Hip Pain: How To Know If It’s Osteoarthritis

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Pain in your groin and at the front of your thigh could be a symptom of osteoarthritis in a hip joint. And if you feel stiffness in the joint, particularly after you’ve been inactive for a time, that could also be a sign that you have osteoarthritis.

Osteoarthritis, the most common form of arthritis, results from the wearing away over time of cartilage, the soft, protective tissue at the ends of bones where they form joints. As the cartilage wears away, the bones rub against each other, which can cause pain, stiffness, loss of movement, and formation of bony growths, called spurs.

Who’s most at risk of osteoarthritis?

That’s hard to say, says orthopedic surgeon Ryan Bauman, MD. But, he adds, “It’s a very common problem that affects many people. And specifically with hip arthritis, there’s not a direct correlation that patients who are overweight or obese are at an increased risk compared to someone of normal weight.” Arthritis can run in families, and trauma or previous hip injuries can increase risk of arthritis later in life.

Dr. Ryan Bauman explains who may be at risk of developing arthritis.

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Diagnosis Of Hip Osteoarthritis

Early diagnosis of hip arthritis is important, so you and your doctor can begin treatment before your joints suffer further damage. Your doctor may conduct a physical exam and order blood tests or X-rays.

Imaging tests such as X-rays or MRIs allow your doctor to see what’s going on inside the joint. As cartilage wears away, the space between the bones of the joint becomes smaller, and an X-ray can show how much space remains, indicating how advanced the osteoarthritis is.

If the X-ray doesn’t provide a definitive diagnosis, your doctor may follow up with an MRI or an injection in the hip to confirm that the hip joint is the primary source of the pain.

Hip injections can help differentiate back pain from hip pain. If the hip injection does not relieve the pain, your doctor may refer you to a back specialist “to see if a pinched nerve is causing radiating pain to your hip,” Dr. Bauman explains.

He adds, “Osteoarthritis or arthritis symptoms in the hip are typically deeper in the hip and are those symptoms found in your groin, thigh, deep in your butt.”

Hip pain can also result from bursitis. “Bursitis is inflammation or swelling in a fluid-filled sac (bursa) that is on the outside of the hip where muscles and tendons insert into the bone,” Dr. Bauman explains. “Bursitis symptoms are typically pain when laying on your side, and it’s primarily on the outside or lateral aspect of your hip.”

Bursitis rarely requires surgery. It is more commonly treated with physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and injections into the bursa.

Hip Impingement: Another Cause Of Pain

Hip impingement is a condition in which the ball-and-socket structure of the hip joint doesn’t fit together well, causing bones to rub together. “This can cause pain and could limit activities that would require you to bend or squat and can predispose you to arthritis later in life,” Dr. Bauman says.

Diagnosis of this condition is becoming more common “as people are becoming more and more active in sports and are active in sports later in life,” he explains. People with hip impingement say they notice pain during more strenuous activity.

Treatment typically begins with nonsurgical options, such as activity modification, NSAIDs, and physical therapy. If these don’t work, arthroscopic surgery, which involves small incisions, is often used to correct the problem. Severe cases may require open surgery.

Start With Conservative Hip Pain Treatment

When you’re first diagnosed with hip arthritis, Dr. Bauman says, “You want to try conservative measures before even considering surgery.” These include:

  • Activity modification
  • Nonsteroidal anti-inflammatory drugs, such as Advil, Aleve, and ibuprofen
  • Injections into the hip joint
  • Physical therapy

Dr. Bauman adds, “Weight loss is oftentimes helpful in alleviating some of the pain of hip arthritis because any loss is weight that’s not going through your joint when you go up and down stairs.” While losing weight may slow some of the effects, it won’t reverse damage caused by arthritis.

While there’s no evidence that physical therapy limits the progression of arthritis or delays the need for surgery, physical therapy can help maintain strength in muscles that support the joint.

Dr. Ryan Bauman talks about conservative, nonsurgical treatment measures for hip pain.

Surgical treatment methods are only considered after all nonsurgical options have been tried without success.

The Dual Role Of Injections For Hip Pain

As well as being used to help treat and alleviate hip pain, injections can serve as a diagnostic tool, Dr. Bauman says. “They can be diagnostic, letting us know whether or not most of the symptoms are coming from the hip joint itself and they can potentially treat your hip pain for six months or more.”

The injections, which include a numbing medicine and a steroid, are administered into the hip joint under X-ray or ultrasound guidance. “The numbing medicine gives immediate relief,” Dr. Bauman says. By how effective it is in treating the pain, the doctor can determine what percentage of the symptoms come from hip arthritis.

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Ryan Bauman, MD

Ryan Bauman, MD

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