Chronic Hip pain is not nearly as common as knee or back pain, but it still impacts much of the population and it can be quite debilitating – especially when it doesn’t go away.
People routinely report hip pain in the side of their hip and in their groin. They may even complain that it radiates into their back and down their thigh. When hip pain goes unresolved, it impacts your ability to walk, hike, play golf, squat, bear weight on one leg, and even sleep on your side through the night.
The big question, though, is why does it go away for some and persist for others?
If your hip pain isn’t going away – here are three reasons why:
1. You’ve been mis-diagnosed
This is the most common reason why hip pain doesn’t go away. Just about everyone I see in my office with hip pain tells me they’ve been diagnosed with “hip bursitis”, when in reality, only 15% of women and 8% of men have true hip bursitis.
Hip bursitis occurs when you have inflammation of the bursa on the side of your hip. It’s typically caused by blunt trauma to your hip, or overuse/imbalance of the musculature there. It’s actually extremely easy to resolve so if your hip pain is persisting, this is likely not the reason.
Another reason for chronic hip pain is a gluteal tendon injury. Just like our Achilles tendon in the ankle and the patellar tendon in the knee, the gluteal tendon can similarly become irritated and need re-conditioning. This happens with gradual weakness in the glutes.
The other common mis-diagnosis I see is that your chronic hip problem is actually coming from your lower back. If you’ve got radiating pain into your thigh, you must always rule out that it’s not coming from your spine.
Because if it is – and you don’t address it – your hip pain will never go away.
To learn more about what’s causing your hip pain, read this blog post.
2. You’ve got the wrong treatment approach
If you’ve got the right diagnosis and the right treatment then your hip pain should go away. If not, then we need to consider the treatment approach. The most common mistake I see with hip pain treatment is implementing too much muscle stretching and not enough joint mobilization and strengthening. The hip joint is one of the most mobile joints in our bodies and needs to stay that way.
Because of that, it seems obvious we need to stretch.
Many patients will tell me, “but Nick, I stretch and I stretch, how can my muscles be so tight?”
The problem with this is the muscles are tight because they are weak and being overloaded causing damage to the tendons which limits the muscle and tendon elasticity.
This doesn’t mean we abandon stretching.
Having optimized mobility in your hip joint is paramount. Without good, adequate mobility, your muscles will struggle to function as well as they can, and this will impact strength. I have a saying in my office: “lengthen before you strengthen”. This means we work to open stiff joints through a combination of mobilization techniques and light, specific stretching.
If you don’t check mobility first, you risk strengthening and stabilizing around a joint that isn’t moving as well as it could. This could be a reason why your hip pain isn’t going away.
Here is a link to our youtube channel with simple exercises to help with arthritic hip pain
3. You need a hip replacement
This is the last reason your chronic hip pain isn’t going away after you’ve tried everything else.
Your hip joint has become so arthritic and worn down that it’s time to get a new one. If you remember my last email about the 4 degrees of arthritis, this is the 4th degree.
But here’s the thing to keep in mind, whether or not you need a hip replacement should not be decided by your X-ray – it should be decided by your symptoms.
Far too many people rely on the “bone-on-bone” diagnosis from imaging to be the determining factor.
But there are hundreds of people walking around with fully functioning hips that have bone-on-bone and don’t need joint replacements yet.
When you need a new hip, the presentation is typically constant, unrelenting pain along with severely restricted mobility that has not responded to months of physical therapy or injections. In these instances, getting a new hip is going to be life-changing and it should have a significant impact on your hip pain.
If you’ve got hip pain that isn’t going away, I hope this article has given you some food for thought.
Approximately 70-80% of all musculoskeletal problems, including hip pain, can be resolved naturally and without relying on pills, procedures, or surgery.
If you’re not having success with getting rid of your hip pain, then it’s important to question what you’re doing and consider that something has been missed.
You deserve to live an active and mobile lifestyle doing all the activities you love.
Are you sticking around for the summer?
Find out if your joint tightness is caused by a muscular or capsular restriction.
Click HERE to schedule a Discovery Session to find out what to do next.
Dr, Nick’s greatest passion is seeing his patients recover from injury and return to their activities that bring them joy.
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