Hip pain occurs whenever there is pain or discomfort around the hip joint. There are many possible causes of hip pain, which can result in pain in different areas of your hip. No matter the cause, hip pain can be debilitating in your daily life.

Your hips play a crucial role in your daily activities, such as walking, standing, and climbing stairs. It is estimated that up to 14.3% of adults have experienced significant hip pain in their recent past. Hip pain symptoms may reduce your range of motion or strength, affecting your ability to move around.

Physical therapy for hip pain can improve your mobility and strength and reduce pain levels. Your physical therapist will assess your condition and develop a treatment plan tailored to your needs. With Direct Access, you don’t need to wait for a physician’s referral to make your appointment today. Continue reading to learn more about physical therapy for hip pain treatment.

Causes of Hip Pain 

The hip joint is a complex ball-and-socket joint located at the top of your leg. Some common causes of hip pain can include:

• Hip osteoarthritis is a condition in which gradual degenerative changes inside the hip joint can wear away the protective cartilage, leading to bone-on-bone friction.
• Rheumatoid arthritis is an autoimmune disease that causes inflammation and pain in the joints.
• Iliotibial band syndrome occurs when there is friction between the iliotibial band, or IT band, and your femur (thigh bone). The iliotibial band runs down the outside of your upper leg.
• Piriformis syndrome is a condition where the piriformis muscle presses on the sciatic nerve, causing pain and numbness in the hip, back, or buttock. 
• Labral tears occur when there is injury or damage to the hip labrum, a ring of cartilage around the hip socket.
• Femoroacetabular impingement (FAI) is a condition where the bones of the hip joint pinch or rub together inside the joint.
• Trochanteric bursitis is inflammation of the fluid-filled sac that cushions your greater trochanter, part of your femur located on the outside of your hip.
• Fracture or trauma
• Overuse injuries
• Muscle strains

Several risk factors can increase your chance of experiencing hip pain, including age and being overweight. Repetitive hip motions in your job or sport may also increase your risk, as may chronic conditions like diabetes. 

Symptoms of Hip Pain 

Symptoms of hip pain can vary depending on the underlying condition causing the pain. However, here are a few common hip pain symptoms you may experience:

• Pain in the groin, buttock, or outer hip.
• Stiffness or reduced range of motion.
• Weakness or a feeling of instability.
• Painful popping or clicking inside the joint.

Hip pain may worsen after prolonged periods of rest, such as getting out of bed in the morning. It can make activities like walking or standing up more difficult. 

Diagnosing Hip Pain 

Contact your physical therapist if you’ve been experiencing hip pain for two weeks without improvement. Treating hip pain early is important to prevent it from worsening and causing more symptoms. However, even if you’ve been experiencing hip pain for longer, it’s advisable to make an appointment. With Direct Access, you don’t need a referral to make your physical therapy appointment today.

Your first hip pain physical therapy appointment will include an initial evaluation. Your physical therapist will begin by reviewing your medical history and assessing your level of hip pain before starting a physical examination. During the physical examination, your physical therapist will use a combination of range of motion and strength testing and special tests to gather more information about your hip pain. 

Your pain levels will be monitored throughout the examination to ensure your comfort. After the examination, your physical therapist will work with you to create a personalized plan of care that meets your needs. Your plan of care will include physical therapy exercises for hip pain, along with any hands-on treatments or modalities appropriate for your condition. You will also work with your physical therapist to set realistic goals for therapy, helping you get back to doing what you love.

After your initial evaluation, your physical therapist may refer you for further imaging or diagnostic tests. Diagnostic imaging may include X-rays, MRI scans, or ultrasounds.

Treatment Options

Non-Surgical Treatment Options

Physical therapy

Physical therapy is a primary conservative treatment option for hip pain. With Direct Access, you don’t need a referral to make your physical therapy appointment today. Our skilled physical therapists treat hip pain using individualized exercise prescriptions, which have been shown to improve physical function and reduce pain levels. Depending on your specific case, your physical therapist may also use hands-on techniques, called manual therapy, or other modalities such as heat or ice. 

Medication

Over-the-counter (OTC) medications, such as ibuprofen or naproxen, may be helpful when used in conjunction with your physical therapy treatments. Your physical therapist will refer you to your doctor to discuss medication options if needed. Depending on your pain levels, your doctor may prescribe stronger OTC medication or muscle relaxants for more persistent pain.

Corticosteroid Injections

Corticosteroid injections, also known as cortisone injections, are administered by a doctor to relieve hip pain and inflammation. While these injections can reduce pain and improve function, physical therapy can restore strength and flexibility in the joint after pain levels are reduced. 

Lifestyle Changes

Lifestyle changes involve adjusting how you physically participate in your daily life or at work. The goal is to maintain your activity levels while minimizing your hip pain and discomfort. This can be achieved by changing the activity’s intensity or duration, making position or postural adjustments, or using an assistive device. Your physical therapist can help you navigate these changes.

Surgical Treatment Options 

Consult with your physical therapist if you are considering hip surgery. Undergoing surgery is a significant decision, and your physical therapist can provide additional resources and recommendations to get you back to your activities without surgery. 

If conservative options have been exhausted and are unsuccessful, surgery may be an option. Reasons to undergo surgery include severe, persistent pain, significant hip instability, or significant loss of range of motion affecting daily function.

There are many different surgical procedures to address hip pain. Regardless of the procedure, your physical therapist can guide you through your post-surgical rehabilitation and help restore your hip function.

