Hip Pain

Hip Pain treatment in Gurgaon | Physiotherapy for Hip Pain

It is mostly common condition in adults usually of all age group. It can affect in children, young or adults also. Children presenting with congenital abnormality can also result in pain. It can also associated be any underlying disease like Osteoarthritis. Pain is characterised by; anterior, lateral or posterior pain in the hip region. Clinical diagnosis of Hip pain is necessary to plan for effective treatment at Hip joint.

We are DynaFisio provide the Hip Pain treatment in Gurgaon, Here we are told about  Hip Pain Causes, Symptoms & Treatment. If you have any contact us for Hip Pain treatment. Our Doctors give Best physiotherapy for Hip Pain

When to Consult a Doctor?

Severe pain around hip joint, Inability to bear weight on affected side, limping in walking, decreased ranges of hip, Swelling or stiffness at or near Hip joint, history of trauma or fall, age related obesity or fall can also result in fracture of hip bone or any muscular trauma. In case of any leg length discrepancy also, one should immediately consult to a doctor.

Hip Pain Symptoms

Pain, tenderness, swelling, change in contour of hip joint, difficulty in changing positions, pain while prolonged sitting or pain after walking few steps, limping gait, pain may radiate to buttocks, thigh or leg, apparent or true shortening of leg can also be seen. Stiffness and restricted movements can also be seen.

Relevant history taking is must for evaluating patient hip pain. It should include pain area, history of any other hip problems, congenital and hereditary history, pain aggravating or relieving factors, any fall or trauma history.

Hip Pain Diagnosis

X-Ray, MRI can reveal if any bony or musculoskeletal related issue present. Decrease in neck shaft angle, Break in Shanton’s line of abnormal Q angle can reveal different conditions in hip. Arthrography or ultrasonography can also be used for diagnostic purposes in severe case of injury. Your doctor will use these radiographic features go diagnose such conditions of hip.

Careful examination of gait pattern, weight bearing status, balance and posture and leg length while sitting and lying are done.

Differential Diagnosis

There may be various conditions affecting Hip joint and resulting in hip pain.

Anterior Hip pain may be due to:-

  • Hip Osteoarthritis – It is the most common cause affecting old age group, resulting in pain with sitting or prolonged standing. Difficulty in hip movements especially external rotation and abduction. Patient may also present with antalgic gait pattern which often starts gradually. Best revealed in X-Ray.
  • Hip Fracture - It can affect any age group but commonly occur in older age again due to osteoporotic bone which causes fracture even after a minor fall in bathroom. Patient complains of inability to bear weight on affected leg and presents with abducted and externally rotated leg.
  • Avascular Necrosis – It may occur in adults after an accident which results in poor blood circulation in hip joint and does not allow bone to reunite or heal. It is also presented with antalgic gait but had a history of accident. It is misdiagnosed in early stages but can be present in X-Ray in later stages.
  • Femoral Neck Stress Fracture – It generally occur in sportsperson by an overuse injury or improper muscular energy balance of Hip muscles. It is also presented with difficulty in walking or going back to sports activity. Patient will be unable to stand or move his leg freely.
  • Spondylolisthesis and Spondylolysis – Scottish dog appearance wearing a collar is a clinical feature in X-Ray and MRI for Spondylolysis. Similarly, head elongated from neck of the dog is a characteristic feature of listhesis. Spondylolisthesis also shows Step up deformity on physical examination. It usually restricts backward bending as the body may further slip on bending.
  • Labral tears – It is associated with overuse gradual injury and is presented as a popping, catching, or clicking sound associated with activities such as dance, gymnastics, hockey, basketball, and soccer. It is tested physically by FABER Test and revealed by MRI.

Lateral Hip pain may be due to:-

  • Greater Trochanteric Bursitis – It usually affects more in 40-60 years of females. It results due to tight IT band or Gluteus medius tendinopathy causing friction over greater trochanter. Patient have a lateral side pain and tenderness at Hip joint or GT. Pain is usually affected by sleeping on same side or after physical activity.

