The hip is a highly complex structure and is often misdiagnosed and confused with low back pain. Commonly may range from very mild to completely debilitating to the patient. It requires an x-ray investigation and full physical assessment to diagnose and treat accurately.

1) IT Band dysfunction

Iliotibial band syndrome is where a tendon called the iliotibial band gets irritated or swollen from rubbing against your hip or knee bones. The tendon is on the outside of your leg and goes from the top of your pelvic bone down to your knee. It rubs against your bones when it gets too tense (tight). There are many reasons why your iliotibial band might be painful. The problem may arise from the hip and or knee due to overuse or abnormal running and walking patterns. Good exercises habit consisting of stretches and correction of footwear usually work with these cases.

2) Hip Impingement

Femoroacetabular impingement (FAI) is a condition in your hip or hips that may cause hip pain, leg pain, and limited overall mobility. The pain from FAI may prevent you from performing your normal work or recreational activities. Identification of the cause and exercise prescription works with a majority of the patients.

Working with a physical therapist can help you regain your range of motion and strength and improve your mobility. Strengthening and stretching exercises are vital to recovering from FAI. A physical therapist can map out an exercise routine for you.

3) Piriformis syndrome

Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain). The sciatic nerve runs just adjacent to the piriformis muscle, which functions as an external rotator of the hip. Hence, whenever the piriformis muscle is irritated or inflamed, it also affects the sciatic nerve, which then results in sciatica-like pain. The diagnosis of piriformis syndrome is not easy and is based on clinical history and presentation. Other conditions can also mimic the symptoms of piriformis syndrome including lumbar canal stenosis, disc inflammation, or pelvic causes. Therefore you need to be assessed and treated by a trained physiotherapist. Surgery can usually be avoided by stand-alone physiotherapy.

4) Bursitis

A bursa is a fluid-filled sack that decreases shear forces between tissues of the body. Trochanteric bursitis (inflammation of a bursa) is caused by excessive stress on the bursa between the IT Band and the greater trochanter. Signs and symptoms include pain over the outer aspect of the hipbone, which often is exacerbated when lying on the affected side, standing on the affected leg, or excessive walking. Treatment often includes rest, ice, and compression; physical therapy, including stretching and progressive strengthening, and steroid injection may be helpful.

5) Labral tear and groin pain

This injury usually occurs in sports where cutting, side-stepping, or pivoting are required. Often, there is a forceful separation of the legs or twisting of the toe outward. Signs and symptoms include pain and tenderness in the inner thigh region.

6) Hip Arthritis

Osteoarthritis of the hip occurs when the cartilage coverings on the ball (the head of the femur) and the socket (the acetabulum) wear out. It is worse when you bear weight on the affected limb. Range of motion is often limited especially internal rotation and hip flexion. Recent studies have demonstrated that physiotherapy, including joint mobilisation and stretching, can result in significant pain relief.

7) Post-surgery (Hip replacement)

For some osteoarthritic hip joints and femur fractures, the only option is a total hip replacement. Both (the head and neck of the femur) and the socket (the acetabulum) are replaced. You will receive physical therapy in the hospital. Recent research suggests that patients can gain significant strength and improve balance skills with additional outpatient physical therapy.

8) Fracture of hip

A bad fall or blow to the hip can break (fracture) the thigh bone, typically around the femoral neck region. If the broken bone does not heal properly, the joint may slowly wear down. Blood flow through the femoral head may be restricted or cut off, leading to the necrosis of the joint.

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