When I ask patients to point to their hip, I get a variety of locations. Some point to their buttock area, some to the outside part of their thigh, and some to their groin. Buttock pain is often due to spine problems such as osteoarthritis of the spine or disc problems such as a herniated disc in the spine. Pain on the outside of the thigh is typically due to hip bursitis, inflammation of the bursa sac on the outside of the hip. True hip pain manifests itself as deep groin pain which can extend down the front of the thigh to the knee. The most common cause of this type of pain is osteoarthritis, or wear and tear changes of the hip joint itself. Osteoarthritis of the hip can range from mild to severe and accompanying symptoms can vary as well. Mild pain can often be controlled with anti-inflammatory medications. These can either be over the counter (non-prescriptive) or require the prescription of a doctor. When taken on a daily basis, these medicines can help to keep the inflammation associated with arthritis to a minimum, thus reducing pain. More progressive arthritis can interfere with one’s ability to walk or participate in sports such as golf. A course of physical therapy may be helpful to strengthen the muscles around the hip, thus taking the force off the damaged hip joint and relieving pain. Sometimes, a cane or walker is needed to minimize the stress across the joint. Cortisone, a concentrated dose of anti-inflammatory medicine, can be injected directly into the damaged hip joint under image guidance. This medicine can provide months of relief of pain, allowing individuals to return to activities in a pain free manner and can be repeated several times a year as needed. In severe arthritis, often the only cure is hip replacement surgery. This surgery removes the worn out hip joint and replaces it with artificial components. Only you and your doctor can determine the etiology of your pain and the treatment regimen that is best for you!
Jennifer L. Cook, M.D.