Hip pain comes in a garden-variety like shoulder pain, knee pain, and back pain, and there is no one-size-fits-all treatment for it. You can get hip pain when you sit or run. It can manifest in your glutes or in the front by your groin. Sometimes different causes of hip pain overlap with one another, like hip flexor pain in the psoas major with snapping hip syndrome. This makes diagnosis tough for many clinicians, and treatments could be a trial-and-error process. 

Instead of blaming a “tight” muscle, a pinched nerve, osteoarthritis, and a ton of other factors that may cause hip pain, an in-depth look at some of the common causes of pain can help you seek the most proper care and communicate better with your healthcare provider. 

Femoroacetabular Impingement (FAI)

types femoroacetabular impingement

Image: OpenStax College – Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013.

Femoroacetabular impingement syndrome is an abnormal contact between the round head of the femur and the pelvis’s acetabulum. This can lead to microtrauma to the joint, damaging various joint structures, which may lead to hip osteoarthritis. 

Gluteal Tendinopathy

piriformis syndrome massage

Photo: Penny Goldberg

Pain from gluteal tendinopathy usually occurs in the lateral hip area by the greater trochanter of the femor. Similar to hip arthritis, gluteal tendinopathy can starts as “a subtle, nagging pain that gradually worsens over time.

Piriformis Syndrome

gluteal tendinopathy treatment massage therapy

Photo: Penny Goldberg

The symptoms of piriformis syndrome are quite consistent, despite that there are many causes, including sciatica. Unlike sciatica, this condition is often not associated with spinal problems. Patients with piriformis syndrome typically report deep pain in the gluteal region that may have pain radiating down into the back thigh. 

Although the reports of pain location and quality are similar across many patients, they can vary because of intensity, duration, and frequency.

Hip Flexor Pain

brazilian capoeira performance

Photo: Fábio Ericeira

Compare to other types of hip pain, there is less research about hip flexor pain, which makes it difficult to diagnosis and treat. Sometimes the pain is not from the psoas or iliacus but from visceral pain, such as appendicitis, diverticulitis. This story also examines whether “tight” psoas are the culprit to hip pain and low back pain and whether massage therapists can actually “work on” the belly of the psoas muscles. 

Sciatica

sciatica pain hip

Photo: Halley Moore

Sciatica is the radiating pain that tends to “shoot” down the leg and sometimes into the heel of the foot. While it tends to affect one side of the body, sciatica is sometimes caused by the irritation of the sciatic nerve in one side of the hip. Oftentimes, the piriformis muscle is to blame, but there are multiple causes of sciatica where some of them are less obvious. 

Sometimes the pain can last for days or weeks, and sometimes it “happens” without warning. But the good news is: sciatica does go away on its own most of the time.

Iliotibial Band Syndrome

men running it band pain

Photo: Tania Dimas https://pixabay.com/photos/run-exercise-race-beach-jogging-5532448/

Excessive friction between the iliotibial band and the side of the knee or the thigh muscles are often blamed for iliotibial band syndrome. This usually happens to those who engaged in prolonged repetitive movements in the legs, such as runners and cyclists. 

While many massage therapists suggest that the IT band should be massaged and “softened,” pain research and current understanding of the IT band suggest that “deep tissue” work may not be the answer, but there are alternatives to alleviate iliotibial band syndrome.

Sacroiliac Joint Pain

massage therapy pelvic tilt

Photo: Milius007Many narratives about sacroiliac joint pain is more than ten years behind current research. So what is the better narrative and what therapists can do in practice?

An interview with Dr. Thorvaldur Palsson from Aalborg University who explains the nature and research behind sacroiliac joint pain.

 

Leg Length Discrepancy

knee osteoarthritis pain massage therapy

Photo: Pixabay

“People can have really crazy deformities and NOT have pain. Pain is a multi-factorial, personal experience of a person. If it were as simple as correcting a leg length discrepany, we’d have solved the most expensive and debilitating healthcare issue in the world.” ~ Dr. Sarah Haag

A closer look at the scientific evidence behind the relationship between leg length discrepancy and pain.