Does osteoporosis cause hip pain?

March 6, 2024

Osteoporosis is a common bone disease that affects approximately 10 million Americans over the age of 50.¹ It is more common in women, affecting almost 20% of women and nearly 5% of men.² This disease causes your bones to weaken, making them more likely to break. The most commonly affected bones are in the hips, forearm, wrists, or spine.

Normally, your body replaces old bone with new bone tissue. With osteoporosis, your body loses bone faster than it can replace it. This causes your bones to become more porous and weaker over time, putting you at a higher risk for fractures. Most people have heard of osteoporosis and associate it with aging. Another form of osteoporosis that can cause issues in your hips, too.

Age-related osteoporosis

Age-related osteoporosis is often called a “silent” disease because you typically will not have symptoms. It develops slowly over time, causing bone loss in multiple bones throughout your body. You may not even know you have the disease until you break a bone. The good news is that regular screenings and preventive measures can decrease your chances of a fracture or broken bone.

Transient osteoporosis

Transient osteoporosis of the hip is a rare condition that causes temporary bone loss in the upper part of your thighbone (femur). This disease also weakens your bones and increases your risk of fractures.

Transient osteoporosis of the hip develops over time, although some activities can cause pain from day one. The pain will tend to worsen over weeks or months.

Painful symptoms will gradually go away and usually end within 6 to 12 months. In most people, bone strength in the hip will also return to normal after this period.

Does osteoporosis cause hip pain?

Yes, both types of osteoporosis can cause hip pain, although in different ways. Let’s look at the reasons why.

Age-related osteoporosis occurs gradually, and the first sign of pain may be when you break your hip bone. If the condition is severe, something as simple as twisting or tripping can cause a fracture. More often, though, a fracture is caused by trauma, such as a fall. So, while osteoporosis doesn’t cause hip pain directly, you are at a higher risk for hip fractures. Hip fractures can then result in pain and limited mobility.

With transient osteoporosis, you may experience sudden pain when you walk or do other weight-bearing activities, even without having fractured your hip. The pain may get worse over time.

Signs and symptoms: Recognizing hip pain from osteoporosis

As mentioned earlier, with age-related osteoporosis, your first sign might be from a painful fracture. Typically, the first sign of a hip fracture is extreme pain. Although not typical, in some cases, it is possible that you could fracture your hip bone, even without a fall or some other obvious cause. Some signs and symptoms that you may have a hip fracture are:

• Pain at rest. You may experience pain that doesn’t go away, even when you are resting. This constant discomfort can significantly impact your daily activities and overall well-being.
• Swelling and bruising. You may notice some swelling and bruising around the hip area.
• Limited Range of Motion. Fractures in the hip can lead to a decreased range of motion. You may notice difficulty in moving the hip joint, or you may experience stiffness.

In transient osteoporosis, your symptoms will look different. You may experience:

• Sudden pain. You may experience a sudden onset of pain, often in the groin, front of the thigh, side of the hip, or buttocks area.
• Pain with activity. You may have pain that worsens with weight-bearing activity, such as walking but goes away at rest.
• Limited range of motion. You may feel like you have slightly restricted movement in your hips. The pain intensifies when trying to do larger hip movements.
• Gradual worsening of pain. You may notice pain that is gradually getting worse over weeks or months. The pain can eventually become severe and debilitating.

Other possible causes of hip pain not related to osteoporosis

While osteoporosis can significantly contribute to hip pain, there are some other potential causes to consider.

• Osteoarthritis, rheumatoid arthritis, and other inflammatory joint conditions can cause hip pain. Osteoarthritis is the most common, where the cartilage in the joint begins to break down and cause changes in the bone.³
• Bursitis is when the bursa (fluid-filled sacs that cushion the hip joint) become swollen and painful. Repetitive movements or injuries can contribute to bursitis.
• Tendinitis can develop when you overuse the muscles in the hip. This causes inflammation or irritation of the tendon. You may experience mild swelling, tenderness, or pain near the affected joint.
• If you’ve fallen or experienced some other forceful trauma to the area, you could have sprained your muscles or ligaments.
• Although less common, infections affecting the hip joint can cause pain and discomfort. This may be accompanied by other symptoms, such as fever or swelling in the hip.

Are you at risk for hip pain from osteoporosis?

