Think that hip pain is bursitis? Think again.

Pain on the side of your hip is more likely from tendinitis, tight muscles, or another condition.

 Image: © Jan-Otto/Getty Images

Hip bursitis — an inflammation between your thighbone and nearby tendons — is commonly diagnosed when patients have pain on the outer side of the hip. However, several other conditions can cause similar pain, and require different treatments. “Doctors often assume that pain on the outer side of the hip is due to bursitis. But 90% of the time, it’s not bursitis,” says Dr. Lauren Elson, a physiatrist with Harvard-affiliated Massachusetts General Hospital.

What’s causing the pain?

Dr. Elson says pain in the side of your hip most often results from one of the following conditions:

Tendinitis. This is an inflammation of the tendons (fibrous bands of tissue) that connect the gluteal muscles in your buttocks to the hip bone. “Tendinitis develops because of muscle imbalance. It could be from a lack of activity, crossing your legs, or even sitting on a wallet,” Dr. Elson says.

Overuse injury. When you walk or run, weak hip and buttock muscles can tighten and irritate the iliotibial (IT) band — a long band of connective tissue that runs from the knee to the hip. It merges with the gluteal muscles to stabilize the leg.

Tight muscles in the buttocks and hip. If the gluteal muscles and IT band are too tight, they pull at the thighbone where they attach, and that causes pain on the side.

Spine problems. “The body isn’t always smart in recognizing where the pain is coming from,” Dr. Elson explains, “and spine arthritis, a pinched nerve, or bones in the spine rubbing together can create pain in the side of your hip.”

Symptoms and diagnosis

With all of these conditions, the pain lingers or even worsens when you lie on your side, or when you sit and cross your legs. It may ease with activity. But left untreated, the pain can become so severe that you’re unable to walk.

You may need to seek treatment from a primary care physician or specialist (such as a physiatrist, sports medicine specialist, or physical therapist) who can interpret your symptoms and imaging tests to determine the cause of pain on the side of your hip.

Starting your treatment

The good news: “Pain almost always goes away with targeted exercise and stretching,” says Dr. Elson.

She typically recommends massage and a course of physical therapy, which focuses at first on easing tight tissues by stretching them. These include the hip flexors, the IT band, and the piriformis muscles in the buttocks.

It’s also important to avoid habits that can tighten muscles and add to pain at the side of the hip, such as crossing your legs or sitting too long.

Strengthening the muscles

Along with improving flexibility, physical therapy sessions aim to strengthen the abdominal or core muscles, such as the transversus abdominis muscle. “This helps align the pelvis better, so you won’t stress the hip when you stand or walk. Stronger abdominals also support your spine,” explains Madhuri Kale, a physical therapist at Harvard-affiliated Brigham and Women’s Hospital.

With a stronger core, you can then move on to strengthening the muscles at the hip that let you move your leg in various directions. “We may have you do side or back leg lifts, performed while standing, with a resistance band. And clamshells are also helpful,” Kale says. You do this exercise by lying on your side with your knees bent and raising and lowering only your top knee while keeping your feet together.

In time, you can restore balance to the body and reduce pain. “Pain comes on because of an imbalance from tight or weak muscles,” Dr. Elson says. “If you can restore balance, you can help the body function better and eliminate pain.” For more information, check out the Harvard Special Health Report The Joint Pain Relief Workout (/jprw).

5 Common Causes of Hip Pain in Women

Does your hip hurt? As with other types of chronic pain, women tend to experience it more than men. But because hip pain can have a number of different causes, determining the correct one is the key to getting the best treatment.

The Diagnosis: Is It Your Hip?

When you tell your doctor your hip hurts, the first thing she should do is confirm that your hip is actually the problem. Women might say they have hip pain, but what they may mean is that they have pain in the side of the upper thigh or upper buttock, or they may be experiencing lower back pain, says Stephanie E. Siegrist, MD, an orthopedic surgeon in Rochester, New York, and a spokeswoman for the American Academy of Orthopaedic Surgeons. Hip pain is often felt in the groin or on the outside of the hip directly over where the hip joint (a ball-and-socket joint) is located.

