Why Does My Hip Hurt? Where Does It Hurt?

An arthritic hip is painful because the joint has broken down. The articular cartilage on the surfaces of the joint has worn away leaving raw bone exposed. Movement between the two joint surfaces is no longer smooth and friction free. As a result, the tissues within the joint become inflamed and the joint begins to hurt. An excess amount of joint fluid may be produced and the resultant swelling of the joint adds to the symptoms.

The exposed raw bony surfaces have a greater nerve supply than the articular cartilage and pressure on these surfaces causes pain. As the joint becomes stiffer, greater strain is placed on the hip muscles as they move the joint. This too can be painful. The friction between the exposed bony surfaces can cause grinding and a feeling of discomfort.

When the joint in inflamed, there may be pain both with activity and when the joint is at rest. Anatomically, the hip joint fits deep in the groin. For this reason, groin pain may be the first sign of an arthritic hip. The pain may radiate to the outside or lateral side of the hip or to the back or posterior aspect of the hip. It will often extend to the mid portion of thigh and down to the knee. Since the ball of the hip, the femoral head, is part of the femur the pain travels down the length of the entire bone and will be felt in the thigh and the knee.

When the pain goes below the knee, it is often a sign of a different problem, such as sciatica or poor circulation.

When Will I Have Hip Pain?

An arthritic hip can hurt any time. Much of the time pain will occur after prolonged standing, walking, or any other weight bearing activity. It may also come from activities that put stress on the hip such as bending, twisting, running, and climbing stairs.

Sometimes the pain may develop spontaneous and be present when you are doing nothing at all. This is called resting pain. Frequently,  this kind of pain can occur at night and can awaken you from sleep.

People who have osteoarthritis will sometimes complain of pain in an affected joint when there is a change in the weather. An episode of pain may last for several days and then recede. It is not clear what triggers the inflammatory response that causes the pain.

In many people with advanced osteoarthritis, the pain is constant and is present all the time. It is unrelieved by rest, by any change in position, or by medication.

Why does my hip sometimes make a crackling noise when I try to move it?

A crackling or snapping of the hip joint can be disconcerting. It feels uncomfortable and it makes a loud noise that sometimes other people in the room can hear. The medical term for crackling or snapping is crepitus.

In simplest terms, crepitus occurs because bone is rubbing against bone. The joint cartilage has broken down and the joint surfaces become irregular. When this happens, the joint no longer moves smoothly. There is friction between the two bones. The joint may catch or get stuck momentarily before it starts to move again. Crepitus is often painful when hip joint gets stuck. It may make you stop in your tracks as you are trying to move forward. It may make it especially hard for you to go up and down stairs.

Factors other than osteoarthritis can cause crepitus. Sometimes, the presence of a loose body or fragment of bone or cartilage moving in the joint can cause momentary friction. You can also get a grinding sensation if there is disruption in the joint surface such as from an old fracture.

The presence of crepitus in an arthritic joint is usually a sign that arthritis is advanced and will soon require hip replacement.

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