Hip pain

How common it is

Osteoarthritis is the most common form of arthritis in Australia, with around 2.1 million people, about 8.3 per cent, estimated to be living with it in 2022, and it mostly affects the knees, hands and hips. ^[1]

It is common enough that it deserves naming rather than avoiding. Some hip pain is arthritic change, and where that is the picture, the honest conversation is about management and referral rather than about adjusting the problem away.

What can be behind it

The hip is a deep ball and socket joint that carries your body weight, surrounded by large muscles and several bursae. Pain in the groin usually comes from the joint itself, pain on the outside of the thigh more often from the tendons and bursa there, and buttock pain frequently from the lower back or the sacroiliac joint rather than the hip at all.

Risk factors named for hip osteoarthritis include being overweight, a previous hip injury, jobs involving lifting heavy loads, and a family history. ^[2] Knowing which of those apply changes the conversation about what to do next.

• Arthritic change in the hip joint itself
• Irritation of the tendons and bursa on the outer hip
• Referral from the lower back or the sacroiliac joint
• Restricted hip rotation loading the back above it

How we assess it

We separate hip from back deliberately. Passive hip movement in every direction, tests that load the joint, then lower back and sacroiliac examination to see whether your familiar pain can be reproduced from the spine.

Where the history and findings suggest established arthritic change, X-rays may be worth taking and we explain why first. Night pain that will not settle, fever, a recent fall in an older person, or an inability to weight bear are medical referrals on the day.

What care looks like

The examination guides whether we discuss chiropractic care or recommend another assessment. We explain which findings relate to the hip, lower back or sacroiliac joint, and the limits of any proposed care.

Staying active is strongly recommended for people with osteoarthritis, ^[2] so the home work matters at least as much as the visits. Where the picture calls for medical management or a surgical opinion, we say so and write to your doctor.

When to seek urgent care

We are not an emergency service. If you have loss of bladder or bowel control, numbness in the saddle area, weakness in both legs, or pain after a serious accident, call 000 or go to an emergency department.