Health Library Hip Problems, Age 12 and OlderFrom Healthwise

Hip pain can make it difficult to walk, go up and down stairs, squat, or sleep on the side that hurts. A clicking or snapping feeling or sound around your hip joint (snapping hip) may bother you or cause you to worry. But if your hip is not painful, in many cases the click or snap is nothing to worry about. Home treatment may be all that is needed for minor hip symptoms.

To better understand hip problems, it may be helpful to know how the hip works. It is the largest ball-and-socket joint in the body. The thighbone (femur) fits tightly into a cup-shaped socket (acetabulum) in the pelvis. The hip joint is tighter and more stable than the shoulder joint but it does not move as freely. The hip joint is held together by muscles in the buttocks, groin, and spine; tendons; ligaments; and a joint capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint and let the tendons and muscles glide and move smoothly. The largest nerve in the body (sciatic nerve) passes through the pelvis into the leg.

Hip problems

Hip problems may develop from overuse, bone changes with age, tumors, infection, changes in the blood supply, or a problem that was present from birth (congenital). Oddly enough, a person who has a hip problem often feels pain in the knee or thigh instead of the hip. Hip problems include:

The type of hip pain you have may help your health professional determine the cause of your pain.

• Pain when resting does not increase with motion or standing. This type of pain is usually caused by a less severe problem, unless the pain does not go away or awakens you from sleep.
• Pain with movement increases when you move the hip or leg but does not increase when you stand or bear weight. This type of pain is most often caused by a muscle injury, inflammation, or infection.
• Pain with weight-bearing increases when you stand or walk and may cause you to limp. This type of pain usually means you have a problem with the hip joint itself. Pain that is severe enough to prevent any weight-bearing is more likely to mean a serious bone or joint problem.

Pelvic, groin, thigh, or knee pain (referred pain) may be present along with a sore, painful, or tender hip . Hip pain can have many causes.

• Snapping pain on the outside of the hip and sometimes the knee may be caused by iliotibial band syndrome.
• Pain in the hip, thigh, or knee of an older child or teen may be caused by conditions such as slipped capital femoral epiphysis, in which the upper end of the thighbone (femur) slips at the growth plate (epiphysis), or Legg-Calve-Perthes disease.
• Pain that is worse in the morning and improves during the day may be caused by osteoarthritis, rheumatoid arthritis, or lupus.
• Pain may be a sign of inflammation of the large sac that separates the hipbones from the muscles and tendons of the thighs and buttocks (trochanteric bursitis).
• Pain can occur with signs of infection in a joint (septic arthritis), bursa ( septic bursitis), or bone ( osteomyelitis).
• Pain and stiffening in the hip may be caused by lack of blood flow to the hip joint (avascular necrosis). Pain in the knee may also be present.
• Pain that shoots down the leg from the hip or lower back may be caused by an irritated or pinched nerve (sciatica).
• Pain with weight-bearing that gradually worsens over several months may be caused by transient osteoporosis. This is more common in middle-aged men but also can affect women in the later part of pregnancy (third trimester). Osteoporosis related to pregnancy usually goes away on its own within 12 months of delivery.
• Some types of bone cancer (osteosarcomas) and the spread of cancer to the bone (metastatic disease) can cause bone pain.

Treatment for a hip problem depends on the location, type, and severity of the problem, as well as your age, general health, and activities (such as work, sports, hobbies). Treatment may include first aid measures; application of a brace, cast, harness, or traction; physical therapy; medicines; or surgery.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

• Sudden severe pain and you are not able to stand or or move your hip.
• Sudden numbness or tingling is present in the buttocks, genital area, or one or both legs.
• A hip or leg has turned pale, white, blue, or cold.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• Hip injury: Go to the topic Hip Injuries, Age 12 and Older.
• Bleeding: Go to the topic Cuts or Puncture Wounds.

