Hip arthritis often causes pain that extends beyond the joint itself, frequently radiating down the leg. This phenomenon is known as referred pain, and it is common for people dealing with the deterioration of the hip joint. Hip arthritis, most commonly osteoarthritis, involves the progressive wear-and-tear of the protective cartilage that cushions the ball-and-socket joint. When this cartilage thins or breaks down, it leads to friction, inflammation, and pain within the joint capsule.
The Mechanism of Referred Pain
The sensation of pain traveling down the leg from an arthritic hip is a result of shared neural pathways between different parts of the body. The hip joint receives its sensory input primarily from branches of the obturator nerve and the femoral nerve. These nerves also supply sensory branches to the skin and muscles of the upper leg, including the thigh and knee. Because the brain receives pain signals from the hip joint and the leg through these same or closely connected nerve roots, it struggles to pinpoint the exact location of the injury. Blocking these shared nerve branches with an injection can sometimes temporarily reduce the referred pain, confirming the neurological connection.
Specific Areas Affected by Hip Arthritis Pain
The primary location for pain originating from the hip joint is often felt deep in the groin area. However, the referred pain frequently manifests in the front of the thigh, traveling down the quadriceps area, a common pattern due to the distribution of the femoral and obturator nerves. In many cases, the pain extends all the way down and localizes around the knee joint. Patients may report that the knee pain is more severe or noticeable than the discomfort in the hip itself. The pain can also refer to the side of the hip or the buttock area.
Distinguishing Hip Arthritis from Other Causes of Leg Pain
When leg pain occurs, it is important to distinguish hip arthritis from other conditions, particularly lumbar radiculopathy, or sciatica. Hip arthritis pain is typically a dull, deep ache that worsens with weight-bearing activities like walking or standing, and intensifies with movements that rotate the joint, such as putting on socks. Sciatica, which stems from a compressed nerve in the lower back, presents differently, often as a sharp, shooting, or burning pain that follows a distinct path down the back of the leg. Sciatic pain may also include neurological symptoms like tingling, numbness, or weakness, which are less common with hip arthritis. Back-related pain often worsens when sitting for long periods, bending, or twisting the spine, while imaging tests and a physical examination help differentiate the source of the pain.
Managing Pain Caused by Hip Arthritis
Management of pain from an arthritic hip focuses on reducing inflammation and improving joint function to alleviate both local and referred pain. Initial treatment often involves conservative measures, such as nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease pain and swelling, and physical therapy to strengthen supporting muscles and maintain flexibility. Corticosteroid injections can be delivered directly into the hip joint to provide localized anti-inflammatory relief, temporarily reducing both hip and referred leg pain. For individuals with severe pain that does not respond to conservative treatments, surgical options become necessary. Total hip replacement, or arthroplasty, is a highly effective procedure that removes the damaged joint surfaces and replaces them with artificial components, resolving the underlying source of the pain.