Hip pain during hip extension or flexion could be due to various reasons — arthritis, postural issues and weakening of muscles around the hip or even IT band syndrome. It can also be caused by an anatomical abnormality in the hip joint. This condition is known as hip impingement syndrome or femoroacetabular impingement (FAI).
What causes hip impingement?
The hip is a ball and socket joint, where the head of the femur (thigh) bone fits into the socket of the pelvic bone, known as the acetabulum. There is a cartilage layer between the head of the femur and the acetabulum which facilitates smooth movement of the femoroacetabular joint. However, some people have an abnormality in the anatomy from birth.
Dr Lalit Panchal, consultant orthopedic, SL Raheja Hospital, Mahim, Mumbai, explains, “This can occur either from the cup side or the femoral head.” In the paper Femoroacetabular Impingement published in Arthritis & Rheumatology, hip impingement syndrome is described as pain emanating from contact between the abnormal femoral head and acetabulum during hip rotation. “Under normal circumstances, when the hip rotates, there is no problem,” adds Dr Panchal. “But if there is an anatomical problem, or a deformed shape either in the acetabulum [cup] or the femoral head then it can cause hip impingement.”
Symptoms of hip impingement syndrome
The symptoms of hip impingement appear in people in their 30s or early 40s. And though some may tend to mistake hip impingement pain with hip-flexor pain, they are different. “Hip-flexor pain is a muscular pain with a spasm,” highlights Dr Panchal. “During hip rotation, the impingement causes pain.”
Some of the most common symptoms of hip impingement are:
- Hip pain during physical activities like cycling, climbing stairs and sitting for long hours, among others.
- Stiffness in the hips.
- Struggling during movements like hip flexion and hip extension.
Early diagnosis is crucial
“In hip impingement, there is a high probability that the person may be unaware,” informs Dr Panchal. “Diagnosis can be done with an X-ray and an MRI scan. If ignored, it can progress to arthritis, a chronic pain that is either constant or occurs on and off along with damage to the cartilage. The cartilage damage is a slow progression but progresses along with chronic pain,” he adds.
If ignored, the condition can lead to further complications, including chronic pain and arthritis in the hips.
Treating the hip condition
In the initial stages of hip impingement syndrome, non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed. This is followed by physiotherapy sessions, which form the cornerstone of the treatment. The focus of therapy is to strengthen the muscles around the hips. In extreme cases, arthroscopic surgery is needed.
Takeaways
- Hip impingement syndrome or femoroacetabular impingement is caused by an anatomical abnormality in the ball and socket joint either the head of the femur bone or the acetabulum (socket) side.
- If ignored, the condition can progress to issues like arthritis, chronic pain and cartilage damage.
- During treatment, it is essential to strengthen the muscles around the hips by doing exercises that specifically target the region.
