The most prominent symptom of hip arthritis is pain. Most patients think that their hip is in the region of the buttocks and are surprised to learn that true hip pain is most commonly experienced in the groin. Groin pain of hip arthritis is sometimes misdiagnosed at first as a hernia or a “groin pull”. (There is no known medical diagnosis of, and no Wikipedia definition for “groin pull”, but strangely, patients frequently self-diagnose themselves with this “condition”). The pain can radiate down the front of the thigh for a few inches as well. Occasionally it goes all the way down the thigh to the knee (“referred pain”). This is because the hip and knee have an overlapping nerve supply. In fact, in some patients with hip disease, knee pain may be the only symptom!
Back pain is even more frequently confused with hip pain. Pain in the buttocks, across the low back and down the back of the thigh usually comes from the spine. It usually indicates a pinched nerve in the lower spine. Patients with a pinched nerve will also often have numbness or tingling in the leg. To complicate matters, some patients with an arthritic hip may also have a pinched nerve from a back disorder.
It is important in such cases to determine which problem is causing most of the pain: the hip or the back. If your problem is mainly in your back, you may still be left with most of your pain after going through a hip replacement, and you will not be very happy with the result! If most of your pain is from the hip, a hip replacement may have the added benefit of improving your back condition as well, since the stiffness of an arthritic hip can aggravate a back problem.
Most patients with significant hip disease have a limp and one leg may feel shorter than the other (see true and false leg lengths). Bone-on-bone contact occasionally causes the patient to feel or hear the hip creaking during walking. As the disease progresses, the hip becomes stiff and less movement is possible. This may make it difficult for you to clip your toe nails or to tie your shoe laces, and may also limit your ability to spread your legs. Quite often the first step or two after prolonged sitting may be especially painful. Eventually you may have to “take a break” to ease the pain after walking only short distances. The distance you can walk will gradually decrease until you can only take one or two steps at a time. The three common causes of pain around the hip are arthritis, bursitis, or a pinched nerve in the lower back (the commonest cause). The groin pain of hip arthritis is sometimes misdiagnosed at first as a hernia.