We often take our hip joint for granted; it is massive, and it bears a lot of our body weight, allowing us to walk, move around, stand, sit down and get up. But, just like any other joint in our body, it is susceptible to wear and tear.

As the years go by, structures of the hip joint suffer more and more damage until one day you try to get up and feel a sudden, sharp pain. This intense pain is usually brief; it appears after we’ve been sitting for extended periods of time, and it goes away after walking.

Another important point you need to take when talking about this short-term hip pain is that it can lead to osteoarthritis, so it is vital that you take it seriously.

Before we go ahead and jump to the causes of this condition, we’d like to take a moment to talk a bit about hip anatomy.

The Anatomy Of The Hip

The hip joint is where the thigh bone (femur) connects to the pelvis. Believe it or not, the hip joint is second most mobile joint in the human body (second only to shoulder joint) because of the specific way it is built.

Cross Section Of The Hip Joint
Image 1: Cross Section Of The Hip Joint

We call this type of joint a ball-and-socket joint because the ball-like top of the thigh bone (femur head) fits into the cup-like area on the pelvis (acetabulum).

But, because it carries such a heavy load (our entire upper body) it is designed for stability, rather than a range of motion.

The capsule of this joint is sturdy and thick, locked in place by robust ligaments and muscles.

Why Do You Have Hip Pain When Sitting?


It is important to stress out that hip pain is not normal! Some people acknowledge it as an integral part of aging process, but this is not the case – any time the pain is present, it means something is wrong.

The good(bad) thing about hip pain is that it will not go unnoticed. The hip joint allows us to move around, sit, get up or stand, so if there is a problem with cartilage, tendons, ligaments, or bones, it will manifest itself as sharp radiating pain, stiffness in the joint, or referred pain felt in the groin area, down the inner thigh. Interestingly enough, lower back can cause the pain to radiate to the hip.

So what is causing this pain when sitting that goes away after walking? Here are some of the causes:

  • Hip impingement syndrome
  • Stiff joint
  • Hip bursitis
  • Arthritis
  • Piriformis syndrome
  • Sciatica
  • Tendinitis

Hip Impingement Syndrome

Also called femoroacetabular impingement, it occurs when acetabular labrum(a ring of cartilage surrounding the hip joint – Source: Medicinenet1) is damaged. The damage may be caused by a deformity, wear and tear damage, or by a mechanical injury.

Many HIS sufferers are those individuals that spend most of their day in the seated position. When we assume this position, there is typically enough space between femur head and acetabulum to allow full range of motion.

But if there is an anatomical anomaly present they can bump into each other, limit the range of motion and cause pain. Common causes of these anatomical anomalies are:

  • Shorter femoral neck
  • Enlarged acetabular surface
  • Increased depth of acetabulum etc.

But even people with no anatomical anomalies might suffer from hip impingement if they increase their flexibility to the extreme. This is why a lot of athletes also suffer from this condition – football, hockey, and baseball players for example.

Diagnosing Hip Impingement Syndrome

The syndrome can be relatively easily diagnosed based on your description of the symptoms and physical examination. Other common symptoms include:

  • Groin pain associated with physical activity
  • Painful clicking in the joint
  • Reduced range of motion

In addition, your doctor will probably order imaging tests, just to make sure. These include:

  • X-ray
  • MRI or
  • A CT scan

How To Treat It?

Nonsurgical treatment for hip pain when sitting will involve changing your routine – avoiding activities which cause pain, in combination with physical therapy and medication.

Surgical treatment usually steps in when physical therapy is not enough to relieve pain. In this case, arthroscopic surgery is required, where the surgeon will make small incisions, insert a small camera (called arthroscope) to try and pinpoint the anomaly and address/remove it.

Keep in mind that it is still unknown whether the surgery can prevent or even delay osteoarthritis, there is still some research to be done concerning this issue.