Causes of Hip Pain in Women

When a female patient comes to Dr. Siegrist complaining of hip pain, she considers the patient’s age, build, and activity level. If the patient is a thin 20-year-old runner or a heavy, sedentary 80-year-old grandmother, “the possibilities at the top of my list will be different,” she says.

Among the most common causes of hip pain in women are:

1. Arthritis Chronic hip pain in women is often due to arthritis, particularly osteoarthritis, the wear-and-tear kind that affects many people as they age. “The ball-and-socket joint starts to wear out,” Siegrist says. Arthritis pain is often felt in the front of your thigh or in the groin, because of stiffness or swelling in the joint.

2. Hip fractures Hip fractures are common in older women, especially those with osteoporosis (decreased bone density). Symptoms of a hip fracture include pain when you straighten, lift, or stand on your leg. Also, the toes on your injured side will appear to turn out, a sign that can aid your doctor’s preliminary diagnosis.

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3. Tendinitis and bursitis Many tendons around the hip connect the muscles to the joint. These tendons can easily become inflamed if you overuse them or participate in strenuous activities. One of the most common causes of tendinitis at the hip joint, especially in runners, is iliotibial band syndrome — the iliotibial band is the thick span of tissue that runs from the outer rim of your pelvis to the outside of your knee.

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Another common cause of hip pain in women is bursitis, says Marc Philippon, MD, an orthopedic surgeon in Vail, Colorado. Fluid-filled sacs called bursae cushion the bony part of the hip that is close to the surface. Like the tendons, these sacs can become inflamed from irritation or overuse and cause pain whenever you move the hip joint.

4. Hernia In the groin area, femoral and inguinal hernias — sometimes referred to as sports hernias — can cause anterior (frontal) hip pain in women. Pregnant women can be susceptible to inguinal hernias because of the added pressure on the wall of their abdomen.

5. Gynecological and back issues “Hip pain in women can have gynecological causes,” Siegrist says. “It’s important not to just assume that the pain is caused by arthritis, bursitis, or tendinitis. Depending on your age and other health issues, the pain in your hip could be coming from some other system.”

Endometriosis (when tissue similar to the uterus lining tissue grows outside the uterus) can cause pelvic tenderness, which some women describe as hip pain. Pain from the back and spine also can be felt around the buttocks and hip, Siegrist says. Sciatica, a pinched nerve, typically affects one side of the body and can cause pain in the back of the right or left hip — the pain from sciatica can start in your lower back and travel down to your buttocks and legs.

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Treatment Options for Hip Pain

Treatment for hip pain depends on the diagnosis, but pain that’s caused by overuse or sports injuries is often treated with heat, rest, and over-the-counter anti-inflammatory medication. To prevent injuries, it is important to stretch before exercising and wear appropriate clothing, especially good shoes when running, Dr. Philippon says.

If certain activities or overuse are causing hip pain, stop those that aggravate the discomfort and talk to your doctor. Excess weight can put pressure on the hip joint, so losing the pounds can provide relief and help you avoid further problems. Some causes of hip pain, such as fractures or hernias, may need surgical repairs. If your hip pain persists, talk to your doctor about the possible causes and treatments.

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Hip pain

There are many health conditions that cause hip pain. Some of them are congenital, others are formed with age. The causes of pain in the thigh can be infectious diseases, tuberculosis of the bone.

Most often, hip pain is associated with pain in the hip joint.

Causes of pain in the hip joint are:

• increased load on the joint,

• joint injury, overweight,

• hormonal disorders,

• metabolic disorders, age,

• genetic predisposition.

The most common diseases that give pain in the hip joint are coxarthrosis (arthrosis of the hip joint) and intervertebral hernia.

Nature of pain and development

1. In case of arthrosis of the hip joints, the earliest and most sensitive symptom of the disease is limited internal rotation with a flexed hip joint and pain in the hip. As a rule, the pain comes from the upper part of the thigh and gives to the knee, which is especially felt when walking. Often aggravated by standing on one leg (on the affected side). The mechanical rhythm of pain is characteristic, that is, their occurrence in the evening hours under the influence of daytime stress and subsiding during the night’s rest. Such pains indicate that there has already been a decrease in the depreciation properties of the cartilage and the osteoarticular surface to loads. At night, dull pains associated with venous stasis in the subchondral bone and increased intraosseous pressure may disturb. When walking, these pains usually disappear.