	Yes	Do you have hip pain or tenderness?
When to See a Doctor See significance of hip pain or tenderness if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have severe hip pain? Yes Is your hip red, hot, and swollen? Yes Are you not able to put weight on the affected leg? Yes Do you know or think you have a fever? Call your health professional today if you answer "Yes" to the following question. Yes Do you have a limp? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Do you still have moderate hip pain, a limp, or are not able to move your hip normally after 24 hours of home treatment? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Have you had mild hip pain off and on without other symptoms for 2 weeks or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Are you unable to bend, straighten, or move your leg normally?
When to See a Doctor See significance of an inability to bend, straighten, or move your leg normally if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Are you not able to bend, straighten, or move your leg normally? Yes Have you had hip surgery and now: Have moderate to severe hip pain? Cannot move the hip or leg? Have new weakness or numbness in the hip or leg? Know or think you have a fever? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Do you have hip stiffness or cannot move your leg normally after 48 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have hip pain with numbness or tingling in the hip, groin, or leg?
When to See a Doctor See significance of hip pain with numbness or tingling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have hip pain with new numbness or tingling? Call your health professional today if you answer "Yes" to the following question. Yes Has numbness or tingling become worse since you were seen by a doctor? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Do you have hip pain for 24 hours with numbness or tingling that comes and goes and you have not seen a doctor? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Did you feel or hear a snap, pop, or grating in your hip?
When to See a Doctor See significance of feeling or hearing a snap, pop, or grating in the hip if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to any of the following questions. Yes Does your hip feel loose or unstable since you felt or heard a snap or pop in your hip? Yes Are you having a hard time walking since you felt or heard a snap or pop in your hip? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had a painful snapping feeling in your hip with movement (such as when you sit or squat) for 48 hours or longer but you are still able to walk normally? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Have you had a snapping or grating feeling in your hip but you do not have pain? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have any signs of inflammation or infection?
When to See a Doctor See significance of signs of inflammation or infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have increased swelling, redness, or warmth around the hip? Yes Do you have increased pain with any little movement of the hip? Yes Do you have red streaks extending from the hip? Yes Is the hip extremely tender to the touch? Yes Do you have any drainage of pus from the hip wound? Yes Do you think or know you have a fever? Yes Do you have diabetes? Yes Do you have peripheral arterial disease? Yes Do you have a disease or take medicine that causes problems with your immune system? Call your health professional today if you answer "Yes" to the following question. Yes Do you have mild pain and swelling with redness less than 1 in. (2.5 cm) around the hip? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had swollen gland (lymph nodes) in your groin for 24 hours or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have pale, white, blue, or cold skin?
When to See a Doctor See significance of pale, white, blue, or cold skin if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have pale, white, blue, or cold skin? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your hip feel loose or unstable after hip surgery or hip replacement?
When to See a Doctor See significance of loose or unstable hip if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Does your hip feel loose or unstable? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Has your hip felt loose or unstable off and on for 1 week? Yes Has your hip felt loose or unstable and your symptoms have become worse since you were seen by a doctor? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following symptoms?

• Groin problem or injury: Go to the topic Groin Problems and Injuries.
• Tailbone or low back injury: Go to the topic Back Problems and Injuries.
• Unexplained leg pain or swelling: Go to the topic Leg Problems, Noninjury.
• Leg injury: Go to the topic Leg Injuries.
• Limping after a toe, foot, or ankle injury: Go to the topic Toe, Foot, and Ankle Injuries.
• Limping after a knee injury: Go to the topic Knee Problems and Injuries.
• Burn, scrape, bite, or bruise: Go to the topic:
  • Burns.
  • Scrapes.
  • Animal and Human Bites.
  • Insect Bites and Stings and Spider Bites.
  • Bruises and Blood Spots Under the Skin.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home treatment may help relieve hip pain, swelling, and stiffness.

