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Facing hip pain while walking after sitting for few hours. What is the underlying cause?

Dec 2012
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General & Family Physician
Practicing since : 2012
Answered : 1704 Questions
I am an active 71 year old male. a My right hip becomes painful to walk with after sitting for about 1/2 an hour. It feels like a bone on bone problem and makes it difficult to walk at first. After walking or exercise it goes away . It is at its worse after playing two hours of tennis and then sitting at breakfast for an hour.
Posted Tue, 26 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Nsah Bernard 3 hours later

Thanks for posting,

It appears to be a mechanical type pain. Hip-related pain is not always felt directly over the hip. Instead, you may feel it in the middle of your thigh or in your groin. Similarly, pain you feel in the hip may actually reflect a problem in your back, rather than your hip itself.
There are numerous causes of this kind of hip pain which could be:
- We would immediately rule out trauma as a cause but it is possible for a pathologic fracture as a cause due to a wide range of cause as osteoporosis or osteomalacia (your age being the major contributing factor)
- Osteoarthritis: inflammation of the hip joint + femoral bone which comes as a result of 'wear and tear'
- Sciatica: which is the inflammation of the sciatic nerve (that extends through the gluteal region and goes down to the calves). This could be compressed by sitting down or through intense physical activity. Originates from low-back.
- Chronic labral tear associated with old trauma,
- Bursitis: it hurts when you get up from a chair, walk, climb stairs, and drive
- Osteonecrosis of the hip
- Strain or sprain
- Tendinitis from repetitive or strenuous activity

Actually, evaluation of the patient with chronic mechanical hip pain has remained a diagnostic dilemma for physicians.
Actually what you should do now is book an appointment with an orthopedic surgeon or general surgeon who would probably request an x-ray, MRI and/or CT scan to identify the cause. When identified, treatment will depend mainly on the cause. Antiinflammatory (steroidal or non-steroidal) may be indicated and you might require physical therapy to assist with the repeated episodes of the pain.

Hope this will be helpful to you and let me know if you got any other further questions.
Please do accept my answer if you are satisfied.
Best wishes.
Dr Bernard, Nsah

Above answer was peer-reviewed by
Follow-up: Facing hip pain while walking after sitting for few hours. What is the underlying cause? 14 hours later
It does not feel like tendonitis or sciatica as these are more an achie type ofss pain. This is type of pain which intensifies. The most likely is the bursitis by you What would be the downside of taking a course course of antibiotic. Would this not be the protocol for bursitis
Answered by Dr. Nsah Bernard 15 hours later

Tendinitis and sciatica is what is termed differentials and not necessarily the actual causes of your condition. Actually difficult to tell specific cause with no supportive imagery or laboratory tests.
Like I said we can never be too sure of the diagnosis and bursitis is just one of the numerous possibilities. Bursitis is often a result of overuse. It can be caused by a change in activity level, such as training for a marathon or by being overweight.

Bursitis can also be caused by trauma, rheumatoid arthritis, gout, or infection. Sometimes the cause cannot be found. Treatment of bursitis is multidisciplinary and involves (does not require antibiotics as it :

- Use ice 3 - 4 times a day for the first 2 or 3 days.
- Cover the painful area with a towel, and place the ice on it for 15 minutes. Do not fall asleep while applying the ice. with the ice on. You can get frostbite if you leave it on too long.
- When sleeping, do not lie on the side that has bursitis.
- For bursitis around the hips, knees, or ankle:
- Try not to stand for long periods of time.
- When standing, stand on a soft, cushioned surface. Stand with an equal amount of weight on each leg.
- Placing a pillow between your knees when lying on your side can help decrease your pain.
- Flat shoes that are cushioned and comfortable often help.
- If you are overweight, losing weight may also be helpful.
- You should avoid activities that involve repetitive movements of any body part whenever possible.

Other treatments include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
- Physical therapy
- Exercises you do at home to build strength and keep the joint mobile as pain goes away
- Removing fluid from the bursa and getting a shot of corticosteroids

As the pain goes away, your doctor or nurse may suggest exercises to build strength and keep movement in the painful area.

Surgery is rarely needed.

Dr Nsah
Above answer was peer-reviewed by
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