Hip pain is a common complaint that often prompts individuals to seek non-surgical treatment, including chiropractic care. This pain may originate directly from the hip joint, surrounding soft tissues, or be referred from the lower back or pelvis due to nerve irritation or alignment issues. Understanding the source of the discomfort is the first step in effective management. A chiropractor’s training in musculoskeletal assessment helps clarify whether a biomechanical issue is contributing to the pain.
Identifying Musculoskeletal Sources of Hip Pain
A chiropractor’s initial evaluation determines if the hip pain stems from a treatable mechanical issue or requires referral to another specialist. Many cases of hip discomfort arise from the pelvis and surrounding soft tissues, not the joint itself. Common causes include gluteal tendinopathy (irritation of hip abductor tendons) or piriformis syndrome (muscle spasms pressing on the sciatic nerve).
Pain can also be referred from the sacroiliac (SI) joint or the lumbar spine, often mimicking true hip pain. This differentiation is accomplished through a thorough physical examination, which involves analyzing posture and gait. The assessment includes range of motion testing and specific orthopedic tests, such as the FABER test (Flexion, Abduction, External Rotation). These tests help distinguish between pain originating from the hip joint, the SI joint, or surrounding soft tissues, guiding the targeted treatment plan.
Specific Chiropractic Treatment Techniques
Once a musculoskeletal source is identified, a chiropractor employs various manual therapies to restore proper function and reduce pain. Treatment often begins with spinal manipulation, targeting the lumbar spine or the sacroiliac joints if misalignments are contributing to hip symptoms. Restoring motion to these adjacent structures reduces mechanical stress on the hip complex.
Direct hip joint mobilization or manipulation may also be performed using gentle, controlled movements to improve mobility and decrease stiffness. Soft tissue therapy is another widely used method, focusing on tight muscles like the piriformis or gluteals. This work may include myofascial release or trigger point therapy to restore normal muscle function.
Treatment plans extend beyond hands-on care to include prescriptive stretches and strengthening exercises. These exercises are designed to correct underlying muscular imbalances, strengthen the core and hip stabilizers, and provide long-term stability to the pelvis and hip complex.
Recognizing When Medical Referral is Necessary
While chiropractors are trained to manage a wide range of musculoskeletal conditions, certain symptoms, known as “red flags,” indicate a need for immediate referral to a medical doctor or specialist. Pain accompanied by fever, unexplained chills, or significant swelling and warmth around the joint suggests a possible infection, such as septic arthritis, requiring urgent medical intervention. Patients with a history of severe trauma or an immediate inability to bear weight should be referred for imaging to rule out a fracture.
Other concerning signs include pain that is constant, unrelenting, and not affected by changes in position or movement, or pain that significantly disrupts sleep. These symptoms may suggest a systemic condition, inflammatory arthritis, or underlying pathology like a tumor, which is outside the scope of chiropractic care.
Neurological symptoms, such as a sudden loss of bowel or bladder control (cauda equina syndrome) or severe, progressive weakness in the leg, also require immediate emergency medical evaluation. Chiropractors are trained to recognize these limitations and refer patients to the appropriate medical professional when serious symptoms are identified.