Hip pain is a common complaint, often leading to concerns about serious conditions like cancer. While hip pain can be a symptom of cancer, this is an exceptionally rare occurrence. Most hip discomfort is caused by common, benign musculoskeletal issues. Understanding the difference between typical mechanical pain and potential warning signs is important for seeking appropriate medical attention.
The Most Common Sources of Hip Pain
Most hip pain relates to joint mechanics, surrounding soft tissues, or degenerative changes. The primary cause of chronic hip pain, especially in adults over 50, is osteoarthritis. This degenerative condition involves cartilage wearing down, causing bone-on-bone friction. This leads to stiffness and a dull, aching pain that typically worsens with activity and improves with rest.
Another frequent source of pain is bursitis, which is inflammation of the bursae—small, fluid-filled sacs that cushion the joint. Trochanteric bursitis causes pain on the outer side of the hip that is often tender to the touch and aggravated by lying on the affected side. Tendinopathy, or irritation of the tendons connecting muscle to bone, is also common in active individuals due to overuse or repetitive stress.
Pain felt in the hip region can also be referred from other areas, rather than originating in the joint itself. Issues in the lower back, such as sciatica or a pinched nerve, frequently cause pain that radiates down the buttock and into the hip or thigh. This referred pain can mimic hip joint pathology, requiring a thorough physical examination to pinpoint the true source of the discomfort.
How Cancer Causes Pain in the Hip Region
When cancer causes hip pain, it is due to tumor involvement in the bones of the pelvis or upper femur. This involvement falls into two main groups: primary bone tumors and metastatic disease. Primary bone cancers, such as osteosarcoma, originate in the bone itself but are extremely rare, accounting for less than one percent of all cancers.
Metastatic cancer, where a tumor spreads to the bone from another part of the body, is the more common cause of cancer-related bone pain. Cancers of the breast, lung, prostate, and kidney often spread to the pelvis and hip bones. Tumor cells disrupt bone remodeling, leading to bone destruction and weakening.
This structural weakening results in constant, deep, throbbing pain. The tumor’s physical growth also creates pressure on surrounding nerves, contributing a neuropathic component that can be sharp or radiating. This process increases the risk of a pathological fracture, where the bone breaks from minimal trauma.
Distinguishing Symptoms of Serious Hip Pain
The nature of the pain is the primary factor differentiating benign hip pain from a serious cause like cancer. Unlike mechanical pain, which improves with rest, cancer-related bone pain often persists and intensifies at night. This nocturnal worsening is a significant “red flag” symptom that warrants immediate medical investigation.
The presence of systemic symptoms alongside hip pain is another major indicator of a serious underlying illness. These signs suggest a systemic process rather than a localized joint problem. Systemic symptoms include:
- Unexplained and unintentional weight loss.
- Persistent fatigue that does not improve with rest.
- Intermittent or persistent low-grade fever or chills.
A noticeable lump or swelling in the hip area, especially one that is firm and fixed, may indicate a tumor. Pain that rapidly progresses in severity over weeks or months, rather than the slow, fluctuating course of typical arthritis, is also concerning. Any combination of these systemic symptoms with persistent, non-mechanical hip pain should prompt a consultation with a healthcare provider.
Medical Evaluation and Diagnostic Steps
Evaluation of persistent or suspicious hip pain begins with a detailed patient history and a thorough physical examination. The physician inquires about the location and quality of the pain, aggravating factors, and the presence of systemic symptoms. The physical exam involves assessing gait, range of motion, and testing for tenderness to localize the source of the pain.
The initial imaging step is plain X-rays of the pelvis and hip, which detect advanced arthritis or subtle changes suggesting a tumor. If X-rays are inconclusive, advanced imaging is necessary. Magnetic Resonance Imaging (MRI) is highly effective for visualizing soft tissues, bone marrow, and identifying tumors or stress fractures.
A CT scan may also provide detailed cross-sectional images of the bone structure. If imaging studies strongly suggest a malignancy, a bone biopsy is the definitive diagnostic step. This procedure involves obtaining a tissue sample from the suspicious area for laboratory analysis to determine if cancer cells are present and to identify the specific type of tumor.