Cause and Treatment of Hip Pain with Physiotherapy and Exercise

Posted on the 11 June 2022 by Fereshteh Yasoubi @physio2health

Hip pain is pain that a person feels in the back of the seat. Because many people have passive occupations behind the desk and their hips are slightly larger than usual, the soft tissue adjacent to the ischial ridge bones is compressed. The ischial protrusion, the swollen or flattened bone of the anterior ischial bone, is the lowest of the three main bones that make up each side of the buttocks. This part is connected to different muscles as the boiling point of ischemia and pubic bone, and when a person sits on a place, it bears the body’s weight.
The most common cause of hip pain is weakness in the structures that attack the ischial ridge. When we sit, our buttocks rest on the ischial ridge. Pelvic pain in the pelvis is called ischial bursitis. Bursitis is a fluid-containing sac that allows tendons and muscles to slip on the bones. Bursitis is rare, and, in addition, the pain is so severe that any pressure on the bursa can cause the person to scream from hip pain. In other words, most cases of this are not caused by bursitis but by weakness or damage to the ligament in this area, which causes sitting pain.

Cause of Hip Pain (buttocks)

Many hip and hip pains are passive and can be treated with conservative treatment, but this becomes severe in some cases. Any pain that does not go away or gets worse within a few days should be checked by a doctor.

The answer to the question what is the symptom of pelvic hip pain?
In most cases, it is very simple; for example, pain can result from excessive exercise. This pain is usually caused by inflammation or stretching of soft tissues such as tendons and often resolves within a few days. But chronic and long-term pelvic joint pain are rooted in certain diseases. Pain caused by a problem in the hip joint also spreads from the buttocks to the knees. Knee pain is sometimes the only sign of a hip problem. Pain can also be felt in the pelvis or outside the hip joint, although back pain can result from low back pain. These types of pain, which are also very common, are called referral pain. Causes of pelvic pain may be one of the following:

  • Sciatica: Sciatica is a disease that causes pain in the lower back, buttocks, thighs, and back of the leg and is caused by inflammation or compression of the sciatic nerve.
  • Piriformis Syndrome: The piriformis muscle is small in the center of the buttocks. This muscle is very active while walking and running and is exposed to pressure. When this muscle is compressed, it tightens and causes pain and inflammation in the hip and buttock area. The sciatic nerve passes near or, in some cases, through the piriformis muscle. When this muscle is compressed and spasms, it puts pressure on the sciatic nerve, and many of the symptoms that appear with a lumbar disc protrusion also occur with this syndrome.
  • Sacred joint pain: This pain occurs at the end of the spine and pelvis. This joint is prone to injury. The sacral joint may cause hip and hip pain. People who sit for a long time feel pain due to the compression of muscles and ligaments in these joints. Pain in this area may also be due to injury, arthritis, or pregnancy.
  • Ankylosing spondylitis: A chronic inflammatory disease that affects the sacroiliac joints and spine. The disease can progress to the point that it affects the joints all over the body, but the first symptoms are usually pain in the buttocks and lower back.

Other Causes of Hip Pain 

  • Muscle weakness, especially in the piriformis and serine muscles
  • Pelvic instability
  • Muscle stiffness, especially in the serine, piriformis, and proximal muscles
  • Injury to the lower back
  • Inadequate hip flexibility
  • Improper and excessive exercise
  • Poor biomechanics
  • Muscle imbalance
  • Inadequate central stability
  • Improper body warming

Symptoms of Pain in the Buttocks

The symptoms of hip pain are simple and clear, pain that occurs in the buttocks. Pain in the lower part of the buttocks, especially when sitting, which may also occur while running, is a sign of this pain. The pain may be severe, mild, tingling, or a combination of these. The area may also become inflamed with pain, and the person may feel pain in the buttocks when touched. Simple tasks such as wearing socks can be difficult. In severe cases, hip pain can interfere with sleep. Pain may also spread from the buttocks to the back of the leg. Buttock pain becomes more severe after waking up in the morning or increases overtime during the day.

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Diagnosis of Hip Pain

It is difficult to correctly diagnose sacroiliac joint dysfunction and pelvic and hip pain due to the similarity of the symptoms of this disease with other diseases of the back and lower body, such as fast joint syndrome or bulging and protruding disc. Radiographs (X-rays) are not very helpful in diagnosing the cause of hip pain; M.R.I. may show signs of sacroiliac joint inflammation, or other potential pathologies may be hidden. The best way to assess sacroiliac joint pain or instability is a complete physical examination by an experienced physiotherapist who specializes in musculoskeletal disorders.

The patient is thoroughly examined to diagnose hip pain. Other tests that can help determine the cause of hip pain include:

Treatment of Hip Pain (Buttocks)

Treatment for hip pain includes the following:

  • Medicines

Marketed nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, and Nuprin) and naproxen (Alio), and nonsteroidal anti-inflammatory drugs (NSAIDs) such as Autodolac, are drugs that can be used to relieve hip pain caused by arthritis. These drugs prevent the body from producing prostaglandins, which cause inflammation.

  • Injection

Corticosteroids are sometimes injected to reduce the inflammation that causes hip pain. Doctors inject these drugs directly into the hip joint. Injecting in this way reduces the side effects of injecting corticosteroids. A non-corticosteroid drug such as hyaluronan can also be injected to lubricate painful joint activity.

  • Physiotherapy for Hip Pain

Physiotherapy for hip pain (back pain) is very important to speed up the treatment process and is considered one of the most effective treatments. Physiotherapy also reduces the risk of hip pain in the future. Physiotherapy for hip pain includes the following:

  • Ultrasound
  • Soft tissue massage
  • warm-up exercises
  • Methods for releasing trigger points
  • Muscle energy practices
  • Joint animation
  • Nerve mobilization
  • Heat therapy and ice packs
  • Education
  • Biomechanical modification
  • Progressive exercises to improve flexibility, central stability, and endurance
  • Method modification
  • Tips on modifying activities
  • Monitor and assist the individual in resuming exercise and activity program

Exercises for Hip Pain

Exercise and proper exercise can help relieve hip pain. Here are some of these exercises:  

Stretching the Serine with the Back  

Lie on your back now with the help of your hands, and pull the knee to the opposite shoulder until you feel a mild to moderate painless stretch in the buttocks or on the front of the thigh. Stay in this position for 15 seconds, and then release your foot. Repeat this movement four times.

Stretching in a Supine Position

This exercise is performed on the knees and arms. Stretch your legs under your chest and abdomen so that your knees are in front of your buttocks and your feet are next to your buttocks. Now gently pull the front of the body to the ground, keeping the back leg in a straight position, to feel a mild to moderate painless stretching motion in the buttocks. Stay in this position for 15 seconds and then release your foot. Repeat this movement four times.

Serine Personal Massage

This exercise is done by placing a barbed massage ball under the buttocks. Now, with the help of your legs and arms, gradually pull your body back and forth and from side to side to breathe normally and relax your legs. Repeat this movement for 15 to 90 seconds to make sure the pain symptoms do not get worse. Apply constant pressure to a specific hard point for 15 to 60 seconds or until the muscles relax. Continue exercising until stretching does not cause hip pain. If you experience severe hip pain while stretching, reduce the amount of stretching and consult your doctor.