Pain in hip may be due to numerous reasons. The pain may be felt only at a single point on the hip or it may extend into the lower back or the leg. The pain may be intense or sharp or you may feel it as dull and achy. It may either be felt on one side or on both sides. It can be made worse by prolonged walking.
Causes of Hip Pain when Walking
It is the most common type of arthritis. It occurs due to gradual wear and tear of the protective cartilage cushioning the ends of the bones in the hip joint.
The various factors that increase the risk of OA are:
- Old age: The risk increases as you grow older
- Sex: The risk of OA is more in females
- Obesity: Carrying more body weight increases the risk as it puts more stress on hip joint. Additionally, certain proteins are produced by fat tissue that can result in harmful inflammation around the hip joint
- Joint injuries: Such as occurring during an accident or while playing sports
- Certain occupations that involve tasks which put repetitive stress on hip joint, may produce OA.
- Bone deformities: People born with deformed joints have an increased risk
The symptoms develop gradually over time. They include:
- Hip pain with walking
- Tenderness on applying even light pressure
- Stiffness of the joint particularly in the morning when you wake up
- Not able to move the joint fully or reduced flexibility of joint
- Grating sensation on using the joint
- Formation of bone spurs around the joint
You should visit your physician if you suffer from stiffness or pain in hip joint that does not feel better.
The aim of treatment is to manage symptoms using lifestyle modifications, medicines, physical therapy and surgery. Performing exercise and maintaining optimal weight are the most important methods to manage OA. Your physician may recommend:
- Medicines: Acetaminophen to manage mild to moderate arthritis pain. OTC NSAIDs such as ibuprofen and prescription NSAIDs may be given to relieve inflammation and pain. Cymbalta, an antidepressant given to treat chronic arthritis pain.
- Physical therapy: You can work with your physical therapist to create an exercise plan to strengthen the joint muscles, reduce pain and increase the range of motion of your joint. Gentle exercises such as walking or swimming done regularly are also equally effective.
If pain is not relieved by conservative treatments, cortisone injections are given in the affected hip joint. In hip joint replacement surgery, the surgeon replaces the damaged surfaces of the joint with metal and plastic parts.
This is another problem that can lead to hip pain when walking. It is characterized by inflammation of the bursa situated on the outside of the hip.
Causes of Trochanteric bursitis:
- Overuse injury of the hip joint. Adults who are active and who regularly run, walk or cycle are prone to get this condition
- Poor posture
- Complication of hip surgery
- Muscle tears
- Injuries to the hip
- Disease including gout
- Rheumatoid arthritis
- Pain situated at the outer portion of the hip, which is made worse by moving downstairs
- Stiffness of hip joint
- Tenderness of the bursa
- Swelling and redness of the area
- Fever in extreme cases
You should visit a physician if you experience these symptoms for greater than two weeks without any improvement.
Trochanteric bursitis usually gets better gradually by itself. Conservative measures including taking rest, applying ice to the affected area and taking an OTC painkiller can ease the pain. If your condition is not improved by conservative measures alone, you may need:
- Medicine: If inflammation is caused due to an infection, you may be prescribed an antibiotic.
- Physical therapy: It is used for strengthening the muscles of the affected area to relieve pain and discomfort.
- A corticosteroid injection may be given in the hip joint to relieve inflammation and pain. You may require an assistive device such as a walking cane temporarily to relieve pressure on the hip joint.
Another cause of hip pain when walking is hip fracture. It is a serious injury that has life-threatening complications. The risk of a fractured hip increases with age due to presence of osteoporosis in the elderly. Poor vision, balance problems and multiple medicines also make the elderly prone to fall easily, which is the most common cause of a fractured hip.
Hip fractures can occur in people of any age group by a severe injury such as in a car accident. In the elderly, it is most often caused due to a fall. In persons whose bones are very weak, hip fracture may occur just by standing and twisting the leg.
- Unable to move post a fall
- Pain (severe) in the groin or hip
- Unable to put pressure or weight on the leg of your injured side
- Bruising, swelling and stiffness around and in the area of the hip
- Shortening of the leg on the side of the injured hip
- The leg on the side of the injured hip turns outwards
You may remain immobile due to hip fracture for a long duration; hence, the complications are:
- Blood clots in lungs or legs
- Infection of the urinary tract
- Loss of muscle, raising your risk of further falls and trauma
Treatment is usually a combination of medicine, surgery and rehab.
- Surgery: The surgery type depends on the severity and location of fracture, whether fracture is displaced or not and your overall health and age. The options are partial or total hip replacement or internal repair utilizing screws.
- Rehab: The focus of physical therapy is on strengthening and range of motion exercises. After you recover from the surgery, an occupational therapist may work with you to make you learn techniques to get independent in routine life such as bathing, using toilet, dressing, cooking etc.
- Medicine: Around 20% of persons who get a hip fracture suffer from another fracture within 2 years. Bisphosphonates are given to decrease the risk of recurrent hip fracture.
Sciatica is another cause of hip pain when walking. It is characterized by pain which radiates on the path traversed by sciatic nerve. Sciatic nerve originates from lower back and branches to go into the hips, buttocks and then down the legs.
It occurs when a bone spur present on the vertebrae, a herniated disc or spinal stenosis compresses the sciatic nerve.
Pain radiating from lower spine to the buttock down the back of leg is main symptom of sciatica. The pain may range from aching to sharp, burning to excruciating pain. Pain is usually present on one side. It may be associated with symptoms of tingling, numbness and weakness of muscles in the foot or leg that is affected.
Mild pain usually gets better with time. If pain is not better your physician may suggest the following:
- Medicines: These include anti-inflammatories, narcotics, muscles relaxants, anti-seizure medicines and tricyclic antidepressants.
- Physical therapy: After the improvement of acute pain, you can undergo physical therapy and do exercises to improve your posture, flexibility and strengthen muscles of your back.
- Injections: Your doctor may inject corticosteroids into the area surrounding the nerve root involved to decrease pain by reducing inflammation.
- Surgery is reserved for cases in which there is loss of control of bladder or bowel, significant weakness or severe pain that doesn’t get better. During surgery, the part of herniated disc or bone spur that’s compressing the nerve root is removed.