Hip and Groin pain

There are numerous conditions that can cause hip or groin pain. The most common ones that patients present with are:

  • Bursitis
  • Osteoarthritis of the hip
  • Muscle injury
  • Referred pain from the lower back or knee

Bursitis in the inflammation of the bursa, which is a small fluid-filled sac between two adjoining structures, usually muscles, tendons and bones. They reduce friction and assist movement of the tendon over the bony surface. A common cause of bursitis is overuse e.g. from jogging, tennis and squash.

Symptoms include localised pain when sitting on a hard surface or when lying on the affected hip, swelling/warmth, worse pain with movement or at night and some limited hip movement.

Osteopathic treatment will look at the lower back and lower limb movement to help determine the cause of your pain. Anything from poor movement control, posture, exercise or a lower back/knee injury can cause the lumbo-pelvic biomechanics to change and affect how the hip is being used. We may also give you some stretches/strengthening advice to help manage the cause of the bursitis.

Osteoarthritis of the hip is commonly found in the adult poulation. This can be due to chronic trauma from a pelvis imblance, dysfunctions of the knee, foot and ankle, or from past sports injuries. Symptoms inclue pain worse with movement but relieved with rest, tenderness around the groin area, limitation of hip movement, grinding noise/sensation in the hip joint, and a change in how the person walks.

Osteopathic treatment can work on the surrounding muscles to reduce stiffness and soreness, whilst improving lymphatic drainage to reduce swelling. We may also give you some exercise, stretching advice or ways to reduce inflammation at home.

Muscle injury often occurs in people who play sports activities e.g. soccer, basketball, running, dancing and AFL/rugby players. Most muscle injuries heal within a few days. However, if it becomes a chronic problem, it is important to have it checked to see if there are any joints dysfunction or muscular imbalance causing it to flare up regularly.

With all the hip complaints, it is important to address the lower back, knee, ankle and foot to see why you are experiencing hip problems. It is possible that the issue is not with the hip itself but from a pelvis dysfunction. Also, it is good to have a comprehensive case history to identify the factor predisposing to the hip pain and to know how to stop it from happening whether it is through a change in posture or activities.

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Research:

Hinman, R

Published in J Physiother. 2014 Mar;60(1):56. doi: 10.1016/j.jphys.2013.12.005. Epub 2014 May 9.

For people with hip and knee OA, manual therapy and exercise therapy supervised by physiotherapists can lead to reduced pain and improved physical function for up to one year, with no added benefit from combining these physiotherapy interventions.

Pinto D, Robertson MC, Abbott JH, Hansen P, Campbell AJ; MOA Trial Team

Published in Osteoarthritis Cartilage. 2013 Oct;21(10):1504-13. doi:10.1016/j.joca.2013.06.014. Epub 2013 Jun 27.

Exercise therapy and manual therapy were more cost effective than usual care at policy relevant values of willingness-to-pay from both the perspective of the health system and society.

Seffinger, M. A
Published in The Journal of the American Osteopathic Association, January 2014, Vol. 114, 63. doi:10.7556/jaoa.2014.010

It is likely that OMT effectiveness would be similar to the manual therapy effectiveness demonstrated in this study. Studies assessing the effectiveness of OMT for patients with hip or knee OA are warranted.