The hip is a "ball-and-socket" joint where the "ball" at the top of the thigh bone (femur) fits inside the "socket" in the pelvis (acetabulum). A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip becomes diseased or damaged from arthritis, hip fractures, bone death or other causes, the joint can stiffen and be very painful. A total hip replacement may be recommended for patients who experience severe hip pain and whose daily lives are affected by the pain.
A hip fracture is a break in the top of the femur (thighbone) where the bone angles toward the hip joint. If the break occurs within two inches of the joint, it is called a femoral neck fracture. If it occurs between two and four inches from the joint, it is known as an intertrochanteric fracture. (A break further down the bone is classified as a broken femur rather than a broken hip.) Femoral neck fractures require more extensive surgery.
Hip fractures usually make it too painful for the person to stand. The leg may turn outward or shorten. They generally require hospitalization and surgical repair.
A person's risk for suffering a hip fracture increases if he or she is over 65, female, or small-boned; has a family history of hip fractures; has osteoporosis or low calcium, which leads to bone weakness; smokes or uses alcohol excessively; is physically or mentally impaired; or takes medications that cause weakness or dizziness. Hip fractures are a common and serious problem for the elderly, for whom a simple fall in the home may be enough to break the bone.
Bursitis is the painful swelling of the bursae, fluid filled sacs on the cushion areas where tendons and muscles slide across bone. Specific to the hip is trochanteric bursitis (also known as greater trochanteric pain syndrome or GTPS), which refers to the bursa by the head of the femur. This shock absorbing sac can become agitated and swollen for unknown reasons or as a symptom of other issues such as gluteal tendon infections, uneven leg length or Iliotibial Band Syndrome. Steps can be taken to prevent bursitis by strengthening the core and hips through a moderate training program. Orthotic inserts for people with flat feet can also help. The condition can be treated by:
- NSAIDs or steroids to reduce swelling