Pain in the front of the hip, or groin, or even in the buttock and down the leg, can be from the hip joint. Common sources of pain include degenerative arthritis and labral tears, which involves the ring of connective tissue at the rim of the hip socket. Hip tendonitis and bursitis are conditions that usually cause pain on the side of the hip and are due to inflammation of a tendon or bursa (a normal fluid sac that limits friction between structures) Pain in the buttock, or back portion of the hip, are often not caused by the hip joint, rather by conditions of the low back, sacroiliac joint, hip girdle muscles, hamstring tendon, and other causes.
History and physical examination are most important. X-rays can be helpful to assess for arthritis, congenital joint deformity, and other bone conditions. For soft tissue conditions, MRI or high-definition diagnostic ultrasound are helpful. For labral tears, an injection of dye into the joint (arthrogram) before having an MRI is usually required to identify this condition.
Treatment often begins with activity modification or rest and use of modalities such as ice. To treat pain, either Tylenol or NSAIDs (anti-inflammatories such as ibuprofen or naproxen) can be considered. If that does not help, manual treatment with a physical therapist, chiropractor, or massage therapist can be helpful in conjunction with therapeutic exercise to improve flexibility, strength, and control. In some cases, injections of corticosteroids (steroids) and/or numbing agents may be considered. With some conditions, surgery may be an option if these treatments are not adequate.
Some patients find benefit from acupuncture, dry needling, and natural medications. Injection of platelet rich plasma (PRP), one’s own blood cells that contains natural healing proteins called growth factors, has shown promise to treat certain peripheral joint conditions such as tendonitis and arthritis.