Today we’re going to talk about hip pain! Many of you have been asking questions about this topic, so let's dive in! One of the first questions most want to start with is: What have you been diagnosed with?
What have you been diagnosed with?
A lot of hip pain diagnoses are generic and/or incorrect altogether. It’s best to get a diagnosis from your doctor, but also make sure that you see your PT so they can determine where your pain is coming from.
There's good news though. You don’t have to have a diagnosis to see a PT! In the state of Georgia you can come off the streets, into a doctor of physical therapy’s office, and see a PT for 21 days before you need to go see a medical doctor. You can get PT started and treatment to head in the right direction (using direct access). Hopefully then you can feel better in those 3 weeks and not even have to see a medical doctor. Fortunately, everyone has the right to direct access, it is slightly different state to state though, so make sure to check with your PT first.
Where does it hurt? What's the pain like?
These two questions will help your PT determine what type of injury you have and how to treat it. Where do you hurt? Does the front or lateral portion of your hip hurt? Is it in your butt? Does it travel down your leg? Do you have symptoms of general achiness? Sharp or pinching? What do your symptoms appear to you as? All of the answers to these questions direct your physical therapist on where your pain could be coming from.
For instance: pain in the front of the hip can be muscular or nerve related (coming from your spine). If you have pain in specific positions like when your legs are crossed or when weight-bearing, it could be arthritis or a muscle or tendon that is inflamed. If you're getting symptoms in your hip that travels down your leg it could be coming from a pinched nerve in your spine. When do your symptoms come about?
Once you’ve gone over all of those details, next is to discuss what may be involved. The first thing your hip pain could be coming from is your joint. You can have an arthritic joint. Arthritis is inflammation of your joint (your bones are inflamed per say). You have to find out why they’re degenerating or inflamed and how you can fix that problem. Sometimes arthritis is a normal degenerative process that happens as we age. Other times that process happens at a younger age or much faster than it should because other factors can be playing into it. A couple of diagnoses you can see with arthritis are osteoarthritis (OA), generic hip pain, or your doctor may give you more of a muscular diagnosis such as tendonitis, which are all very vague.
If you’re experiencing OA of your hip, you may present with decreased mobility in your hip joint. For example, you may not be able to bring your knees to your chest due to pain or cross your legs to tie your shoe. Those would all be signs of lack of mobility in that joint and it is important to get that mobility back. You can learn more about Osteoarthritis in my blog Osteoarthritis... is My World Over? What to Know About Arthritis. You can also be experiencing a tight muscle that’s limiting your motion, (such as your hip flexors or glutes). They can give you different symptoms in your hip that looks like OA but it’s actually muscular...more on muscles in a bit!
It’s important to remember that if you’re working with a PT for Osteoarthritis, they can’t reverse it. The degeneration is already there, but a PT can help it from getting worse and help decrease the inflammation so you can be more functional. While working with your PT the focus will be to determine where the problem is coming from and improve your ROM and strength.
Your physical therapist will also work on strength of the surrounding musculature to help support the joint which includes you participating in a home exercise program consistently. Homework time! Learn more about the importance of a home exercise program here.
Symptoms in your hip could also be coming from your spine. Either your spine or something outside your spine is pressing on the nerves. You might see symptoms down your leg or to your hip depending on where in the spine there is compression. It’s important to be specific when describing where your pain goes so the physical therapist can figure out where it’s coming from. For example, if you’re getting pain in your groin, that tells a PT that it's more of an upper level of your lumbar spine. If the symptoms go to your foot that is in the lower level of your lumbar spine.
When do those symptoms occur? Sitting, driving? Walking, standing? That shows me what’s going on in the spine and directs our treatment to relieve the nerve so you don’t get those symptoms. We can use our hands to open up the spinal segments as well as showing you ways to open up your spine with a stretch or a posture to give the nerve relief so that it can heal.
Muscular pain can be caused by a certain posture or a rotation that we do. If you think about how your office is set up (or any space that you use frequently), is everything placed on one side and you’re constantly twisting and turning to that side? Some of the more common muscles that can be affected are your hip flexor or psoas muscle (you can get to it from the front of your abdominal cavity), your piriformis in your buttocks, and other glute muscles. Once it is determined where your pain is coming from and which muscle, your PT can treat your hip pain. Treatment can include releasing these muscles, showing you how to stretch them and what postures to avoid so they don’t go back to being tight, and how to train your muscles to stay in these relaxed positions.
Get treatment today!
If you’re having hip pain now and not sure what direction to go in then you need to reach out to a PT! 😊 I provide treatment virtually, or I can come to your home if you’re in the Atlanta area. I will assess your mobility and where the pain is coming from and determine a plan. If you’re given a diagnosis of Osteoarthritis or told you need a hip replacement, I recommend seeing a PT first. Sometimes a replacement isn’t needed or can be postponed with the help of therapy.
If you have other questions about hip pain or would like to schedule an evaluation with me, you can request an appointment here!