From the Doctor’s Desk: Hip Pain in Young Adults

A young woman holds her hip in pain while getting up from bed.
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Welcome to our first edition of “From the Doctor’s Desk,” a series where our very own doctors at New York Bone & Joint Specialists share their orthopedic insights. In this issue, Dr. Rupesh Tarwala discusses hip pain in young adults.

Hip pain in young adults (16 years to 50 years of age) is a very common condition in active sports individuals. Any persistent hip pain in young adults is not normal and should be evaluated by a doctor.

Common causes of hip pain in young adults are labral tears, femoroacetabular impingement (FAI or hip impingement), developmental dysplasia, AVN (avascular necrosis), early arthritis, muscle or tendon injuries, or trochanteric bursitis. FAI or femoroacetabular impingement is abnormal contact and friction between the ball (femur head) and socket (acetabulum) part of the hip joint caused by the abnormal shape of either the ball, socket, or both.

It can present as pain in the groin, side of the hip (trochanter area of the hip), or buttocks. The pain is usually described by patients as a sharp-catching or deep dull pain that circles around their hip bone or trochanter (the prominent side bone of the hip). This pain can be triggered by activities such as standing, walking, or sitting for extended periods, including long car rides. Twisting, pivoting, and turning on the affected side, as well as exercises, dancing, or sports activities, can also aggravate the pain.

A physical exam, X-rays, and a hip MRI (arthrogram or standard MRI) can diagnose the condition. Early diagnosis and treatment are crucial to prevent cartilage damage, joint deterioration, and future arthritis.

The first line of treatment is non-surgical and includes targeted physical therapy, nonsteroidal anti-inflammatory medications, and activity modification, which may show improvement for mild cases or patients with trochanteric bursitis or minor muscle or tendon strains. If the pain persists, injections such as cortisone, gel, plasma (PRP), or stem cells may be considered. PRP and stem cells fall under the category of regenerative medicine.

If symptoms and pain continue despite physical therapy and injections, surgical intervention may be necessary. Surgical options include arthroscopy and repair for labral tears, osteotomy for hip dysplasia, core decompression for AVN, tendon repair for tears, or joint replacement for advanced arthritis.

Rehab and physical therapy after surgery are very important to get full strength and range of motion of the joint to return to pre-injury level of sports activities.

If you’re experiencing hip pain that’s dampening your quality of life, don’t hesitate to book an appointment with me. For over 15 years, I’ve helped many patients address a variety of hip conditions and would be happy to help you resolve your pain.

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