Hip Pain in Childhood and Adolescence
Contrary to popular belief, hip problems can start early in life. While relatively rare, persistent hip pain in a child or adolescent should not be ignored. Conditions often seen in this age group are quite different from those affecting older adults.
Pediatric and Adolescent Causes:
- Transient Synovitis (Irritable Hip): This is the most common cause of temporary hip pain and limping in children, usually affecting those between 3 and 10 years old. It often follows a viral infection and resolves on its own with rest.
- Slipped Capital Femoral Epiphysis (SCFE): An urgent condition predominantly affecting adolescents during a growth spurt, where the ball of the hip joint slips backward at the growth plate. It requires immediate medical attention.
- Legg-Calvé-Perthes Disease: A rare childhood condition involving the disruption of blood flow to the head of the femur, causing the bone to die and collapse. It typically affects children between 4 and 10 years old and can lead to arthritis later in life if not treated.
- Hip Dysplasia: This is a congenital condition where the hip socket is too shallow and doesn't fully cover the ball of the femur, leading to an unstable joint. While it is often diagnosed in infancy, symptoms like pain and arthritis can emerge in adolescence or adulthood.
Hip Pain in Young Adults
Active young adults and those who participate in sports may experience hip pain from overuse or acute injuries. The causes here are often related to strenuous activity and the physical structure of the hip joint.
Common Issues for Young Adults (15-40):
- Hip Labral Tears: The labrum is the ring of cartilage that follows the rim of the hip socket. Tears can occur from sports-related twisting injuries or repetitive motions. This can cause groin pain, a clicking sound, and a feeling of instability.
- Hip Impingement (FAI): Also known as femoroacetabular impingement, this condition involves extra bone growth on the femoral head or hip socket that causes them to rub against each other during movement. This can lead to pain and eventually damage to the cartilage.
- Overuse Injuries: Conditions like hip flexor tendinitis, stress fractures in the hip bones, or bursitis from repetitive stress are common among runners and athletes.
Hip Pain in Middle Age and Beyond
For many, the question of when do hips start hurting is answered after turning 40, when age-related wear and tear becomes a more significant factor. The most common culprit in this demographic is arthritis.
Causes from Age 40 and Up:
- Osteoarthritis (OA): This is the most common form of arthritis and a primary cause of hip pain as people age. The protective cartilage in the hip joint gradually wears down, causing bone-on-bone friction, stiffness, and pain.
- Rheumatoid Arthritis (RA): This is an autoimmune disease where the body's immune system attacks the joints, leading to inflammation, pain, and eventual joint damage. Unlike OA, it can affect people of any age.
- Bursitis: The bursae are small, fluid-filled sacs that cushion the hip joint. Inflammation of these sacs, often due to repetitive motion, can cause pain on the outside of the hip.
- Avascular Necrosis (Osteonecrosis): This less common condition results from a disrupted blood supply to the ball of the hip joint, causing the bone tissue to die. It can lead to severe pain and joint collapse over time.
- Spinal Conditions: Lower back problems like sciatica or a herniated disc can radiate pain to the hip, making it difficult to pinpoint the source of the discomfort.
Comparison of Hip Pain Causes by Age Group
To better understand the differences, this table compares the most common causes of hip pain across different life stages.
| Age Group | Common Causes | Typical Symptoms | Onset | Treatment |
|---|---|---|---|---|
| Children/Adolescents | Transient Synovitis, SCFE, Perthes Disease, Dysplasia | Limping, restricted motion, occasional fever (with infection) | Often sudden, especially with limping | Rest, physical therapy, surgery for severe cases |
| Young Adults (15-40) | Labral Tears, Impingement, Overuse Injuries | Groin pain, clicking or catching, stiffness | Gradual or sudden following activity | Conservative management, physical therapy, arthroscopy |
| Middle-Aged (40+) | Osteoarthritis, Bursitis, Spinal Conditions | Stiffness, pain that worsens with activity, morning stiffness | Gradual, progressive | Pain management, lifestyle changes, physical therapy, joint replacement |
| Older Adults (65+) | Advanced Osteoarthritis, Fractures, Avascular Necrosis | Severe, persistent pain, reduced mobility, pain with weight-bearing | Gradual or sudden (fracture) | Physical therapy, medications, total hip replacement |
When to Seek Medical Attention
While mild, temporary hip pain might resolve with rest and over-the-counter medication, you should consult a doctor if you experience any of the following:
- Persistent pain that worsens over time or interferes with daily activities.
- Pain that wakes you from sleep.
- Hip pain accompanied by fever, swelling, or redness, which could indicate an infection.
- Inability to bear weight on the affected leg.
- Sudden, severe pain, especially after a fall or injury.
Conclusion: Proactive Care is Key
There is no single age that dictates when hip pain begins. It's a complex issue influenced by genetics, activity levels, and overall health. From childhood developmental issues to the cumulative wear and tear of older age, understanding the different potential causes is the first step toward effective management. If you are experiencing persistent hip discomfort, seeking a professional evaluation can help you determine the root cause and find a path to relief. For more in-depth information, you can visit the Hospital for Special Surgery website to explore various hip conditions and treatments. Ultimately, whether you're a young athlete or a senior, listening to your body and addressing new or persistent pain can help maintain mobility and quality of life for years to come.