2. Secondary changes in the bone with subchondral sclerosis, osteophytes and narrowing of the interarticular space during the progression of the disease, in addition to pain associated with movement, cause joint deformity, limited range of motion, crunching, clicking sensation in the joint.

3. With a herniated disc in the lumbar spine, the pain in the joint is aggravated by exertion or movement (for example, rising from a sitting position, standing, walking, standing up on toes) and is felt primarily in the groin. However, it can radiate along the anterior and lateral surface of the thigh, into the buttocks, into the anterior part of the knee, and occasionally along the anterior surface of the lower leg up to the ankle joint. A prolapsed intervertebral disc can cause pain in the groin. The abrupt nature and aggravation on exertion (cough + additional pain in the back) allow us to establish its nature.

4. Trochanteric bursitis causes local pain and tenderness over the trochanter, sometimes radiating down the lateral surface of the thigh. It is especially painful when lying on a sore side. The pain of ischio-gluteal bursitis is felt mainly from behind and worsens when the patient is sitting.

5. Fibrosis of the articular capsule leads to compression of the nerve endings, which leads to pain during certain movements associated with the expansion of the capsule.

6. Constant pain during any movement in the joint can cause reflex spasm of nearby muscles. Tension in the groin is usually the result of a sports injury and is aggravated by standing on the affected leg.

Recommendations

For hip pain, great attention is paid to reducing the load on the joint. It is better to do housework in a sitting position, wash the floors only with a mop, and not tilt, the height of the chair and toilet should be sufficient, it is better to install handrails in the bathroom to make it easier to climb. The use of a cane in coxarthrosis can reduce the load on the vertical axis on the joints. The cane must be carried in the hand opposite the affected joint.

Treatment

In the treatment and rehabilitation center “ODA” a complex of therapeutic measures is used to relieve pain in the thigh. We influence all stages of the development of the disease.

1. Laser therapy has a powerful analgesic effect. Elderly people and patients for whom electrical procedures are contraindicated at the ODA Medical Exhibition Center can be offered magnetic therapy.

2. Joint traction on the ORMED computer bed. Joint traction is carried out in a dosed manner, 10-12 procedures are performed, during which the blood supply to the joint improves significantly, the interarticular gap increases.

3. Lithium electrophoresis stimulates cellular immunity, increases the function of lymphocytes, and has an antihistamine effect. When conducting electrophoresis with lithium in diseases of the joints, an increase in the production of collagen was found, which goes to the construction of the cartilage tissue of the patient. Lithium electrophoresis is especially effective in the presence of osteophytes.

The latest equipment used in the ODA center eliminates the causes that affect the development of the disease, modern drugs inhibit the destruction of articular cartilage and restore the function of the affected joint.

Drawing pain in the thigh, buttock and groin – diagnostics and treatment in Moscow

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Pain in the thighs, buttocks, groin is a manifestation of such a wide range of traumatological, neurological, rheumatological, vascular and infectious diseases that only an experienced doctor can understand this diversity and make a correct diagnosis.

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Positive dynamics in 97% of cases

The results of the treatment course are confirmed by control MRI images.

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No side effects

The methods used in our clinic are safe and have no side effects.

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Long-term effect

Treatment minimizes the risk of new hernias in other segments, as well as hernia recurrence.

The main causes of pulling pain in the leg, caused by damage to the musculoskeletal system

Most often, pain in the thigh, buttocks, groin is accompanied by many diseases with damage to the spine, muscles, tendons, nerve trunks and blood vessels of the lower extremities.

Osteochondrosis of the lumbosacral spine

With degenerative processes in the cartilage tissue that occur with osteochondrosis, there is a decrease in the height of the intervertebral discs. As a result, pressure increases on the radicular nerve trunks, which combine to form the sciatic nerve. Since the nerve passes along the back of the buttocks and thighs, its irritation leads to unpleasant sensations in this area in the form of pulling pains and cramps in the leg. The pain is aggravated by walking and exertion.