Stiff Joint

Stiffness2 can grab hold of every joint of our body; it is not only limited to the hip. In most cases, this is just a short-term condition brought up by a mechanical injury, such as a hip fracture, dislocation, or tight hip flexor muscles.

On the other hand, it can also be a part of a long-term, chronic medical condition. Some of the most common conditions are:

  • Osteo and Rheumatoid arthritis – osteoarthritis is a chronic condition where cartilage(protective tissue at the end of the bone) starts to deteriorate, and the bones start rubbing against each other. Rheumatoid arthritis, on the other hand, is an autoimmune disease(a condition where your immune system mistakenly attacks your own body) that damages joint tissue
  • Tendinitis – tendons are thick cords of tissue that join muscles to the bones. If for some reason, they become inflamed or irritated, a person will develop a condition called tendinitis
  • Ankylosing spondylitis – AS is a type of arthritis primarily affecting your spine, leading to pain, and disability
  • Lyme disease – this is an infectious disease caused by a bacteria called Borrelia burgdorferi, transmitted by an infected tick. The disease advances in three separate stages with a different set of progressing symptoms. A localized rash characterizes the first stage; chills, fever, fatigue, and sore throat characterize the second one while the third one may lead to severe headaches, brain disorders and arthritis

Symptoms And Diagnosis

The main symptom is, of course, a stiff joint, but you will also notice localized pain, limited range of motion and hear a clicking sound as you move.

A physical exam is usually enough for a correct diagnosis, but your doctor might need some additional information such as a clear list of symptoms, existing medical conditions, injuries, etc.

X-ray and MRI are usually not needed to make the right diagnosis, but they can be used to pinpoint the location of the problem or rule out other, unrelated conditions.

Treating A Stiff Hip


Treatment will depend on the underlying cause. In most cases of hip stiffness, a doctor will advise his patient to adopt some light stretching exercises to release tension within the muscles, walk, and rest when the pain appears.

Arthritis, on the other hand, is not a curable medical disease, so appropriate medication is prescribed to help patients manage the condition and reduce the pain.

Hip Bursitis

Hip or trochanteric bursitis is an inflammation of the trochanteric bursa on the outside of the hip joint.

Bursa3 is a small, fluid filled sack situated in places in tissue where friction would commonly occur. So, its main role is a protective one.

Trochanteric bursa is located on the outside of the hip joint, where the pelvic bone meets the top of the thigh bone. When this bursa gets inflamed, the patient will experience some of the following symptoms:

  • Hip pain
  • Inability to lie on the affected side
  • Pain when getting up
  • Pain when remain seated for longer

There are numerous ways of addressing the inflamed hip bursa, depending on the severity of the condition. In its early stages, doctors usually prescribe physical therapy, ice, and painkillers to help reduce the swelling and pain. This is why you might feel the pain going away after walking.

Doctors will treat more severe cases with injections and bursa draining; if that doesn’t help, they might even use surgery as a last resort.

Arthritis

Arthritis4 is a term we use for the conditions affecting out joints and the surrounding tissue. Early signs of arthritis are swelling in the joints, pain, and stiffness; over time, the disease will progress and cause severe joint damage.

Here are the six most common types of arthritis:

  • Osteoarthritis
  • Autoimmune arthritis
  • Juvenile arthritis – a type of athritis affecting children
  • Infectious arthritis – arthritis as a result of an infection within the joint
  • Psoriatic arthritis – psoriasis is a skin disease causing patches of thick, red, itchy skin. Some patient suffering from psoriasis can also develop a type of arthritis we know as psoriatic
  • Gout

Osteoarthritis

OA is severe, degenerative disease (most common in hip, knees, spine and small joints of the hand) that breaks down the cartilage in the joints.

It is more prevalent in older individuals, people that are obese and often come as a result of a direct injury.

OA is usually diagnosed using a combination of physical exams, medical imaging technology, and blood tests. And as for the treatment, the doctor will often prescribe topical creams, physical therapy and exercise and, in more severe cases, operation or even a complete joint replacement (hip replacement surgery).

