Hip pain, groin pain and what causes them

Written by: Mr Dean Michael
Published: | Updated: 05/03/2019
Edited by: Cal Murphy

Hip and groin pain is no laughing matter, and it is not a problem that is limited to elderly people. Sports injuries, accidents, and many other factors can lead to pain, so we asked consultant orthopaedic surgeon Mr Dean Michael to tell us more.

Image courtesy of Injurymap

What causes hip and groin pain?

There are a number of causes of hip pain. These can be related to specific problems with the hip joint itself, to the muscles and tendons around the hip, or, in fact, to referred pain from the back. Pain around the lateral aspect and side of the hip is often related to either bursitis or tendinopathy. Pain in the groin itself can be related to hip flexor tendon problems or adductor tendon issues (often referred to as a groin strain). Pain which is often described by the patient as coming from the hip is often related to the lower back, while pain felt deep in the groin is, in fact, more typically from the hip joint itself.

Groin pain, if related to the hip joint, is either as a result of arthritis (more commonly in older patients) or can be related to tears to the cartilage rim of the hip socket (the labrum). Tears to the labrum may occur as a result of specific twisting or sporting injury, or as a result of a process called impingement. In impingement, the patient’s hip has formed either with a particularly deep socket or with a bump on the front of the hip bone. As the leg is brought into flexion the front of the hip bone rubs or impinges upon the rim of the socket and over time this can cause tears to the cartilage rim (labrum) or damage to the cartilage surface of the joint.

Cartilage injuries of the hip can particularly occur if there is forced or deep flexion particularly when associated with a twisting lesion. Typically this can occur in repetitive flexion or lunging sports, such as skiing, rowing, or squash.

One of the most common problems causing hip and groin pain are tendon injuries of the hip. These often occur during sport.


When should someone see a specialist about pain?

Most tendon and ligament injuries about the hip settle with conservative treatment in the form of anti-inflammatory tablets, rest, and physiotherapy. If symptoms persist beyond six weeks then it is advised to seek a specialist opinion so that investigations can be undertaken to exclude structural damage such as a cartilage injury or a torn labrum, and a diagnosis of impingement (femoralacetabuluar impingement (FAI)) can be made. The importance of this condition is that it is thought to be the precursor to the development of arthritis and so if symptoms persist it is advised to identify the problem and treat it.


How is the cause of hip/groin pain diagnosed?

The causes of hip pain can often be diagnosed by a thorough clinical examination, but investigations such as a CT or, more commonly, an MRI arthrogram of the hip will be undertaken. A CT scan gives very good information as to the shape and bony structure of the hip joint but MRI arthrogram (which involves injection of dye into the hip) is the gold standard test for identification of cartilage injuries around the hip.


 If you are concerned with hip pain, visit Mr Dean Michael’s profile to book an appointment.

By Mr Dean Michael
Orthopaedic surgery

Mr Dean Michael is a consultant orthopaedic surgeon with a specialist interest in all types of lower limb surgery. Mr Michael sees patients with a range of conditions including ankle injuries, bunions, sports injuries, and osteoarthritis, offering surgical treatments from hip resurfacing and ankle ligament surgery to full hip and knee replacements.

Mr Michael originally qualified from St Bartholomew's Hospital in 1994 then undertook specialist training in hip and knee surgery at The Middlesex Hospital and The Royal National Orthopaedic Hospital. He completed a specialist Hip and Knee Surgery Fellowship in Australia in 2005, before returning to the UK to take up the post of Consultant Orthopaedic Surgeon at St Peter's Hospital, Chertsey, where he works to this day.

In 2011, Mr Michael became the director of the Surrey Orthopaedic Clinic. The Surrey Orthopaedic Clinic works across major hospitals in Surrey and London, bringing together a UK-qualified team of specialists to provide a complete package of high-quality musculoskeletal care. Mr Michael is also a member of the British Orthopaedic Association, the British Orthopaedic Foot and Ankle Society, and the British Hip Society.

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