HIP PAIN: How can hip pain be treated?


The hip joint itself is the second largest weight bearing joint. It is a ball and socket joint comprising of the femur and the pelvis. The head of the femur which is the ball at the top of the femur fits into the acetabulum which is the concave part of the pelvis that encloses the head of femur. The ligaments within the joint provide great stability to the joint. As there are various components within the joint they all assist in the hips mobility, so if any were to be damaged, it would affect the overall mobility. 


Different muscles around the hip work together to allow certain movements. These movements are flexion, extension, internal rotation, external rotation, adduction and abduction. The groups of muscles that perform these movements are the quadriceps, hamstrings and glutes, along with slightly smaller muscles that all work together. 


Hip pain is a conventional term for any type of pain that is felt in or around the hip joint. This may also be referred pain down the leg or originate from the lower back. It can be caused by a range of reasons such as direct trauma, inflammation, repetitive strain or degeneration. 


If hip pain is persistent, and is also swollen or warm, is it vital to seek medical advice. There are many healthcare professionals who can help treat hip pain such as chiropractors, physical therapists, osteopaths and GP’s. These specialists will all offer a range of different treatment options such as hands on treatment, stretches and exercises. The treatment received and bespoke plan created by the therapist will depend on what is causing the pain. 


How can a physical therapist help with hip pain?


Physical Therapists focus on the musculoskeletal system. They will firstly look at the way the hip moves and feels by carrying out certain tests along with gathering information about the aggravating and relieving factors, and past medical history. This will help to determine where the problem originates and what structure is damaged. The therapist can then initiate a plan of treatment and ways to control the symptoms and improve the functional mobility and strength of the hip. Depending on the diagnosis, hands on treatment is usually the first treatment option and they will work on damaged structures. If muscles are tight, trigger point therapy would be used to release this. In order to continue care when the patient is at home, stretches and exercises may be given, this is to aid more mobility and strength to the joint to keep the joint healthy and working. As pain and mobility begin to improve, more advanced exercises will be provided to maximize hip function. 


How can Chiropractors help with hip pain?


Chiropractors also focus on the musculoskeletal system and surrounding areas, however the way they go about their treatment for hip pain is slightly different to that of a physical therapist. With an aim of improving joint function and reducing pain and inflammation, chiropractors use either a force, like a spinal manipulation or something more gentle, such as a mobilisation. 

To carry out a manipulation a small force is put through the joint which may result in a popping sound which is a release of gas within the joints. This type of treatment may be used in the hip joint or surrounding structures. A mobilisation will be the best treatment option for degenerative conditions such as osteoporosis as it is not a firm thrust, however it has the same goals as a manipulation.  


Along with the treatment given, chiropractors may also give advice on dietary changes. This not only helps patients feel better within themselves, but also puts less pressure on the joints. The hips carry a large amount of body weight and therefore are prone to injury. Chiropractors will also provide advice on exercise and sleep practice. Exercise can be key to healing and keeping the joints moving, which helps aid mobility. Hip pain can often be more intense at night and may stiffen due to lack of movement, therefore a chiropractor will be able to suggest the best mattress type and sleeping position to help with hip pain. This is usually side lying with a support between the knees.


To gain the best possible outcome even after the hip pain has gone or been reduced, regular care is encouraged to prevent any future problems occuring. Having both chiropractic care and a physical therapist working together is a good way to gain maximum care, this is because they work on different structures within the body.


Do knee pillows help hip pain?


Hip pain can keep you up throughout the night, this could be due to your sleeping position being an aggravating factor. If you are still when sleeping it can lead to pain and stiffness in the morning. However, as the hip joint does have a lot of pressure going through it throughout the day, it may also ease any pain as it is relaxed. 


Having hip pain at night is usually caused by a range of different conditions such as osteoarthritis, tendonitis and bursitis, or referred pain from the lower back. It may be linked to something more simple such as sleeping position, the type of mattress, or pillows. 


When visiting a healthcare professional with hip pain they will first look into the best treatment plan before giving any advice on any health and lifestyle changes that may be appropriate. Sleeping position is a key piece of advice that is given. They will first ask about your sleeping pattern and positioning to see whether that is what is causing or aggravating the hip pain. 


It is highly recommended that you sleep on a slightly firm mattress as this will give your whole body enough support. You should avoid a mattress that has internal springs as they may create pressure points.


Sleeping on your side is the ideal sleeping position especially with having hip pain, however it is important to give support between your knees to take pressure off the hips and lower back. Using a specially designed knee cushion is ideal to help align spine and hips. 


Whilst the most suitable sleeping position is on your side it may provoke hip pain in some people so sleeping on their back may be more appropriate. When sleeping on your back it is important to support under your knees or ankle to take any pressure off the lower back and hips. 


Using a knee pillow has been proven to ease any pain within the hip joint during sleep, it may not eliminate pain completely but helps alleviate any symptoms in the morning. 

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