Front hip pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Hip-related pain is not always felt directly over the hip. Instead, it may be felt in the front of the hip or thigh.

Hip pain may be associated with the following:

•Pain when ascending stairs and/or getting up from a seated position
•Pain with standing for long periods or for sitting for extended periods
•Difficulty sleeping because of pain
•Limited range of motion of the hip

A common cause of pain in the front of the hip is hip flexor strain . This is characterized by:

•Overload or overuse of the muscle in front of thigh and hip such as climbing stairs, marching or uphill running
•There may be a limp and shortened stride
•Mechanical imbalance in lower extremity

Hip pain can be brought about by excessive pronation in the foot

Pronation (a flattening of the arch) is a normal movement of the foot that helps the body to absorb shock. If the foot is weak or tired and/or the footwear is not supportive, then the arch can flatten more than normal, ie., excessive pronation.
Excessive pronation leads to increased rotation of the leg, knee, thigh and hip, causing added stress to the hip joint.

Contributing factors to the development of hip pain are:

•Limited flexibility
•Muscle imbalance
•Leg length differences
•Tightness of the iliotibial band, a tendon/muscle that runs from the outside of the hip to the outside of the lower leg just below the knee
•Flat feet
•Poorly supportive shoes
•Biomechanical changes in the foot that increase pronation

Two common and concerning causes of frontal hip pain are fractures and insufficient blood flow to the hip (aseptic necrosis).

A hip fracture occurring in an older individual can be devestating. Fewer than 50% of those with a hip fracture return to their former level of activity. In addition, while recovering from a hip fracture, several complications can occur and they may be be life-threatening. These include pneumonia and a blood clot traveling to the lungs. Both are due to immobility following a hip fracture and hip surgery.

Aseptic necrosis can happen due to chronic high dose steroids, sickle cell anemia, or trauma. Regular use of alcohol and injury also increase the risk.

Legg-Calve-Perthes disease is a hip disorder that happens in children.

Other possible causes of hip pain include:

•Arthritis -- often felt in the front part of your thigh or hip.
•Iliopsoas bursitis -- inflammation of the bursa that sits in front of the hip joint.
•Tendinitis affecting the hip flexor tendons from repetitive or strenuous activity.
•Strain or sprain.
•Low back pain with referred pain from a pinched nerve.
•Infection of the hip joint.

Here's how to deal with the pain

•Avoid activities that aggravate the pain.
•Over-the-counter pain medication, like ibuprofen or acetaminophen may help.
•Sleep on the non-painful side with a pillow between the legs.

Surgical repair or hip replacement may be recommended for aseptic necrosis. Hip replacement is necessary for hip fracture and severe arthritis.

Preventative tips:

•Avoid activities that raise one of the hips above the other for extended periods of time, like running on an uneven surface.
•Warm up before exercising and cool down afterward. Stretch the hips, low back, and thighs.
•Avoid falls.
•Wear hip pads for contact sports.


The 3 S's - Stretching, Strengthening, and Supporting, along with Ice and Rest, have been found to be the simplest and most effective treatment for these injuries

•Stretching of the iliotibial band, hamstrings, quadriceps, and psoas major can help to decrease and eliminate many of the problems.
•Strengthening of the muscles of the abdomen, quadriceps and hips can assist in avoiding problems.
•Wearing supportive shoes.

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