Hip pain and disability are common and have a telling impact on our community particularly around the Perth Hills area with its undulating terrain. Significantly curtailing the living quality and life expectancy of many residents.
A painful hip invariably requires considerable scanning, a multitude of medical appointments and ultimately a high likelihood of invasive surgery. An accurate diagnosis can be complicated by the often co-existing conditions of hip arthritis, hip tendinopathy and bursitis, as well as back and pelvic pain. Further, there is increasing evidence that hip surgery does not always lead to the anticipated outcomes that patients expect. In contrast, exercise therapy for the hip is non-invasive, cheap, virtually complication free and associated with high levels of patient satisfaction and functional improvement.
Teasing out which structures and to what extent each is involved in hip pain is complex. Despite significant advances in medical technology and diagnostic imaging, this has not always lead to meaningful improvements in patient outcomes. This is in no small part due to the overwhelming reliance on those technologies to direct treatment when it is the patient and not the condition that requires the attention. The critical point is that physicians need both the time and skill to interview the patient and perform an advanced physical examination followed importantly with a discussion with the patient and options for any intervention.
Any pain radiating along the side of the hip and thigh is almost invariably hip tendon and bursa in origin. It is now known that the bursitis component of the condition is a symptom of the condition and that the gluteal tendon damage is the main pathology. It affects 1 in 4 females and has the same impact on life quality as an arthritic hip. The condition is related to hip (gluteal) tendon damage and weakening of the hip muscles. The pain eventually affects the person’s ability to walk, climb stairs and sleep. It is distinguished from back pain in which the spreading ache typically runs down the back of the leg, or hip joint pain which shows itself in the groin area.
The key signs are:
- Ache running down the side of the thigh rarely past the knee
- Difficulty lying on the side, getting out of chair, walking
- Standing or sitting still often annoys it
- Tender around the point of the hip on the side of the thigh
- Feelings of weakness in the leg or imbalance causing a characteristic waddle with walking
1. Sit with cushions under your bottom to sit higher and do not cross your legs;
2. Use pillows between your knees when lying and if the pain is sharp in nature use ice; otherwise use heat if the pain is an ache;
3. Try and adopt a symmetrical stance position and prop your foot up on a support
4. Use a stick in your opposite hand if you limp and try to shorten your steps
5. Strengthen your hip muscles initially in lying and then progress to upright positions