Autoimmune Arthritis

Autoimmune diseases5 occur when there is a malfunction in our immune system. Usually, our immune system protects us from diseases and infection, but in some cases, it can produce antibodies that attack healthy cells and tissues within our own body!

This is precisely what happens in RA patients. Unlike OA, RA can affect even your eyes, mouth and lungs; it is not strictly a “joint disease.”

Noone still knows what exactly causes RA, but the good news is we can slow down the progress of the disease with medication and lifestyle changes.

Gout

Gout is also a common type of arthritis occurring when there is an increased uric acid build up in the body. It causes intense pain, stiffness, swelling, and increased the temperature in the joints.

Uric acid6 is a substance resulting from the breakdown of purines7, commonly found in meat products.

Usually, uric acid gets dissolved in our blood and passed through the kidneys out of our body in urine. Sometimes though, this uric acid can build up within the body in a needle-like crystal form. When these formations accumulate within the joint, they can cause tremendous pain.

Gout will first “go after” your big toe, but it can also spread to ankles, knees, wrist, fingers, and elbows.

Risk groups for gout are:

  • Men
  • Oveweight individuals
  • Those that drink alcohol
  • Or eat foods rich in purines

Piriformis Syndrome

 The Path Of The Sciatic Nerve
Image 2: The Path Of The Sciatic Nerve

Piriformis syndrome is a condition caused by a comppression to the sciatic nerve by the piriformis muscle.

Piriformis muscle is a flat, pyramid-shaped muscle located in the pelvic region. Its primary functions are to rotate the thig outward, abduct it(move away from the midline of the body), and to hold the acetabular head in place.

A gap at the lower border of the muscle allows for the neurovascular structures to pass(along with the sciatic nerve). This gap can become tight and put pressure the passing nerves, causing piriformis syndrome.

Some of the main causes of this condition are:

  • A blow to the region
  • Tightness in the muscle
  • Sitting for long
  • Various sport activities
  • Penetrating wounds etc.

Sciatica

We refer to sciatica as a symptom of one or more problems with the sciatic nerve.

We’ve already written extensively on the topic sciatica, to find out more about the condition, please visit our article titled “13 Ways To Get Natural Pain Relief From Sciatica”.

Tendinitis

Tendinitis8 is characterized by pain, swelling, and stiffness in a tendon and the surrounding joint. A tendon is a thick band of tissue connecting the muscle to the bone.

Tendinitis is a common condition, usually caused by repetitive motion; such motions occur in professional sports such as tennis, but may also be found in carpenters and musicians.

There are many different types of tendinitis, mostly named after the activity that is causing them or the location:

  • Golfer’s elbow – an injury to the inner tendon of the elbow caused by a golfer’s swing
  • Tennis elbow – possibly the most “well-known” type of tendinitis. It is an injury to the outer elbow tendon
  • Rotator cuff tendinitis – here pain is present at the tip of the arm and may be worsened when reaching, pushing, or pulling heavier loads
  • Achilles tendinitis – tendinitis in the tendon at the back of the heel
  • Jumper’s knee – mostly affecting individuals who play sports that require jumping. As the name suggests, these activities cause knee tendons to become inflamed

Tendinitis Treatment

Some of the most successful forms of tendinitis treatment are:

  • Rest and elevation of the affected limb
  • Taking medication to reduce pain and swelling
  • Gentle stretching and strengthening exercises
  • Massage
  • Brace or a splint


References:
1. Medical Definition of Acetabular labrum
2. What Causes Hip Stiff?
3. The Free Dictionary/Medical Dictionary – Bursa
4. MedlinePlus – Arthritis
5. National Institute of Environmental Health Sciences – Autoimune Diseases
6. Uric Acid
7. Purines
8. Tendinitis
Image 1 Source: Gray H. Lower Limb, Atlas Of Anatomy, page 278
Image 2 Source: Gray H. Lower Limb, Atlas Of Anatomy, page 282

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