or foot.
Physical examination may be able to map out which
nerve root from the spine is involved.
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Arthritis If arthritis narrows the hip joint and
impinges the femoral head's gliding motion within
the acetabulum or if there is a tear in cartilage
or labrum, the patient may describe a click,
catch, or feeling that range of motion is somehow
impeded. Usually, there is pain almost
immediately that does not get better as activity
continues.
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Pain from arthritis tends to be worse after a
period of inactivity and gets better as the joint
"warms up" with use. Hip arthritis often causes
pain at night. However, as activity increases,
the pain will return.
Bone cancer Cancer that arises primarily in bone
or is metastatic, having spread from another site
in the body, can cause intense, constant pain. It
is often not related to activity and not made
better with rest. Its location and radiation
(where the pain spreads) may depend upon the
location of the cancer within the hip or pelvis
and what neighboring structures are involved or
irritated.
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