Posterior Hip pain also have certain causes like:-

  • Piriformis Syndrome – Deep buttock pain which is often associated with no injury, pain usually gets worse after prolonged sitting especially in a car. It can also cause Sciatic Nerve compression which radiates pain from your buttock to thigh to lateral side of leg to big toe. It can be tested only by physically through Seated Piriformis Stretch test.
  • SI Joint Pain – Pain is referred to hip due to SI Joint dysfunction. Tenderness and pain is present at PSIS or L5 level. Can be tested by X-Ray or physical examination by FABER Test or SLR positive above 80degrees. It can also lead to LBP due to decrease in hip joint mobility.
  • Coccyxodynia – It is an uncommon injury which result only after fall in sitting position or prolonged sitting on an unpadded surface. It is also termed as tailbone pain due to the same reason. It may aslo coexist with low back pain.

Congenital disorders of hip may be:-

  • Coxa Vara or Valga – It is an abnormality of neck of thigh bone (femur) characterised by an increase or decrease in neck shaft angle. It may result in marked shortening or lengthening of the leg. Trendelenburg gait pattern is noticed in these type. It occurs due to mal-development of bones during growth. Revealed by measuring Neck shaft angle in X-ray of hip joint.
  • Legg-Calve-Perthes disease – It is most common in young age boys of 2-6 years and is characterised by avascular necrosis and malunion of epiphyseal growth plate. Patient presents with painless limp, antalgic gait, muscle spasm and aim in hip, thigh or knee. This condition requires early consult to the doctor in order to prevent further deformity.

Physiotherapy Treatment for Hip Pain

  • Conservative management can be done in few cases by giving Rest, Ice and elevation to the hip joint in initial stages.
  • Medical management for pain and inflammation can be given. Use of NSAIDs and Corticosteroid injections can be helpful in certain cases.
  • Surgical treatment is done in cases like malunion or developmental deformity. Surgical method like osteotomy is widely used in cases like coxa vara and valga.
  • Physiotherapy treatment is necessary in Hip joint conditions in order to make patient independent walking and bear weight while standing

Hip Pain Physiotherapy Treatment

  • Pain, inflammation and muscle spasm can be reduced by – Cryotherapy in initial stages and Thermotherapy in later stages. Both Ice pack and Moist heat pack can be applied for 10-15 minutes.
  • Use of cast and avoid external rotations in case of dislocations of hip.
  • Improvement of ROM exercises can be done by Passive Rom exercise, Active assisted ROM to flexors, extensors, abductors, adductors and rotators are prescribed according to the hip condition.
  • Strengthening exercises for Hip muscles can be done by Resistive strengthening exercises, PRE, Active resisted exercises and isometrics all are done according to the patient condition and gradually progressed.
  • Stretching exercises for Piriformis, gluteus muscle and hamstring muscles are also required often. Stretching of QL, Iliopsoas and quadriceps is also required according to the condition.
  • Prevention of contractures in immobilisation phase is important by making patient prone lying, or sustainable slow stretching the hip joint muscles.
  • Thera band exercises in non-weight bearing phase can be started in lying position for various group of muscles.
  • Clam shell exercises for abductor weakness is very beneficial exercise.
  • Hip mobility exercises like Dead bugs, Cat n camel exercise, Superman exercises, Pelvic tilting results in greater mobility of Hip joint in initial pain phase.
  • Weight bearing and non-weight bearing with the help of crutches and crutches are taught in certain cases like during post op rehabilitation of Total hip replacement, or fracture.
  • Different Gait pattern can be taught on parallel bars with the help of mirror feedback.
  • Wobble board training can be done for balance.
  • Once patient achieves functional balance and gait, our focus shift towards strengthening Hip muscles to prevent further damage or to maintain the current status.
  • Advance strengthening exercises like wall supported squatting, side lunges, forward lunges one leg press, one leg squat, full squats, sumo squats all are done according to the patient and progressed gradually.

Different strategies for different condition of hip according to the patient are applied to avoid any further complications. Therefore, for better rehabilitation program contact our clinic at www.dynafisio.com or reach us at our different branches in Gurugram. For further details contact at: 8929294515