Hip and Pelvis Conditions/Pathology

 You should always seek a professional healthcare provider if you are unsure of your pain for assessment and management.

You may have been diagnosed with one or more of these however they may not tell the whole story about your pain. Often the pain is from something else. The findings on your scans may be incidental.

If you have pelvis or hip pain which is not getting better and there are other symptoms you should seek a healthcare practitioner immediately.

At the side of your hip there is a bony point (greater trochanter) where muscle tendons  attach. This region has a lubricating cushion (bursa) in the area to decrease friction to the area. GTPS is an umbrella term for an irritation of the tendons or bursae; tendinopathy or bursitis, respectively. Trauma or sustained micro-trauma is normally the cause of this pain. This micros-strain may be due to a change in activity or in biomechanics.

The Iliopsoas muscle bends the front of the hip and is attached to the front of your spine. There is a lubricating cushion (bursa) and sometimes this is aggravated. People normally complain of hip deep inside the joint or groin region. Normailly 

 ITB syndrome pain is normally felt on the outside of the mid thigh to knee. The ITB starts from the upper outside portion of the pelvis. It normally slides past the bony parts on the outside of the knee with the help of the lubricating cushion (bursa). The band sliding across a bump is thought to irritate the region causing pain. The pain normally increases with prolonged activity like running.

When the thigh is moved forward and back (flexion and extension) the hip can 'snap'/'click' as the ITB moves across the bone. In most cases this in painless. There is an other type of snapping hip where the muscles deeper in may cross a different bony point causing similar but deeper symptoms.

The cushioned soft bone (cartilage) in the hip can change over time and the joint space may decrease causing pain and stiffness deep in the hip. In severe cases, a hip replacement may be required for pain management. Physiotherapy will decrease the disability pre and post operatively. 

This specialised soft bone (labrum) increases the contact surface of the ball of the hip joint. Damage to the labrum can limit the range of the hip and cause pain. In some cases the surgery is required if conservative management is not successful.

Sciatica may present as pain, loss of sensation, pins & needles and loss of strength around the pelvis region and of the lower limbs. The nerve itself may be irritated however this symptom may be related to your back. Sciatica is an umbrella term for symptoms that are felt that relate to the sciatic nerve and its branches. 

The pelvis is comprised of a ring bones which join at the front (symphesis pubis) and back (SIJ). Dysfunction may cause difficulties with dressing, getting in and out of cars/bed and squatting. There are muscle attachments all around the pelvis which may be a factor in contributing to the pain.

Pelvic health is not often discussed unless it is regarding women's health and pregnancy however if you have problems with bowel or bladder control, painful sex, erectile dysfunction you should seek a pelvic health physiotherapist or GP who can assess and will refer you to an obstetrician, gynecologist or urologist if necessary.