Common Causes of Hip Pain in Young Adults
Wondering what the common causes of hip pain in young adults are? this blog will provide you with the information that you need to understand possible causes and will recommend when to seek treatment.
Signs & Symptoms
Hip pain tends to present with a variety of symptoms including:
Clicking or “locking” of the hip joint
Pain in the groin which may be made worse by various positions such as sitting or prolonged walking
Difficulty putting on shoes and socks
Pain in the buttocks
Hip pain in older individuals can be caused by osteoarthritis (“wear and tear”) of the ball and socket joint.
In younger individuals, a myriad of reasons for hip pain exist.:
Simple groin strains – which respond well to physiotherapy
Inflammation of the tendons around the hip
Subtle hip shape deformities such as Dysplasia, and Impingement.
Early osteoarthritis.
This blog will be delving further into hip pain caused by subtle deformities of the hip joint that give rise to either Dysplasia and/or Impingement.
What is Hip Dysplasia?
Dysplasia quite simply means “abnormal development”. Thereby hip dysplasia indicates that in a certain individual, their hip (the ball and socket joint) has not developed normally. There is usually a genetic cause for this, and it frequently runs in families.
Most commonly, hip dysplasia is characterized by a “shallow” socket that does not adequately cover the femoral head. When the femoral head is not completely covered by the socket, the hip is unstable, may become painful and eventually develop osteoarthritis. Patients often feel like the hip may dislocate, and it may click on occasion.
In its severest form, it presents in newborns with a dislocated hip. This is picked up at birth and treated. In its mildest form, it may not become symptomatic until the patient is in their 20’s or 30’s.
How is Hip Dysplasia Diagnosed?
Hip Dysplasia is diagnosed with a combination of clinical history, examination findings and imaging. Dysplasia is often seen on a standard radiograph (“X-Ray”) of the Pelvis and both hips. Additional investigations which help guide treatment options include CT and MRI scans. Finally, a diagnostic injection of local anaesthetic into the hip joint may be performed to ensure the correct diagnosis is reached.
What is the treatment of Hip Dysplasia?
As with most hip conditions, we would always advise non-operative treatment initially. This includes physiotherapy and painkillers. However, if non-surgical treatment fails, hip dysplasia is corrected by surgery. If hip dysplasia goes untreated, arthritis is likely to develop. Symptomatic hip dysplasia is likely to continue to cause symptoms until the deformity is surgically corrected.
Many patients benefit from a procedure called a periacetabular osteotomy or PAO. The medical term “periacetabular” means “around the acetabulum” or “around the hip socket.” The term “osteotomy” refers to any procedure in which bone is cut. Thus, a PAO is a procedure where the bone is cut around the hip socket. The socket is placed into the optimal position and secured using 3 or 4 bone screws.
The surgery is performed under a general anaesthetic, through a minimally invasive surgical incision (about 10cm) in the bikini-line region of your upper thigh. The surgery itself can take up to 3 hours. After surgery, the patient would be required to walk with crutches for up to 3 months.
By correcting the patient’s anatomy, the procedure has been shown in numerous studies to relieve hip pain and delay the progression of osteoarthritis within one’s hip.
What is Hip Impingement?
Hip impingement, or femoroacetabular impingement (FAI), is a condition where the bones in the hip joint are abnormally shaped. Either the hip socket has too much bone along the rim of the socket. Or the femoral head on the leg bone isn’t sufficiently rounded.
This abnormal shape of the joint leads to uneven wearing, friction and pinching of the soft tissues around the hip. It is possible to have both socket and femoral head deformities at the same time. Hip impingement can affect anyone of any age.
The causes of hip impingement include many sporting activities including martial arts, weight training, golf and football, but also lifestyle and occupational causes. Often there may be a genetic cause and it may run in families.
The impingement often occurs when the hip is flexed or “bent up”. This may occur when sitting for long periods, squatting, or running.
How is Hip Impingement Diagnosed?
Hip Impingement is diagnosed with a combination of clinical history, examination findings and imaging. Impingement is often seen on a standard radiograph (“X-Ray”) of the Pelvis and both hips. Additional investigations which help guide treatment options include CT and MRI scans.
How is Hip Impingement Treated?
As with most hip conditions, we would always advise non-operative treatment initially. This includes physiotherapy and painkillers. This being said, if non-surgical treatment fails, hip impingement is often corrected by surgery. If hip impingement goes untreated, arthritis is likely to develop.
Surgical treatment is directed to the aspect of the hip, which is not normal. Often this is either due to excess bone on the socket and/or femoral head (ball) of the hip joint. In this case, a keyhole operation to the hip (hip arthroscopy) can be beneficial. This procedure is performed under general anaesthesia and may take up to 3 hours to perform fully. During this procedure, the leg is attached to a specialised traction device and table which enables a small gap between the ball and socket to be achieved. Once the gap is opened, we are able to insert a camera through a small incision to the side of the hip. A second small opening is made adjacent to that to allow us to insert further equipment such as a small shaver/burr to remove the excess bone and tissue. This is usually a day case procedure and the patient is expected to make a full recovery within 6 weeks.
If there is an issue with the rotational alignment of the socket and/or ball of the femur, then we may advocate a procedure to correct this. Correcting the rotational malalignment of the socket would involve performing a periacetabular osteotomy (as described above). Rotational malalignment of the ball of the femur would involve an osteotomy (cut to bone) to the femur (thigh bone) and fixation with a metal plate on the side of the bone.
Book an Appointment
Hip Dysplasia and Impingement are relatively common conditions that are amenable to treatment if identified early. The majority of patients with the condition, once diagnosed, may be treated with good results. Do not delay in seeking specialised orthopaedic assessment if you suspect you may suffer from either of these conditions. Early treatment avoids progression to arthritis and the inevitable hip replacement. Book an appointment at Coriel Orthopaedic Group today or contact us to find out more.Book Treatment