Compressive pressure on the sciatic nerve can be caused by protrusion of the disc and herniated disc.

Arthrosis of the hip joint

Deforming osteoarthrosis — coxarthrosis appears in old age as a result of degenerative changes in the cartilaginous tissues of the hip joint. Women are more often affected.

A characteristic sign of coxarthrosis is the restriction of motor activity of the affected limb. The pain increases with active movements, calming down at rest.

Arthritis of the hip joint

Disease in the hip joint is rare, is autoimmune in nature and is secondary to current rheumatism or psoriasis. The pain is severe and usually bilateral.

Trochanteritis

This is inflammation or damage to the tendons surrounding the hip joint. The most common cause of the disease is an injury or overload of the legs (excess weight, carrying weights, running). Characterized by pain during movement, localized on the outer surface of the thighs – the area of ​​\u200b\u200b”breeches”. Pain is aching constant, but unlike coxarthrosis, there is no restriction in the mobility of the leg.

Aseptic necrosis of the femoral head

The symptoms of this pathology are in many respects similar to the manifestations of coxarthrosis – a significant difference is only the duration of the disease. With coxoarthrosis, the symptoms develop gradually – over the years, and with necrosis, the pathological process progresses rapidly, in a few days the intensity of pain increases rapidly, haunting the patient even at night. In addition, aseptic necrosis of the femoral head often affects young men aged 20-45 years, and women suffer from this pathology 7-8 times less often.

Piriformis syndrome

Manifestations of this syndrome are associated with compression of the trunk of the sciatic nerve and blood vessels when they pass through the hole in the ilium. Compression occurs due to contraction of the piriformis muscle.

The disease develops as a complication of previous injuries, with incorrect injections into the buttock or as a result of hypothermia. The main symptom of nerve compression is constant pulling pain (sometimes with shooting), which is localized along the back of the thigh from the buttock to the foot. The pain may be accompanied by a feeling of numbness or weakness in the leg.

Potential causes of pulling pain in the thighs, not associated with damage to the musculoskeletal system

• Feverish syndrome with hyperthermia, accompanying colds, bacterial and viral infections.
• Iron deficiency and hemolytic anemia.
• Cerebral circulation disorders occurring with paralysis of the lower extremities.
• Damage to blood vessels in the pelvic area and soft tissues of the thigh: varicose veins, obliterating endarteritis, atherosclerosis of the vessels of the legs.
• Lymphostasis and secondary lesions of the lymph nodes.
• Complications of diabetes mellitus in the form of angio- and neuropathies.
• Migration in the muscles of larvae of intestinal parasites.
• Diseases affecting the arachnoid (arachnoid) membranes of the brain and spinal cord: tick-borne encephalitis, poliomyelitis and other infections.
• Muscle dystrophy as a result of prolonged lack of motor activity (immobility).
• Nutritional deficiency of essential trace elements: potassium, magnesium, calcium.
• Fibromyalgia.
• Convulsive syndrome.
• Tumors of the small pelvis.
• Pain in the hip in pregnant women is physiological in nature due to deformation of the axial skeleton and resolves on its own after childbirth.

Treatment success is 90% dependent on experience
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During the consultation, we carry out a thorough diagnosis of the entire spine and each segment. We are exactly
we determine which segments and nerve roots are involved and cause symptoms of pain. As a result of the consultation
We give detailed recommendations for treatment and, if necessary, prescribe additional diagnostics.

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Diagnosis

In Dr. Length’s clinic, to make a correct diagnosis, a patient with complaints of pain in the thighs, buttocks and groin is prescribed the following examination methods:

• History taking.
• External examination with assessment of neurological status.
• Analysis of the biomechanics of the musculoskeletal system: range of motion in the joints, movement restrictions.
• Kinesiology testing of joints and musculoskeletal system.
• General and biochemical blood tests, rheumatic tests.
• Instrumental methods: radiography, ultrasound, CT, MRI.

