Common Causes of Hip Pain
Hip pain is a common complaint with a broad differential diagnosis. The location of pain — anterior groin, lateral hip, posterior buttock, or diffuse — provides important diagnostic clues. Accurate anatomical diagnosis is essential because the treatment approach differs substantially depending on which structure is the pain generator.
- Hip osteoarthritis — cartilage loss in the femoroacetabular joint producing anterior groin pain and limited internal rotation; the most common cause of significant hip disability
- Greater trochanteric pain syndrome (trochanteric bursitis) — lateral hip pain exacerbated by lying on the affected side, climbing stairs, and prolonged walking
- Hip labral tear — fibrocartilage ring tear causing anterior groin pain, clicking, and instability
- Femoroacetabular impingement (FAI) — abnormal bony morphology causing mechanical conflict and cartilage damage
- Iliotibial band syndrome — lateral hip and knee pain from IT band tightness
- Hip flexor tendinopathy and snapping hip — iliopsoas pathology producing anterior hip pain and snapping sensation
- Referred pain from the lumbar spine — L1–L3 nerve root pathology can mimic hip joint pain
Diagnosis at CHLMD
Differentiating the source of hip pain requires a structured clinical examination — assessing range of motion, specific provocation tests (FABER, FADIR, Patrick's), strength testing, and gait analysis. Dr. Lichtblau reviews plain radiographs and MRI to identify structural changes and correlates imaging with clinical findings. When lumbar nerve involvement is suspected, EMG and nerve conduction studies help confirm or exclude a spinal contribution.
Nonsurgical Treatment Approach
Hip osteoarthritis is treated with a combination of hip abductor and external rotator strengthening, corticosteroid intra-articular injections for inflammatory flares, and activity modification to reduce joint loading. For patients with early-to-moderate OA, a structured exercise program combined with strategic injection therapy can provide years of meaningful symptom relief and functional improvement.
Greater trochanteric pain syndrome responds well to corticosteroid injection at the trochanteric bursa combined with iliotibial band stretching and hip abductor strengthening. Trigger points in the gluteal and piriformis musculature — common contributors to lateral and posterior hip pain — are treated with targeted injection therapy. Hip labral tears without severe structural damage are managed with activity modification, hip stabilization exercise, and intra-articular injections.
Maintaining Hip Function Long-Term
For patients managing hip OA or recurrent bursitis, long-term maintenance of hip abductor and external rotator strength is the most important modifiable factor in preserving function and delaying progression. Dr. Lichtblau provides comprehensive hip exercise programs and ongoing physiatric management to sustain functional gains over time.
