What’s causing my deep hip pain?

If you’re experiencing deep hip pain, you know just how frustrating it can be!

Trying to find a diagnosis feels like finding a needle in a haystack.

So is there any way to figure out what’s causing the pain deep in your hip?

More importantly, is there a quick way to reduce the pain or get rid of it?

Finding a diagnosis for deep hip pain

The difficulty with getting a diagnosis is that one pathology will often generate other issues.

So while your first problem might have related to the hip joint, it very quickly becomes a joint + muscle + tendon issue.

That means any treatment targeting a symptomatic area might not be effective as they’re missing the underlying cause.

Top tips to identify the main cause of your hip pain

So here are the best questions to consider to diagnose your deep hip pain:

1. Is it worse first thing in the morning or after a prolonged period of inactivity?

This indicates an inflammatory component to the underlying issue.

These diagnoses include hip arthritis and hip muscle tendinitis/tendinopathy.

2. Does it flare up during high intensity exercise (eg. running) or hip strength exercises?

Pain during exercise tends to indicate a component of overload.

These diagnoses include muscle fatigue and bone stress injuries.

3. Is there a prolonged effect from taking anti-inflammatory medication?

This means that the pain stays reduced for days/weeks after you’ve stopped taking the meds, not just while you’re on them. This confirms an inflammatory condition rather than just a pain-relieving or masking effect from the meds.

These diagnoses include hip arthritis and hip muscle tendinitis/tendinopathy.

4. Have you lost range of motion in your hip?

You might notice that it’s more difficult to reach your shoelaces or that you can’t bring your knee to your chest on the painful side. A loss of range is usually an indication that the hip joint is involved.

This includes diagnoses such as hip osteoarthritis and femoroacetabular impingement (FAI).

5. Does the pain extends further down into the leg or up into the lower back?

If the pain radiates from the buttock down into your leg or hamstrings, that can indicate nerve involvement, referred pain or hamstrings muscle pathology.

Diagnoses in these categories include sciatica, referred lower back pain, nerve root compromise at the lower back and hamstrings tendinopathy.

6. Do you have pins & needles or numbness into the leg?

Tingling or numbness in the leg, anywhere from the back of the thigh right down to the foot, is almost always an indication of a nerve problem.

These symptoms are usually the results of a compromised or pinched nerve in the lower back.

Treatment for deep hip pain

Once you’ve identified the possible underlying cause from the questions above, you need to carefully plan your management strategy.

Treatment for nerve-related hip pain

If there is a possible involvement of nerve, with tingling, numbness or referred pain down the leg, the best plan is to seek proper assessment with a health professional. This type of injury is difficult to self manage and can become a more significant problem if not addressed.

Treatment for joint-related hip pain

When the joint is part of the underlying cause of your hip pain, a combination of exercises and medication give the best results.

Over-the-counter medication is limited to short periods of use due to the likelihood of side effects. Seeing your doctor for prescription medication is a better option as it can be used more consistently for longer periods.

The exercise approach needs to focus on building hip strength without irritating the symptoms. Because the “no pain, no gain” approach often causes more trouble than it fixes and worsens inflammatory reactions.

Treatment for muscle- or tendon-related hip pain

Muscles and tendons respond well to loading – more specifically, to strength exercises.

The trick is striking a careful balance between doing enough to stimulate improvement without doing too much and irritating symptoms.

Start with a simple collection of exercises that seem like they’re challenging but comfortable. It might be a little boring to start with but it’s a necessary building block.

Every two weeks, make the exercises slightly more challenging and monitor your symptoms. If you experience of flare up when you first change exercises, stick with it for another two sessions.

If the pain is getting gradually worse or the soreness after exercise is not improving, drop back to the previous program. Then you can try a different set of exercises after a week or so.

If you experience repeated flare-ups, or if you don’t seem to making progress, speak to a health professional to diagnose your injury and design and appropriate program.