Sometimes, hip pain can radiate to the knee or lower leg. Joint stiffness is often associated with lower limb pain. This makes it difficult to do daily activities. Commonly, lower limb activities such as walking, standing after sitting, and putting on shoes are affected.
Hip pain can be felt in the hip’s front, side or back. Radiating pain can be caused by nerves that run down the leg from the hip. Sometimes, pain may be referred to muscles or joints. These are possible causes of hip pain that radiates down to the legs.
Variable symptoms may occur when the labrum (or the cartilaginous rings around the hip socket (acetabulum), tears. Labral tears are most commonly responsible for pain in the groin. Sometimes, pain can also be felt along the buttocks or side of the hip.
Initial pain due to a labral tear can be felt after or during exercise, as well as other vigorous activities. You may feel pain when you sit down or do other strenuous activities.
Nerve pain from the hip to the leg
Sometimes hip pain can radiate from the back of your hip down to the front, rear, or side legs through the nerves. This pain is also known as sciatica. It may be caused by irritation of the lumbar or sacral nerve roots. Sciatica-like symptoms can also be caused by musculoskeletal conditions such as piriformis syndrome or sacroiliac dysfunction.
A doctor should be consulted if severe hip pain persists or starts suddenly. A doctor should be consulted if you experience symptoms like swelling, weakness in the legs, nausea, fever, and/or leg numbness.
Basics of labral tear
Your hip is a ball-and socket joint. It consists of the rounded head of the femur or thigh bone, cup-shaped acetabulum and smooth, slippery cartilage that runs along its surface. This allows for smooth joint movement and optimal range.
A special cartilage type, the labrum, is used to keep your hip joint stable and secure. It forms a tight seal around the femoral head. It’s similar to a rubber ring on the lid of a glass container.
The labrum helps to keep the ball in its socket and protects your joint from damage caused by everyday impacts.
Although the labrum is extremely strong and resilient, it may tear under intense pressure from an acute injury to the hip joint or dislocation. It can also tear when it comes into contact with repetitive motion (overuse), structural abnormalities (femoroacetabular impingement) or chronic conditions (arthritis). This will accelerate the normal wear-and tear process within the joint.
All ages can suffer from labral tears. The problem often occurs in adolescents and young adults as a result of a sports-related injury or participation in an activity that requires repetitive hip flexion or rotation such as dance, football, soccer, or hockey.
Labral tears in older adults are more likely to result from accelerated degeneration. This could be due to a structural problem like hip impingement, or a chronic condition such as osteoarthritis.
Hip Labral Tear Symptoms
There are many symptoms that can be caused by a tear in the hip labral. Most common is an anterior hip or groin problem that can radiate to the knee. The pain develops slowly and is usually dull. It can be worsened by running, walking, pivoting and turning. MRI scans can easily show hip labral tears. Its importance as a source for pain must be doubted.
Limitations due to Hip Labral Tears
Hip labral tears can cause discomfort and pain in the hips that may interfere with daily activities. One possible outcome of a labral tear is:
- Having trouble participating in sports. Running, golf, soccer, and ballet are just a few examples of activities that can make the pain worse.
- You will need a railing to climb stairs. A weak hip can cause joint instability and difficulty climbing stairs.
- Difficulty walking for long periods of time. Long distance walking may be difficult for those with hip instability or pain.
- Pain can occur after sitting for more than 30 minutes.
- Feeling uncomfortable while standing. Long periods of standing can be painful and difficult. Although falling is unlikely, it can feel like the hips are giving way.
- Limping. In some cases, the hip pain can cause a limp when you walk.
Many patients feel intense hip pain from a labral tear injury. This “deep” hip pain can radiate into the buttocks or groin for some people who engage in hip-intensive activities. You may experience joint stiffness, which can make it difficult to move or allow you to sleep comfortably throughout the night.
Patients may also feel a locking or catching sensation when they walk, run, or rotate the affected hip joint. A hip joint that locks, or catches, can cause discomfort and make it difficult to feel stable on your feet.
The pain in the labral tear usually increases with increased activity, and it subsides after a long period of rest. Resting for too long will not heal a labral tear. The pain will return once you resume normal activity.
What causes a hip labral tear?
Many things can cause hip labral tears, including the following:
- Hip labral tears can also occur when there are structural problems. Femoroacetabular impingement (FAI) is a condition in which the femoral heads don’t fit properly into the socket. Improper fit can lead to long-lasting groin pain, and movement restrictions. This is the leading cause of labral tear.
- Injury: A hip labral tear can result from trauma to the hip. People who engage in repetitive, high-impact sports such as football, soccer, and ice hockey can experience this.
- Degenerative conditions: Osteoarthritis refers to a long-term (chronic) wear down of cartilage between the joint. The cartilage becomes more susceptible to tearing as it erodes slowly over time. Osteoarthritis can be more common in those who are older and heavier. Osteoarthritis patients often experience stiffness and pain in multiple joints.
