Hip pain is a common complaint arising from issues involving the joint, surrounding muscles, or nerves. Discomfort is typically felt in or around the hip joint, including the groin, outer hip, or buttocks. While cancer is a concerning possibility, malignancy is a rare cause of hip pain compared to musculoskeletal issues. Nevertheless, persistent or unusual pain in this area should always be evaluated by a healthcare professional for an accurate diagnosis.
More Common Causes of Hip Pain
Most instances of hip discomfort are linked to mechanical issues, overuse, or aging. The most frequent culprit is osteoarthritis, a “wear-and-tear” condition where the protective cartilage within the hip joint gradually breaks down. This degradation leads to painful bone-on-bone friction, causing stiffness and a deep, aching pain that is often worse with activity and improves with rest.
Another prevalent cause is bursitis, which involves the inflammation of bursae, the small, fluid-filled sacs that cushion the tendons and muscles near the hip bone. Trochanteric bursitis, specifically, causes tenderness and pain on the outer side of the hip, frequently aggravated by lying on the affected side or after repetitive movement. Pain can also originate from tendinitis, which is the inflammation of the thick cords that attach muscle to bone, typically resulting from repetitive strain or athletic activities.
Hip pain can also be referred from other parts of the body, such as the lower back or spine. For example, sciatica, which is the compression of the sciatic nerve, can manifest as pain that radiates from the lower back through the hip and down the leg. Muscle strains or tears, particularly of the hip flexors or groin muscles, are common in physically active individuals and present as sharp pain during specific movements.
Mechanisms of Cancer-Related Hip Pain
When cancer causes hip pain, the discomfort arises through several distinct physiological mechanisms. The physical presence of a tumor is a primary cause, whether it originates in the bone (primary bone cancer) or spreads there from another site (metastatic cancer). Tumor growth within the rigid bone structure causes intense pain by increasing pressure within the bone marrow cavity.
Cancer cells can also trigger the release of chemicals that stimulate pain receptors and disrupt the normal balance of bone remodeling. For instance, some tumors cause excessive bone breakdown, known as osteolysis, which creates painful lesions and weakens the bone structure. This structural compromise increases the risk of a pathological fracture, a break that occurs from minimal trauma due to the underlying disease.
Tumors located in the pelvis or near the hip joint may also cause pain by pressing directly onto nearby nerves. This nerve compression results in a sharp, shooting, or burning pain that follows the path of the nerve, sometimes causing numbness or weakness in the leg. Additionally, a large mass within the pelvic cavity can cause referred pain felt in the hip, even if the bone structure itself is not primarily involved.
Specific Cancers Associated with Hip Pain
Hip pain caused by cancer typically involves malignancies that have a high propensity to affect bone tissue. Primary bone cancers, which start directly in the hip bones (pelvis or femur), are rare, accounting for less than one percent of all cancers. These include types such as osteosarcoma and chondrosarcoma, with the latter often arising in the flat bones of the pelvis and hip.
Most cancer-related hip pain stems from metastatic disease, where cancer cells have traveled from a primary tumor site to the bone. The hip and pelvis are among the most frequent sites for these bone metastases due to their rich blood supply. Cancers that commonly spread to the hip structure include those originating in the breast, prostate, lung, kidney, and thyroid.
Multiple myeloma is another malignancy frequently associated with bone pain, as it is a cancer of plasma cells that accumulates in the bone marrow. The abnormal plasma cells can cause widespread bone destruction, often affecting the spine, ribs, and the pelvic bones that form the hip socket. Detecting these bone lesions is often a significant step in the diagnosis and staging of these specific cancers.
Differentiating Symptoms Requiring Medical Attention
Recognizing certain “red flag” symptoms is important for distinguishing potentially serious causes of hip pain from common musculoskeletal complaints. A primary indicator is pain that is constant and does not fluctuate with activity or rest, often persisting or worsening at night. Unlike mechanical hip pain, which usually improves when lying down, cancer-related bone pain can wake a person from sleep.
The pain associated with malignancy is frequently described as deep, aching, or throbbing and may be unresponsive to standard over-the-counter anti-inflammatory medications. Systemic symptoms, which affect the entire body, also warrant immediate medical attention. These include unexplained weight loss, persistent fevers, and drenching night sweats, none of which are typical features of arthritis or muscle strain.
A sudden inability to bear weight or a fracture occurring with minimal trauma may signal severe bone weakening. New numbness, tingling, or weakness in the leg or groin area could indicate nerve involvement by a tumor. These persistent or systemic symptoms require prompt medical evaluation for an accurate diagnosis.