• Rest. Try to rest and protect a sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
• Ice will help your pain and swelling. Put ice or cold packs on the sore area immediately. Put ice on for 20 minutes out of every hour and do this 4 or more times in the first 1 to 2 days. If your child is cooperative, use the ice often. Wrap the ice in a wet towel. Do not put the ice right on the skin. Do not fall asleep with an ice pack on your skin.
• Sleep on your unaffected hip with a pillow between your knees, or sleep on your back with pillows beneath your knees.
• Gently massage or rub your hip to relieve pain and help blood flow.
• If the swelling is gone, heat can be put on the area. Moist heat with a hot water bottle, warm towel, or a heating pad set on low may feel good on your hip. You can carefully begin normal activities and gentle stretching.
  • Prone buttocks squeeze, to strengthen the buttocks muscles. These support your back and help you lift with your legs.
  • Pelvic tilts to stretch the lower back.
  • Hamstring stretch to stretch the muscles in the back of the thigh.
  • Hip flexor stretch to stretch the muscles in the hip that help the hip glide and work smoothly.

Do not smoke. Smoking may delay healing because it interferes with blood supply and tissue healing. For more information, see the topic Quitting Tobacco Use.

Cast care tips

If you have a cast, see cast care tips.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• Signs of infection develop.
• Numbness, tingling, or weakness develops.
• Pale, white, blue, or cold skin develops.
• Symptoms do not get better with home treatment.
• Symptoms become more severe or more frequent.

The following tips may prevent hip problems or injuries.

Keep bones strong

• Eat a nutritious diet with enough calcium and vitamin D, which helps your body absorb calcium. Calcium is found in diary products, such as milk, cheese, and yogurt; dark green, leafy vegetables, such as broccoli; and other foods.
• Exercise and stay active. It is best to do weight-bearing exercise, such as walking, jogging, stair climbing, dancing, or lifting weights, for 45 to 60 minutes 4 days a week. Weight-bearing exercises help new bone growth by working the muscles and bones against gravity. Exercises that are not weight-bearing, such as swimming, are good for your general health, but do not help new bone growth. Talk to your health professional about an exercise program that is right for you. Begin slowly, especially if you have not been active. For more information, see the topic Fitness.
• Do not drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman. People who drink more than this may have a higher chance for developing osteoporosis. Alcohol use also increases your chance of falling and breaking a bone.
• Stop or do not begin smoking. Smoking also increases your chance for developing osteoporosis. It also interferes with blood supply and healing. For more information, see the topic Quitting Tobacco Use.
• Cut down on caffeine. Caffeine in coffee and soda pop may increase calcium loss from your body and increases your chance for developing osteoporosis.

Exercises to keep your hip and back area strong

Warm up and stretch before exercising prevent problems.

• Prone buttocks squeeze, to strengthen the buttocks muscles. These support the back and help you lift with your legs.
• Pelvic tilts, to stretch the lower back
• Hamstring stretch, to stretch the muscles in the back of the thigh
• Hip flexor stretch, to stretch the muscles in the hip that help the hip glide and work smoothly

To prepare for your appointment, see the topic Making the Most of Your Appointment

You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:

• What are your main symptoms? How long have you had your symptoms?
• Have you had this problem in the past? If so, do you know what caused the problem at that time? How was it treated?
• Do you have hip pain when you walk? How far can you walk without discomfort? Does the pain get better or worse as you continue to walk?
• Have you had X-rays of your hip? When and what were the results?
• What activities make your symptoms better or worse?
• What sports activities are you involved in? Have you recently started a new activity?
• Do you think that activities related to your job or hobbies caused your symptoms?
• Have you had any recent illness or fever?
• What home treatment measures have you tried? Did they help?
• What prescription and nonprescription medicines do you take?
• Do you have any health risks that may increase the seriousness of your symptoms?

• Back Problems and Injuries
• Developmental Dysplasia of the Hip
• Groin Problems and Injuries
• Hip Fracture
• Hip Problems, Age 11 and Younger
• Juvenile Rheumatoid Arthritis
• Knee Problems and Injuries
• Low Back Pain
• Lupus (Systemic Lupus Erythematosus)
• Osteoporosis
• Rheumatoid Arthritis
• Toe, Foot, and Ankle Problems, Noninjury

Author:	Jan Nissl, RN, BS	Last Updated: October 27, 2006
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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