Signs, symptoms and treatment advice if you have pain on the outside of your hip.
Who gets lateral hip pain and why?
There also appears to be a high prevalence of lateral hip pain in people with osteoarthritis of the peripheral joints or spine and rheumatoid arthritis. In fact, it has been suggested that 91% of people with lateral hip pain have one of these co-existing pathologies.
Pain is widely accepted to be a result of a tendinosis; ie. chronic irritation of the tendon. In the case of the lateral hip, the gluteal (bottom muscle) tendon is irritated by the load placed on it. This may be load from exercise or from the compression of the tendon on the bone caused by the iliotibial band. This irritation builds up until it eventually becomes painful and limits function.
- Laying on the affected side (although this can also be painful laying on the other side too).
- Prolonged standing
- Sit to stand
- Climbing stairs
- Crossing your legs
What can I do to make it better?
With lateral hip pain (and most injuries when I think about it) there are 2 key principles to help make it better as the first port of call:
- Try not to irritate it
- Exercise the gluteal musclesSounds obvious right? But how do you do this? Well if we are avoiding irritating it, firstly I would suggest that you avoid stretching the area – that’s stretching the gluteal muscles and causing discomfort in the lateral hip. Stretching can be an aggravating factor – it is not a case of ‘no pain no gain’. Taking into account the aggravating factors mentioned earlier I would also advise:
Laying down – Try to sleep on the unaffected side with a pillow between your knees to stop them from crossing over. Or, alternatively lay on the affected side but put something soft underneath such as another duvet.
Prolonged standing – I know it’s obvious, but try not to stand until your pain comes on. However, it may also help to not ‘hang’ on your hip to avoid compression of the area.
Sit to stand – Try to sit in taller chairs with you knee below the height of your hip, it may also be helpful to use your arms to assist you when standing from sitting.
Running – This is tricky, but in my experience, it is best to do some running rather than avoid it completely. It can help to shorten your stride or slow your pace. Keep running but do it within acceptable limits of pain.
Climbing stairs – Try going upstairs leading with the unaffected side and the affected side on the way down.
Crossing your legs – Don’t do it!!!!!!!!!!!
And exercising the gluteal muscles?????
With lateral hip pain, I would make a slight adjustment to the demonstration by placing a towel or pillow between your knees for comfort. If this exercise is uncomfortable, then you may need to change it so that instead of lifting and lowering, you just lift the leg and hold it for 30 seconds to 1 minute and repeat this about 5 times a day.
This is a good place to start and may help, however, you may also need to work on balance and stability around your trunk so that you can stop irritating it when you return to full activity. However, these may need to be personal to you and therefore advise from a professional is necessary.
What else can be done?
Shockwave therapy can also be used to help with lateral hi pain that has been ongoing for more than 3 months. There is some literature to suggest that although it may not be as effective in the short term as steroid injections, it can help with a better long term effect. NICE has produced a summary on shockwave for lateral hip pain for patients which you can see here, but if you want more information contact us and we will be more than happy to answer all your questions.
Thanks for reading, Josh.