Hip Pain Treatment in North Vancouver

Hip pain can look very different

There isn't one type of hip pain. The location of your symptoms, what makes them worse, how they started and how your hip moves can all provide useful information. Four common examples illustrate why this matters.

Pain on the outside of the hip

Pain over the bony point on the outside of the hip is often described as bursitis. Today, this presentation is more commonly referred to as greater trochanteric pain syndrome and often involves the gluteal tendons. It may be worse when lying on that side, walking uphill, climbing stairs or after increased activity.

When a tendon, bursa, or surrounding tissue has become sensitive and painful, the solution is usually to find the underlying cause. Treatment depends on how irritable the area is and what demands are being placed on it. Massage or manual treatment usually help people with associated muscle tension or discomfort. Once pain is reduced, muscle strengthening can help rebuild tolerance where needed.

Deep groin pain and hip osteoarthritis

Pain felt deep in the groin, particularly when accompanied by stiffness and reduced hip movement, can sometimes be associated with osteoarthritis of the hip. Osteoarthritis can also be associated with pain in the knees, glute region, or in the lower back. Every case of groin pain is not arthritis, and the location of pain alone cannot establish the cause.

Where osteoarthritis is present, regular movement and appropriate exercises are important parts of management. The aim is to maintain as much comfortable movement, strength and functional capacity as possible.

When the hip and lower back are involved together

The hip and lower back don't operate independently. The pelvis transfers load between the trunk and legs, and movement at one part of the system can influence what happens elsewhere. Someone may therefore feel pain primarily in the hip while also having restricted movement or altered load sharing around the pelvis or lower back.

As an example, you might have symptoms in your glute region that is myofascial pain caused from muscles in the lower back. The assessment looks at the system rather than automatically deciding which structure is"the problem."

The hip is part of a movement system

A hip doesn't move by itself. Every step requires coordination between the foot, ankle, knee, hip, pelvis and trunk. The pelvis transfers forces between the legs and the spine, and the trunk provides a stable but adaptable base from which the legs can move.

This is one reason a hip assessment may include areas that don't hurt. It doesn't mean the painful hip is being ignored. It means we're looking at how the hip is functioning within the movement system.

What does the assessment look at?

During the assessment we look both at the pain and how it behaves as well as the range of motion.

• Hip mobility: Are there restrictions in the movement of the hip itself?
• Muscle activity: Are some muscles working excessively while others are not contributing effectively?
• Pelvic control: Can the pelvis remain controlled during movement?
• Lower back: Is the lower back compensating for restricted or poorly controlled hip movement?
• Movement under load: Does the way you move change when you squat, step, walk, balance or add resistance?
• Functional capacity: What can the hip tolerate in your actual life — walking, stairs, sitting, sport, lifting or other activities that matter to you?

What treatment may involve

There isn't one treatment that is right for every hip problem.

The approach depends on what the assessment finds and on your activities.

Massage and manual treatment

Massage can be useful for some types of hip pain.

It may help when muscles are tight, overloaded or contributing to discomfort.

Specific mobilization may also be used to improve restricted joint mobility, reduce muscle guarding or make movement more comfortable.

Often treatment is combined with exercise or other treatment to help restore movement and capacity.

Strengthening exercises

Commonly, weak muscles found in the area are strengthened through exercises.

Movement Retraining

If there are imbalances in movement patterns these are addressed by neuromuscular training.

What to expect

Hip problems usually improve through an approach that matches the person's symptoms, needs and goals.

After the assessment, Eva will explain what she found, what she thinks is relevant to your symptoms and what treatment may be useful.

The goal is to help you get back to the activities that matter to you and, where appropriate, give you the tools to manage your hip yourself.

The Scandinavian Clinic

• A thorough bio-mechanical assessment first.
• Massage and manual treatment. These can be useful treatments in their own right for appropriate presentations, and may also be combined with exercise where useful.
• Swedish-trained orthopaedic manual therapy. Five years of university-level training in Sweden, with a strong emphasis on clinical reasoning and biomechanical assessment.
• Czech-trained in Dynamic Neuromuscular Stabilisation. DNS is available as an additional approach for selected patients where movement coordination appears relevant and who want to actively work on it.
• Covered by most extended health plans. As a Registered Massage Therapist, Eva's treatments are eligible for extended health benefits.

Frequently Asked Questions