Since pulling pains in the thighs, buttocks and groin can be caused not only by the pathology of the musculoskeletal system, but also by other diseases, the patient is assigned a number of additional studies and consultations of various specialists as part of the differential diagnosis.

Treatment

Pain is a signal of the development of pathological changes in the body. If the patient ignores the growing symptoms for a long time, tries to get rid of pain with the help of various painkillers and does not turn to specialists in time, this can lead to serious consequences in the form of disability with loss of independent movement.

Doctors of Dr. Length clinic successfully treat diseases of the musculoskeletal system with conservative methods that not only relieve the symptoms of the disease, but can also slow down the further progression of the pathological process.

The scheme of complex therapy is compiled for each patient individually, depending on the diagnosis, stage of the disease, clinical manifestations.

Dr. Length’s clinic, which specializes in the treatment of the spine and joints, includes both traditional methods of therapy (medication) and innovative methods of manual therapy.

Taking as a basis the achievements of foreign and Russian scientists in the field of manual therapy, Dr. Dlin developed his own method of Di-Tazin therapy, consisting of three components: soft manual technique, multicomponent electrophoresis and photodynamic laser therapy.

Applying the Di-Tazin therapy method, the doctor achieves the following results in the treatment of patients:

• pain intensity decreases;
• relieves inflammation;
• blood microcirculation is enhanced, and, consequently, the trophism of damaged tissues;
• improves lymph outflow;
• metabolic processes are normalized;
• further destruction of cartilage and bone tissue is suspended;
• regenerative processes are activated in the area of ​​damage;
• links of local immune protection are stimulated.

The therapeutic effect of soft manual therapy lies in the fact that painfully altered muscles and ligaments do not stretch as in the classical technique, but come closer, which leads to a rapid cessation of pain, removal of spasm in the muscles, elimination of restrictions in the movement of the joints.

Due to electrophoresis, pharmacological preparations are introduced into the lesion through intact skin, and the therapeutic effect of the drug lasts for several days.

Photodynamic phototherapy is performed as an application to the skin of a special substance (photoditazine) in the area of ​​pain localization. This photosensitive drug, activated under the action of a certain spectrum of waves emitted by the LED installation, penetrates deep into the tissues and acts at the cellular level, accelerating the regeneration processes.

The technique has proven its effectiveness, has no contraindications , can be used in the treatment of pregnant women, children and the elderly.

In addition, the program of active rehabilitation includes physical therapy, massage, kinesiotherapy.

We are recommended by 94% of patients.
Thank you for your trust and your choice.

Material verified by an expert

Mikhailov Valery Borisovich

Manual therapist, vertebrologist, neurologist

Work experience – 25 years

Video reviews of patients

Articular block in the neck 90 003 Hernia in the lower back and neck

I came to Dr. Length’s clinic with spinal problems. With two intervertebral lower hernias and two intervertebral hernias in the neck. I was assigned a comprehensive 10 step program. For 4 months, my lower vertebrae completely disappeared and crunches in my neck disappeared …

Hernia of the lumbosacral region

“After the first time, my back stopped hurting. I felt relieved. Now 7 sessions have already passed and the back really does not hurt. I began to forget about it. And at first it hurt a lot. ”

Inflammation of the sciatic nerve

“For 4 months I suffered from severe inflammation of the sciatic nerve on the right side. After the first visit, relief came immediately within six hours. After 6 courses, the pain was almost gone.

Pain in the lower back and leg

Yakovleva Natalya Mikhailovna
Head of the department, surgeon of the highest category, oncologist-mammologist
I want to express my deep gratitude for the fact that I was put on my feet in the truest sense of the word. I came to the clinic a month and a half ago with severe pain in the lower back and leg. These complaints were long enough and the treatment that I used in the past was ineffective. Fortunately, I ended up in the clinic of Dr. Length and his team of super professionals!

Osteochondrosis of the cervical spine

“I applied 2 months ago with osteochondrosis of the cervical spine. I have a sedentary job and my neck muscles were very cramped. It was impossible to work. Before that, I went to other doctors, but this did not solve my problem. For 2 months I have a fairly positive dynamics. Every week it gets better and better.”