Understanding the risk factors for osteoporosis can help you and your doctor work together to reduce your risk. Some risk factors are modifiable, but it is impossible to avoid others. You may be at higher risk of age-related osteoporosis if you fall into any of these categories⁴:

• Women, especially those who have undergone menopause, are at an increased risk of osteoporosis. The decline in estrogen levels during menopause contributes to bone loss, increasing the risk of fractures.
• If you have a family history of osteoporosis or hip fractures, you may be at an increased risk for osteoporosis. Genetics plays a role in determining bone density and fracture risk.
• Aging is a significant risk factor for osteoporosis and related fractures. As you age, bone loss happens more quickly, and new bone growth is slower.
• Having a low body weight puts you at higher risk. Thin-boned women and men are at greater risk of developing osteoporosis because they have less bone to lose compared to larger-boned women and men.
• A lack of physical activity and weight-bearing exercise, such as walking, can increase your risk of hip fractures.
• Inadequate calcium and vitamin D intake are necessary to maintain good bone health.
• Chronic heavy alcohol use or smoking is a significant risk factor for osteoporosis.
• Certain medications, such as glucocorticoids, can have a side effect of bone loss. Long-term use of some drugs can put you at higher risk for osteoporosis.

These risk factors don’t apply to transient osteoporosis. Experts still do not know the exact cause or risk factors of transient osteoporosis. It is known that the condition is more common in males and occurs most often in middle-aged men (ages 30 to 60) and pregnant females in the last three months of their pregnancy or who have recently given birth.⁵

Diagnosing hip pain from osteoporosis

Osteoporosis, or the underlying cause of your hip pain, is diagnosed using a combination of medical history, assessments, physical examinations, and diagnostic imaging.

Your doctor will start by asking detailed questions about your medical history, including assessing your risk factors for osteoporosis or any possible injuries to the affected area. Your doctor will also do a physical exam to determine your range of motion. You may be asked to move your hip or bear weight on the affected side during the physical exam.

Most of the time, with transient osteoporosis of the hip, you won’t experience pain when your doctor moves your hip, but you will have pain when you move your hip.

Further testing will usually include imaging studies, such as x-rays, bone density scans (DEXA scan), or magnetic resonance imaging (MRI) to detect fractures, visualize bone density, or see more details about the hip joint.

If your doctor thinks you may have transient osteoporosis, they will likely do an MRI. An MRI is one of the most useful studies to diagnose the condition. This test can detect an abnormality called bone marrow edema, which is a common finding in transient osteoporosis. Bone marrow is a spongy substance located in the long bones. In bone marrow edema, the bone marrow becomes inflamed and full of fluid.

Blood tests may also be done to assess your calcium and vitamin D levels and other markers related to your bone health. Although this can’t diagnose osteoporosis, it can provide additional insights into your bone health and rule out other causes of hip pain.

Treatment of hip pain from osteoporosis

The management of hip pain associated with osteoporosis involves a combination of lifestyle modifications, physical therapy, and medications. Treatment will focus on alleviating pain, preventing further fractures, and enhancing your overall bone health.

A non-steroidal anti-inflammatory (NSAID) medication can help relieve pain and inflammation.

Your doctor may recommend restrictions on your weight-bearing activities. A cane, walker, or other walking aid can be used to help alleviate some of the stress on the weight-bearing hip.

Simple at-home exercises or physical therapy may be suggested to help maintain strength and flexibility in your hips. A customized exercise program can help you maintain mobility and reduce the risk of falls. Water exercises are sometimes helpful since they relieve weight bearing.

The addition of Calcium and Vitamin D supplements is often beneficial in helping to rebuild your bone.

If you have age-related osteoporosis, medication, such as bisphosphonate, will likely be added to slow bone loss and improve bone density. These medications help reduce the risk of fractures.

In severe cases, especially when a hip fracture has occurred, surgical interventions may be necessary to restore your joint function and alleviate pain.

There are many possible causes of hip pain, but your hip pain could be caused by osteoporosis – either age-related or transient. The Healthcare Associates of Texas team is experienced and will work with you to find out what is causing your hip pain. Call us today or visit our website to book an appointment.

References

1. “Osteoporosis Workgroup.” Osteoporosis Workgroup – Healthy People 2030. Accessed January 9, 2024. https://health.gov/healthypeople/about/workgroups/osteoporosis-workgroup.
2. “Does Osteoporosis Run in Your Family?” Centers for Disease Control and Prevention, May 20, 2022. https://www.cdc.gov/genomics/disease/osteoporosis.htm.
3. “Osteoporosis.” National Institute of Arthritis and Musculoskeletal and Skin Diseases, September 25, 2023. https://www.niams.nih.gov/health-topics/osteoporosis#:~:text=Over%20time%2C%20your%20bones%20can,larger%20boned%20women%20and%20men.
4. “Articles.” Cedars. Accessed January 9, 2024. https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/hip-fracture.html.

“Prevalence and Risk Factors for Transient Osteoporosis of the Hip in Adult Osteogenesis Imperfecta Patients: A Cohort Retrospective Study.” Archives of Clinical and Biomedical Research, May 29, 2020. https://www.fortunejournals.com/articles/prevalence-and-risk-factors-for-transient-osteoporosis-of-the-hip-in-adult-osteogenesis-imperfecta-patients-a-cohort-retrospective.html.