Lateral hip pain, or pain on the outside of the hip, can significantly impact a person’s daily activities and overall quality of life. It is frequently caused by issues with muscles, ligaments, tendons, and other soft tissues surrounding the hip joint, although it is occasionally referred pain from other areas, such as the lower back. Understanding the most common reasons for lateral hip pain will enable individuals to effectively address their discomfort and pursue the appropriate treatment options.
One of the most common causes of lateral hip pain is greater trochanteric pain syndrome (GTPS), previously known as greater trochanteric bursitis. This condition may be associated with bursitis but can also result from gluteus tendon tears, often caused by traumatic injuries or wear and tear of the gluteus medius and minimus tendons over the greater trochanter bone.
Another frequent cause of hip pain is osteoarthritis, which is more likely to affect people over the age of 50, particularly females. Later, we will explore three additional reasons for lateral hip pain, helping you to better understand the origin of your discomfort and the potential solutions to alleviate it.
Causes of Lateral Hip Pain
Trochanteric Bursitis
Trochanteric bursitis is a common cause of lateral hip pain, characterized by inflammation of the fluid-filled sac (bursa) near the joint at the outside point of the hip called the greater trochanter. This condition arises when the bursa becomes irritated or inflamed, leading to pain in the hip area.
This is most commonly noted with walking, stairs, and difficulty sleeping. Check out our post here for the best tips on sleeping greater trochantor bursitis.
Tendinitis and Muscle Strains
Lateral hip pain can also result from problems with tendons and muscles surrounding the hip joint. Tendinitis, which is the inflammation and degradation of tendons, and muscle strains are both common causes of discomfort in this area. These issues originate from overuse, improper movement, or a sudden increase in physical activity, leading to pain in the outer hip, upper thigh, or buttock.
Hip Osteoarthritis
Osteoarthritis is a degenerative joint disease that affects the cartilage in the hip joint, causing pain and stiffness. Hip osteoarthritis can manifest as lateral hip pain due to wear and tear on the joint, which worsens over time. This condition typically affects older individuals and can lead to limited mobility and reduced quality of life.
Femoroacetabular Impingement
Femoroacetabular impingement (FAI) is a condition where the hip joint bones have an abnormal shape, causing them to rub together during movement. This friction can damage the joint and lead to pain in the lateral hip area. FAI is often associated with labral tears, which are injuries to the cartilage lining the hip socket.
Greater Trochanteric Pain Syndrome
Greater trochanteric pain syndrome is a common cause of lateral hip pain, affecting the tendons and muscles around the greater hip trochanter. Previously referred to as greater trochanteric bursitis, this syndrome may be associated with tendonitis or muscle strains. It is characterized by chronic pain and tenderness in the outer hip region.
By understanding these various causes of lateral hip pain, healthcare professionals can better diagnose and treat patients experiencing discomfort in the hip area.
Risk Factors and Contributing Factors
Several risk factors and contributing factors can lead to lateral hip pain. Some of the main factors include:
- Overuse: Activities that involve repetitive motions or excessive strain on the hip joint, such as running or playing sports like soccer, can lead to overuse injuries. These can cause conditions such as bursitis and tendonitis, common sources of outer hip pain.
- Athletes: Individuals who participate in high-impact sports or regular vigorous physical activity are at a higher risk of experiencing lateral hip pain. Soccer players, runners, and other athletes who place continuous stress on their muscles, tendons, and hip joints are particularly susceptible.
- Obesity: Excessive weight puts additional pressure on the hip joint, which can contribute to inflammation and pain in the lateral hip area. Maintaining a healthy weight can help to reduce strain on the hip joint, thus lowering the risk of developing hip pain.
- Traumatic injury: Injuries sustained during sports or accidents can lead to lateral hip pain. Common injuries include hip fractures, hip labral tears, and sprains.
- Women: Women are at a higher risk for lateral hip pain due to anatomical differences and hormonal factors. The wider pelvis in women can cause additional stress on the hip joints, leading to hip pain. Moreover, women are more prone to osteoporosis, which can increase the likelihood of hip fractures.
- Hip fractures: Hip fractures are more common in older adults, particularly those suffering from osteoporosis. A hip fracture can cause severe pain and inflammation in the lateral hip area.
- Osteoporosis: This condition leads to weakened bones, making them more susceptible to fractures. As mentioned earlier, older adults with osteoporosis are at a higher risk for hip fractures, which can result in lateral hip pain.
- Hernia: An inguinal hernia can cause pain around the hip joint and, in some cases, may be mistaken for hip pain itself. Hernias occur when a part of the intestine protrudes through a weak portion of the abdominal wall, causing discomfort in the groin and hip areas.
- Sciatica: Sciatica is a condition resulting from the compression or irritation of the sciatic nerve. Though it mainly affects the lower back, buttocks, and legs, sciatica can also cause pain in the hip area.
Understanding the risk factors and contributing factors for lateral hip pain can help individuals make informed decisions about prevention and treatment options.
