Pain around the hip and groin area is one of the more common chronic or long-term conditions that we see in the clinic. This area is very complex and the source of pain can be from any number of structures including the hip, pelvis, or lower back. Chronic pain in this area can be seen in all ages of people such as footballers with chronic groin strains or pensioners with arthritis in the hip.
Location of Pain
The area of the pain gives a good hint at the structure that is causing the pain but it by no means confirms it. For instance pain in the buttock might be from a muscle tear in the area or could also be referred pain from the lower back.
Cause of Injury
The cause of injury also gives us a clue as to the likely structure that is causing the problem, for example pain on the outside of the hip caused by an increase in running training might suggest a bursitis, whereas pain shooting into the buttock after sitting for a long time might point towards a referred pain or nerve coming from the lower back.
Unresolving Hip Pain
When hip pain doesn't resolve, it generally means that there is something there that is continuing to be irritated and therefore not allowing effective healing to happen. Degeneration of the hip joint or a tear in the labrum protecting the joint may cause pain and stiffness in the front and side of the hip and this might show up on x-ray.
Hypersensitivity of the bone on the outside of the hip when lying on that side is a common complaint often becoming more prominent in bed at night which can disturb your sleep. The primary suspects for this type of pain are the bursa or the tendons of the gluteal muscles that attach onto the bone on the outside of the hip. If these are overly taught then they can become inflamed and create a chronic pain that can be difficult to shift.
Chronic pain in the buttock is often wrongly attributed to a hip problem. In fact it is most often referred pain coming from the lower back. The main nerves that come out from the lower back go into the buttock and supply the muscles there so an irritation or stiffness in the back can commonly give people a dull, tight, sensitive feeling in the buttock that just doesn't go away. In many cases of long-term hip pain, recognising this and treating the lower back usually gets the problem solved reasonably quickly.
How We Can Help
All of these conditions can effectively be treated with different physio techniques such as manipulation, soft tissue release, or dry needling. The key is identifying what is actually causing your pain so assessing the whole of the lower back, hip and pelvis is essential. Once the cause has been established and treatment has begun on all of the contributing areas, relief from your pain is often quick.