Hip pain can extend into the pelvic area. This phenomenon occurs due to intricate anatomical connections and shared nerve pathways between the hip and surrounding pelvic structures.
Understanding Hip and Pelvis Connection
The hip is a ball-and-socket joint connecting the thigh bone (femur) to the pelvis, specifically into the acetabulum. This joint is essential for bearing body weight and enabling a wide range of leg movements. The pelvis is a bony ring composed of three fused bones—the ilium, ischium, and pubis—which connect the spinal column to the lower limbs and support abdominal organs.
A network of muscles, ligaments, and tendons stabilizes the hip joint and connects it to the pelvis. Ligaments connect bones, while tendons connect muscles to bones. Nerves also run through this area, carrying signals between the brain and muscles and relaying sensations like pain.
Pain can be perceived in an area different from its source, a phenomenon known as referred pain. This occurs because multiple nerves from different body parts, including the hip and pelvis, can converge and send signals to the same areas of the spinal cord. For instance, nerves supplying the hip joint, such as branches of the femoral and obturator nerves, also supply sensation to areas like the groin, inner thigh, and knee.
Conditions That Cause Radiating Pain
Several conditions originating in the hip can cause pain to radiate into the pelvic region.
Osteoarthritis
Osteoarthritis of the hip, a degenerative joint disease where cartilage wears away, commonly leads to pain in the groin, thigh, and sometimes the buttocks or knee. This pain often worsens with activity and may be accompanied by stiffness.
Labral Tears
Labral tears, which involve damage to the ring of cartilage (labrum) lining the hip socket, can result in deep hip or groin pain that may radiate to the lower back or leg. This pain can be a dull ache or sharp and stabbing, especially with certain movements.
Bursitis
Bursitis, an inflammation of fluid-filled sacs (bursae) that cushion joints, can also cause radiating pain. Trochanteric bursitis typically causes pain on the outer side of the hip and thigh, sometimes extending to the buttocks. Iliopsoas bursitis causes deep groin pain and can be felt during hip flexion movements or when climbing stairs.
Sacroiliac (SI) Joint Dysfunction
Sacroiliac (SI) joint dysfunction, affecting the joint connecting the spine to the pelvis, is another source of radiating pain. Pain from SI joint dysfunction is often felt in the lower back and/or hip and can radiate into the groin or down the leg, sometimes mimicking sciatica. This condition may arise from too much or too little movement in the joint.
Muscle Strains
Muscle strains, such as those affecting the iliopsoas muscle, can also lead to pain radiating to the pelvic area. The iliopsoas muscle, a primary hip flexor, runs from the lower back and pelvis to the thigh bone. Injury to this muscle can cause deep pain in the abdomen or upper groin, which may radiate down the front of the thigh.
Recognizing Accompanying Symptoms
Other symptoms can indicate an underlying issue when hip pain radiates to the pelvis.
Stiffness in the hip joint, particularly in the morning or after periods of rest, is common, especially with conditions like osteoarthritis.
Clicking or popping sounds within the hip may suggest a labral tear or other structural issues.
Limited range of motion in the hip can make activities like bending, walking, or rising from a chair challenging.
Muscle weakness in the affected leg might be present, potentially leading to instability or a feeling of “giving way.”
Numbness or tingling sensations can arise if nerves are compressed or irritated, sometimes extending down the leg.
Changes in gait, such as limping, are also observed as the body attempts to compensate for discomfort or instability.
When to Seek Professional Help
Consult a healthcare professional if hip pain radiating to the pelvis persists or worsens, especially if it interferes with daily activities. Prompt medical attention is warranted for “red flag” symptoms, including:
Sudden onset of severe pain
Inability to bear weight on the affected leg
Noticeable deformity of the hip
Other concerning signs requiring immediate evaluation are:
Sudden swelling
Significant bruising
Warmth or redness around the hip joint
Fever combined with hip pain, which can indicate an infection like septic arthritis, needing urgent medical care.
Any changes in bladder or bowel function alongside hip pain.
An accurate diagnosis is important for effective management of these conditions.