Bechterew’s disease

“I have had Bechterew’s disease for 10 years. The vertebrae began to move out, I began to slouch. I turned to other chiropractors, very famous, media ones. In the end, I didn’t get any results. After 2 sessions I felt much better. Now I don’t have any pain.”

Pain in the spine

“I came in with problems in my back, cervical, thoracic and lumbar spine. I was prescribed procedures, had a massage, and was assigned to do physical education at home. This made it much easier for me. I’m already turning my head. I have no pain.”

Shoulder shoulder periarthrosis

I came to the clinic with severe pain in my shoulder. My hand did not rise, I could not sleep at night, I woke up from pain. After the first treatment session, I felt much better. Somewhere in the middle of the course, my hand began to rise, I began to sleep at night.

Osteoarthritis of the knee joint, 2nd degree

Came in with a very serious illness. I could not walk, I have arthrosis of the 2nd degree of the knee joint. I went through a course of treatment at the Clinic and now I am going 100%.

Herniated disc

“I came to the clinic after I had back pain and it turned out to be a herniated disc. I went to other places, but they only relieved attacks of pain. Hope for a return to normal life was given only by Sergei Vladimirovich, his golden hands!

Scoliosis

“Since I was a teenager, I have suffered from scoliosis in the thoracic region. I felt a feeling of discomfort, tension, periodic pain in the spine. I turned to various specialists, a massage therapist, an osteopath, but I did not feel a strong effect. After treatment, Length S.V. I almost have a straight spine. Currently, I do not feel any problems and discomfort.”

Intervertebral hernia

“At the 5th-6th session there was an improvement. I felt much better. The pain is gone. Improvement progressed more and more each time. Lesson 10 today. I feel great.”

Pain in the lumbar and cervical region

“I am 21 years old. I went to the clinic with discomfort in the lumbar and cervical region. I also sometimes had sharp pains. After undergoing therapy, I felt a significant improvement in my back. I have no pain. The condition as a whole has improved.”

Pain in the back

“At the beginning of the path of treatment, my back hurt very badly. I could no longer walk. I take 5 steps and stop. My entire journey consisted of such stops. In the very first procedure, I left the office with no pain in my spine.”

Cervical hernia

“I came in with a problem in my neck and my right arm was very sore. The neck did not turn, the hand did not rise. After the 3rd session, I felt better. After the 5th, all this pain began to decrease. It turns out I have 2 hernias in my cervical vertebrae. After the sessions, I did an MRI and one hernia decreased. Now he began to move, his hand earned.

Pain in the neck

“I went to Dr. Long because I had a very bad pain in my neck on the right side. I fell on a snowboard 5 years ago, even went to an osteopath, but somehow it didn’t really help. Now everything is fine, there are some consequences left, the muscles were spasmodic. When I came, I had steel muscles, now my neck is very soft.”

Pain in the thoracic region

“I went to the clinic with back pain, namely in the thoracic region. After 10 sessions of treatment, I could already calmly go about my usual business, stay at work until lunch, without howling in pain. Now I’ve come back for an adjustment after 2 months. I’m fine, my back doesn’t hurt.”

Hernia and protrusion

“I came to the clinic with L4-L5 hernia and L5-S1 protrusion. Today the course of treatment has ended. Lower back hurt, it was difficult to bend down. After completing the course and receiving instructions in the form of physical exercises, it became much easier. After a month of treatment, I do not feel any stiffness of movements. ”

Pain in the lower back and hip joint

“From a young age, I was troubled by back pain. When they became unbearable, I went to Dr. Length’s clinic. Already after the first procedure, the pain in the hip joint was gone. After the third procedure, the shooting pains in the lower back stopped.

Applying today will help

avoid surgery tomorrow!

Relieve pain and inflammation

After 2-3 treatments, exhausting pain goes away, you feel better.

Eliminate the cause of the disease

Comprehensive rehabilitation of the spine improves well-being: you feel a surge of strength and energy.

Let’s start the regeneration process

The process of restoration of damaged tissues begins, hernias and protrusions decrease.

Let’s strengthen the muscular corset

Strong back muscles support the spinal column, preventing the recurrence of the disease.