Common procedures include:

• Hip debridement is a minimally invasive procedure using small incisions and cameras to visualize and remove loose or damaged tissue within the joint.
• Labral repair involves reattaching the torn or damaged part of the labrum.
• Labral reconstruction occurs when the labrum is too damaged to repair. The surgeon will use a soft tissue graft to reconstruct the labrum.
• Femoral osteoplasty involves reshaping the femoral head (top of the femur) to relieve hip impingement. This may also include debridement or labral repair to address damage caused by the impingement.
• Periacetabular osteotomy is reshaping or reorienting the bones of the acetabulum (hip socket) to improve joint alignment and reduce pain.
• Partial hip replacement involves replacing only the femoral head. This is used when the acetabulum is still healthy.
• Total hip replacement (or total hip arthroplasty) is the replacement of the entire hip joint. This is indicated when the hip joint damage is too severe to benefit from other treatment options.

Preventing Hip Pain 

Hip pain can affect how you participate in the activities you love. While physical therapy is a great way to address hip pain and restore your hip function, there are several ways to reduce your risk of experiencing hip pain in the first place.

• Regular Exercise: According to the WHO, 31% of adults are physically inactive. Participating in regular exercise is important for your health, including keeping your hips strong and flexible. Aim to get 150-300 minutes of exercise each week to reap the benefits. Your physical therapist can help you develop a long-term physical activity plan to keep you moving.
• Adequate Sleep: Strive for 7-8 hours of quality sleep per night. Ensure you practice good sleep hygiene by setting a regular sleep schedule, establishing a calming bedtime routine, and limiting screen time before bed. Your physical therapist can help you find sleep positions that are most beneficial for your body.
• Proper Nutrition: Consume a variety of whole grains, healthy fats, and high-quality protein to give your body the building blocks it needs to build and repair. When you exercise, your body breaks down muscles and rebuilds them stronger, which requires good nutrients and calories. 
• Stress Management: Managing stress is important to overall well-being. Some strategies for stress management include relaxation and mindfulness techniques, connecting with friends and family, and practicing self-care regularly.
• Activity Modification: Activity modification involves adjusting how you participate in your favorite activities. The goal is to keep you active while minimizing your pain and discomfort. This could mean decreasing the duration or intensity of the activity, using an assistive device, or adjusting your position or posture. Your physical therapist can help you devise an activity modification strategy to keep you doing what you love.

Living with Hip Pain 

Coping with hip pain can be difficult, but there are things that may help. In addition to seeking help from an experienced physical therapist, here are a few strategies to try:

• Mindfulness and deep breathing techniques
• Self-care practices (taking a rest, engaging in a hobby, listening to music, etc) 
• Activity pacing (breaking larger activities down into smaller, manageable pieces)
• Gentle movement or activity

Despite your efforts to prevent pain, flare-ups can still happen. If you’re experiencing a flare-up of shoulder pain, focus on rest, gentle movement, and stress-reduction techniques. Your physical therapist can help you through your flare-up and get you back on track. 

Strive to adopt healthy habits that support your long-term health and well-being. This can include prioritizing stress management techniques, healthy eating habits, regular exercise, and good sleep hygiene.

Physical Therapy for Hip Pain 

With Direct Access, you can make an appointment with one of Confluent Health’s skilled physical therapists without a referral. Using a combination of exercise prescriptions, hands-on techniques, and other modalities, our therapists will help you feel better quickly. Due to the individualized nature of your physical therapy care, you will be reassessed frequently to ensure you are meeting the goals you set with your therapist at the initial evaluation. 

Each physical therapy plan of care is unique and tailored to fit the patient’s needs. However, there are a few common hip exercises that may be included in your exercise prescription. Your physical therapist will ensure you know what exercises to do and how to do them correctly.

• Hamstring stretch: Lie on your back with both legs extended. Bend one leg and place both hands behind your knee. While supporting your thigh with your hands, lift your foot off the floor and straighten your leg. Lift until you feel a gentle stretch behind your thigh. Hold for 30 seconds and repeat 2-3 times on each side.
• Hip flexor stretch: Place a cushion or padded mat on the floor and kneel. Bring one foot in front so you are in a half-kneeling position. Keep your chest tall and your abdominals engaged. Gently push your hips forward, keeping your buttocks tucked, until you feel a gentle stretch in the front of the hip and thigh of the knee on the floor. Hold for 30 seconds and repeat 2-3 times on each side. 
• Bridge: Lie on your back with both legs bent, feet flat on the ground. Place your hands on the floor at your sides. Engage your abdominals and keep your torso straight as you squeeze your buttocks and press through your heels to lift your hips off the ground. Lift until your shoulders, hips, and knees are in a straight line. Hold for 1-2 seconds and then slowly lower with control. Repeat 10-12 times.
• Piriformis stretch: Lie on your back with both legs bent. Cross one ankle to the other knee. Slide both hands around the thigh of the leg with your foot still on the ground. Gently pull your knee toward your chest, bringing the opposite ankle with it. You should feel a gentle pull in the buttock or hip of the crossed leg. Hold 30 seconds and repeat 2-3 times per side.

Your physical therapist will work with you to create an exercise plan that helps you achieve your goals. There are many other hip-strengthening and stretching exercises to choose from. 

In addition to exercises, your physical therapist may use their hands to manipulate your hip in specific ways to improve range of motion or joint mobility. This is called manual therapy. Other modalities, such as heat, ice, or ultrasound, may also be used to enhance your rehabilitation. 

During your treatment sessions, your physical therapist will monitor your pain levels to maintain your comfort. They will also reassess your progress regularly to ensure you are on track to achieve your goals.  

Dealing with hip pain can be challenging, but our skilled physical therapists are here to help you. Contact one of our Confluent Health facilities today to schedule your evaluation—no referral needed!