Diagnosis of Lateral Hip Pain
Physical Exam
A thorough physical examination is essential for diagnosing lateral hip pain. During the exam, the healthcare provider will assess the patient’s range of motion, palpate the hip and surrounding areas, and check for signs of inflammation or injury. Special tests, such as the FABER test (Flexion, ABduction, and External Rotation), may be performed to identify specific causes of pain, such as greater trochanteric pain syndrome or iliotibial band syndrome 1.
X-Rays
X-ray imaging can be useful in identifying underlying issues contributing to lateral hip pain. This may include detecting any arthritis, fractures, or joint dysfunction in the hip 5. Additionally, X-rays can help rule out other conditions that may be causing pain, such as a pelvic or femoral neck fracture.
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) may be utilized when the cause of lateral hip pain remains unclear after a physical exam and X-rays. MRI provides a more detailed view of the soft tissues and can identify tears in the gluteus medius and minimus muscles and possible bursitis or tendon issues 3. This imaging modality can also help assess any underlying abnormalities contributing to the pain, such as hip impingement, labral tears, or stress fractures.
It is important to note that the selection of diagnostic methods depends on the patient’s clinical presentation and history. Additionally, a combination of these approaches may be needed to accurately diagnose the cause of lateral hip pain and determine the most appropriate treatment plan.
Treatment Options for Lateral Hip Pain
Physical Therapy
Physical therapy is often a cornerstone of treating lateral hip pain. A physical therapist can help identify the underlying cause and design a specific treatment plan. This may include manual therapy, load management, and exercises to improve the strength and flexibility of the hip muscles1.
Strengthening Exercises
Incorporating strengthening exercises into a treatment plan can help alleviate lateral hip pain by improving hip muscle balance and support for the joint. These exercises commonly target the gluteus medius and gluteus minimus muscles, contributing to hip stability and control2. Examples of strengthening exercises include:
- Clamshells
- Side-lying leg lifts
- Standing hip abductions
Stretching Exercises
Performing stretching exercises can help reduce muscle tightness and improve hip mobility. Stretching may target muscles such as the hip flexors, hamstrings, and iliotibial band. Some recommended stretches include:
- Pigeon stretch
- Lying hamstring stretch
- Standing quadriceps stretch
Heat Therapy
Heat therapy can relieve lateral hip pain by reducing muscle tension and improving blood flow to the affected area. Patients can use a heating pad or warm compress for 15-20 minutes at a time.
Is Ice or Heat Better for Hip Pain
We prefer using heat in almost all situations of lateral hip pain. Heat brings blood to the area and allows the necessary repair process to continue.
Using ice has been shown to delay healing and is not as good as we originally thought at decreasing swelling. The one benefit of ice is that it does numb the area, which can help with severe pain.
Self Massage
Self-massage, using tools such as foam rollers, massage balls, or massage guns can help alleviate muscle tightness and promote tissue healing. By applying gentle pressure to tight muscles and trigger points, patients may experience reduced pain and improved range of motion4.
In addition to these treatment options, the management of lateral hip pain may also involve the following:
- Rest and activity modification: Limiting activities that aggravate the pain, such as walking or sitting for extended periods, can help the hip recover5.
- Anti-inflammatory medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help control pain and inflammation6.
- Injections: In some cases, corticosteroid injections may relieve pain for a short period; however, long-term use could potentially damage the tendons and tissues7.
- Surgery: Surgical intervention is usually considered only if conservative treatments have not provided satisfactory results8.
Prevention and Lifestyle Changes
Incorporating several practices in daily routines can be beneficial to prevent lateral hip pain and promote a healthy lifestyle.
Strengthening Exercises
One important aspect of prevention involves incorporating strengthening exercises. Engaging in exercises that target hip muscles helps maintain stability and alleviate stress on the hip joint. Examples include:
- Glute bridges
- Clamshells
- Lateral leg raises
Exercise Modification
Modifying exercises to reduce the risk of injury is also essential. Swimming, for example, is a low-impact activity that may help treat hip pain by providing resistance without stressing joints ([source]).
Riding a stationary or regular bike is also a great way to exercise without putting more pressure on the outside of the hip.
Maintain a Healthy Weight
Maintaining a healthy weight can reduce hip pain by limiting extra pressure on joints. A balanced diet and regular exercise are important factors in weight management.
Avoid Prolonged Sitting or Standing
Prolonged sitting or standing can contribute to hip pain. To minimize discomfort, try to change positions frequently and incorporate brief walking breaks into daily activities.
Address Tears and Inflammation
Recognizing and addressing any existing issues, such as a labral tear or bursitis, is crucial in preventing further damage and reducing pain ([source]) ([source]).
Incorporating these lifestyle changes and preventative measures can help reduce the risk of lateral hip pain and encourage healthier habits. Practice consistency and moderation in activities to ensure long-term benefits.
Conclusion
Lateral hip pain can be a frustrating and debilitating condition that affects many people. However, with the right diagnosis and treatment, it is possible to alleviate the pain and get back to normal activities.
Whether the pain is from bursitis, Osteoarthritis, impingement, or glute tendinopathy, it’s important to address the causes and treat them sooner than later.
Check out some of our other posts regarding lateral hip pain for more details on strengthening, stretching, and other great ways to treat lateral hip pain.
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