Hip and leg pain is a broad category of conditions that can range from acute soreness due to a minor injury to long-term chronic pain that can be the result of a disease or disorder. Because of the varying causes of hip and leg pain, there are a number of possible treatments as well, all dependent on the cause and severity of the condition.
How many people suffer from hip and leg pain?
It is estimated that nearly two million people in the United States seek emergency room treatments for sports injuries each year. Sports injuries are most often associated to injuries to the legs.
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Basketball injuries top the list, with over 90% of individuals seeking treatment after an injury in this sport being men. Bicycling, football, and baseball were the next three most common sports causing injuries on the list. Children between the ages of six and 19 made up 20% of all sports injury related emergency room visits.
However, not all sports injuries are treatable by emergency room visits and some more minor injuries can be treated with rest and at-home care. There are also other conditions that can lead to hip and leg pain. Many of these are related to the hip itself.
The hip joint is a ball and socket joint, where the femur connects to the pelvis. The top of the femur is a round ball, which fits into the socket (acetabulum) formed by the pelvic bone.
The ball is allowed to glide and rotate within the acetabulum because a group of ligaments and muscles support the joint and inhibit over extension or malrotation from occurring. Also, within the joint is a synovial lining, which provides lubricating fluid to decrease friction, produced when the joint is in motion.
Any condition that irritates or inflames this joint, like arthritis, can also lead to pain.
What are the major causes of hip and leg pain?
The hip joint is a large weight-bearing joint attaching the leg bone to the pelvis. It allows the body to walk, run, and sit. The most common causes of pain in the hip and leg include:
The most common hip and leg pain issues are caused by minor sports injuries for most of the population. This can lead to:
- Muscle cramps
- Sprains and strains
- Fractures
- Shin splints
Each of these conditions can be treated at home with rest and a few simple at-home remedies.
Muscle cramps are a common condition that can be persistent and painful. They are often referred to as a “Charley Horse” when felt in the calf muscles. Caused by an involuntary contraction of the muscle, the sensation of a muscle cramp is a muscle that will not relax. You may even feel spasms in the affected area. Muscle cramps can occur after a sports injury and they are often related to nutrition and hydration.
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When exercising, running, or playing sports, it is important to stretch the muscles properly before beginning and stay hydrated throughout the activity. To relieve a muscle cramp as it is happening, you may want to stretch the muscle, apply heat, drink more water, or take an over-the-counter pain reliever.
Typically a muscle cramp will go away on its own, but if the pain persists, there may be some concern about nerve damage or another malfunction that is causing the muscle cramps. If the cramps reoccur frequently, you should talk with a doctor about them.
The diagnoses of sprains and strains are among the most common sports injuries, but what do these terms really mean?
A sprain is the stretching or tearing of the ligaments that connect our bones. It is generally caused by some trauma, directly or indirectly, that stretches or ruptures these ligaments. This can be the result of a fall, a blow to the body from another player, or overstretching the leg during the game. Sprains will usually heal with rest and self-care. This may include compression, ice, and elevation as well as the use of over-the-counter pain medications. If an injury is more severe, surgical correction may be necessary.
A strain is an injury of the muscle or the tendons that connect the muscles to bones. Strains are more commonly caused by a repetitive motion or overuse of the muscles in the leg. To prevent a strain, athletes and individuals exercising are advised to take the proper breaks. Strains can also be caused by falls and contact with other players. Strains are treated similarly to sprains with compression, ice, and elevation.
The primary sign of a shin splint is an aching or throbbing in the shin, the front area of the lower leg just above your foot. They can be caused by swollen and irritated muscles, a stress fracture, or flat feet. They are most common for runners or dancers.
In general, shin splints will heal on their own. You can treat them at home with:
- Rest
- Ice
- Non-steroidal anti-inflammatory medications (nsaids)
- Compression
- Arch supports for your shoes
If the pain persists, you may want to talk to a doctor and have them do a complete physical examination of the area to determine if there any additional underlying problems. They may also recommend physical therapy.
What about more serious injuries, like fractures?
A leg breaks when a force great enough to break the bone is applied to the limb. It is a common sports injury, but can also occur due to a car accident or a fall. The treatment for a broken leg will depend entirely on the severity of the break.
A leg fracture can occur in the femur, located in the thigh, or the tibia and fibula which are the two bones that make up your leg from the knee to the foot.
There are several categories of fractures, including:
- Open or compound: The bone ruptures the surrounding muscles and skin
- Closed: The broken bone does not protrude
- Incomplete: The fracture does not break the entire bone
- Complete: Both bones in the lower leg are broken through
- Stress or hairline: A crack in the bone
Stress and hairline fractures will generally heal on their own without the use of a cast. For more severe breaks, medical intervention is required to set the bone and allow it to heal properly. Some broken legs will require surgery if the break is extreme.
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How will my hip and leg pain be diagnosed?
Diagnosing patients with hip and leg pain is never straight forward and is often difficult, as many of the symptoms are similar to other conditions. The first step is taking a comprehensive history and physical exam.
Several aspects will be covered in the history and some of the most common questions your doctor will ask you are:
- Where is the pain located?
- How long has the pain been there?
- What were you doing when you first noticed the pain?
- Is there anything you can do that alleviates the pain?
- Are you currently taking any medications for the pain? Do they work?
- Is there any family history of arthritis or other autoimmune diseases?
After conducting a full history and physical exam your doctor may want additional studies, including radiological films and blood work. Imaging techniques are useful because your doctor is often able to see pathology inside the affected joint.
Common imaging techniques to evaluate hip and leg pain include:
- X-rays: A diagnostic test using an electromagnetic energy ray to produce images of internal tissues.
- CT scans: A diagnostic test that combines X-rays with computer technology to produce cross sectional views of the body. This is helpful because it helps to visualize detailed images of the body, including the bones, muscles, and organs.
- MRI scans: A diagnostic image that uses large magnets and a computer to produce detailed images of the structures within the body. This is even more detailed than the CT scan or an X-ray.
Your physician may also request a blood test, and may need to evaluate the consistency of the fluid accumulation in the joint.
Treatments for hip and leg pain
Most of these leg injuries fall under the category of acute pain. These conditions will heal on their own without lingering, long-term effects. Acute pain can be treated at home, as discussed previously, or with medical intervention.
Once the injury heals, you can normally resume full activity. However, if any pain from an injury continues for longer than three months it has crossed classification from acute to chronic pain. Patients dealing with chronic leg pain after an injury may need to seek more advanced treatment to stop or alleviate the pain long-term.
If you have experienced a sports-related injury, such as a muscle strain or a shin splint, talk with your doctor about the best care for your situation. If home care and rest doesn’t improve the condition, discuss more advanced treatment plans.
The most common and recommended methods for treating arthritis are conservative alternative therapy provided by a pain specialist. Staying active and physical therapy have also proven to be beneficial.
Physical therapy has been noted to significantly improve postural stability in patients suffering from hip osteoarthritis.
Intra-articular joint injections are also rapidly gaining popularity and use in the treatment for arthritis because of their success, minimally invasive nature, and long-acting effects.
Speak with your pain physician today to determine the best way to improve your hip and leg pain. After conducting a full history and physical exam your physician may want additional studies, including radiological films and blood work.
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