- Capsular rigidity. The main source of stability for the hip is a fibrous capsule that’s made up of the ligaments in its hip joint. These ligaments connect the hip’s socket and ball together and surround the joint. When the hip is often over-rotated, laxity (or looseness) can occur. This is common in sports such as golf, gymnastics and dance.
- Hip impingement is also known as Femoroacetabular Impingement. Hip impingement happens when the socket and ball of the hip grow too much bone. This causes abnormal contact between them. Hip impingement causes pain and decreases in hip range of motion.
- Repeated motions. Hip labral tears can result from joint wear.
What causes hip pain radiating down the leg?
Is it possible that a combination of pain down the leg and a hip labral tears could indicate that the labral tear is the cause? It is important to understand the causes of hip pain and anterior thigh pain , since labrum tears can be present in patients who do not have hip pain. These are the main causes.
Muscles; Injury to the quadriceps, inner thigh muscles, hamstrings, and inner thigh muscles can cause anterior thigh or hip pain.
Ligaments; Ligaments are connective tissue thickening bands that connect bone to bone. Multiple ligaments are found in the hip joint. An injury to one of these can cause hip pain and anterior thigh pain.
Blood Vessels; An upper leg blood clot can cause pain and swelling.
Low Back Nerve Irritation; Nerve irritation can be caused by disc protrusions, disc herniations and small joint overgrowth.
Sacroiliac Joint; The sacroiliac (SI), a key joint in the lower back, is formed by your waist bone and the base your lumbar spine (sacrum). It transfers the upper body’s forces to the lower extremities. It is vulnerable to injury, with pain in the anterior and posterior thigh, groin and buttock.
Hip Labral Tears: Treatment Options
The severity of the injury, the level of pain, the level of disability, and findings of a physical exam or MRI will all impact the treatment options. There are many treatment options available.
How hip labral tear pain down leg can be treated?
Although a hip labral tear will not heal by itself, rest and other measures may be helpful in managing symptoms. These are non-surgical treatments:
- Anti-inflammatory drugs: Over the-the-counter pain reliefrs such as ibuprofen (Motrin(r),) can help reduce inflammation.
- Injection of medication: Doctors are able to inject drugs, such as steroids into the hip joint in order to relieve symptoms.
- Physical Therapy: Specific exercises for strengthening and stretching the hip muscles can help with pain relief. A prescription is usually required for physical therapy.
Your doctor may recommend surgery if you have persistent symptoms or severe tear. A hip labral tear can be repaired arthroscopically. This minimally invasive procedure involves the doctor making small incisions in the hip and using miniature instruments to perform the repairs.
- Refixation (stitching the tissue back together)
- Reconstruction: Reconfiguring damaged tissue with healthy tissue taken from another body part or from a donor.
- Debridement is the removal of a small amount of labral tissue
FAI will also be treated to prevent labrum from tearing.
The majority of arthroscopic surgeries are performed outpatient, which means that the patient can return home the same day.
Conservative Care
Rest, activity modification, and safe anti-inflammatory medication such as curcumin and fish oil are all possible.
Injections
Steroid injections to the hip joint can be recommended when conservative treatment fails. Cortisone and other powerful anti-inflammatory drugs may be used to reduce inflammation, but they can also cause damage to cartilage and other orthopedic tissues. Research has shown that steroids can increase the amount of normal cartilage loss in a joint. Avoid steroid injections.
Surgery
Major surgery for hip labrum is hip labrum surgery. This involves inserting a narrow-gauge camera, and other operating instruments into the hip joint. This procedure is known as arthroscopy. It allows the surgeon access to the inside of the hip joint, including the labrum.
Hip arthroscopy, which is not only used for hip replacement, is the most popular hip surgery in America. The number of hip arthroscopes increased 600% in just four years (7). There are always complications. Nerve damage is the most common complication after hip labrum surgery. It has an incidence rate of 16.5% (8)
Are hip labral tear surgery results reliable? A large-scale high-level study comparing hip arthroscopy and physical therapy showed no difference in the results. That is true. Hip surgery results were the same as those with PT.
How can a hip labral tear be diagnosed?
A physical exam is required to diagnose a hip labral tear. The doctor might ask you to move your leg and walk during the exam. The doctor can use your ability to move and any pain you feel while you are moving to help them diagnose you.
Doctors may also use imaging tests to diagnose a hip labral tear. These imaging tests may be ordered by the doctor:
- X-rays:X-rays are able to alert doctors to problems in the hip bones such as femoroacetabular impingement or osteoarthritis. This can lead to a labral tear, and possibly a painful hip.
- Magnetic Resonance Imaging – MRI: This test provides more information about soft tissues. A MRI can show the location of a labral tear and its severity.
What is the best time to call my doctor for a hip labral tear
Although hip and joint pain isn’t usually life-threatening, they can have a significant impact on your daily life. A medical specialist should be consulted if you have persistent hip or groin pain. Call your doctor immediately if you feel severe or sudden pain in your hips or groin.