Hip pain is defined as soreness, tension, and/or stiffness in the anatomical region of the hip (mid-groin region) and can be secondary to multiple conditions including hip osteoarthritis. For more depth on the various conditions effecting the hip please check our section on the hip and pelvis.
Diagnosis of hip pain is derived from the patient’s history and physical exam with an unremarkable neurological exam and no indicators of potentially serious pathology. Imaging studies are confirmatory for diagnoses of moderate or severe osteoarthritis [97,98].
Chiropractors perform a thorough history of complaint and examination (orthopaedic, neurological and chiropractic testing). Assessment may also include the use of diagnostic imaging including X-ray and MRI.
Severe osteoarthritis of the hip is usually best managed by surgical interventions.
Evidence based summary for manual therapy 
Moderate quality evidence that hip manipulation is superior to exercise for the treatment of the symptoms of hip osteoarthritis . For references please see home page/ chiropractic/ research evidence.
Other effective non-invasive physical treatments or patient education 
Exercise therapy, advice about weight loss, and appropriate footwear [97,100,102].
Back-in-Action Clinic Comment
Chiropractic treatment of hip problems in the initial phase is based on improving the movement, position and stability of the hip joint and surrounding structures in order to reduce the risk of stress and further tissue damage. Self help recommendations of using ice or heat is often given in the acute stage. Nutritional approaches can be beneficial to help support soft tissue healing. Chiropractic adjusting techniques (manipulation) and mobilisation may be applied to improve the function of the hip joint itself and other functionally related joints in the lower back and leg. Various muscle release techniques may be applied. An emphasis is placed on self help exercise which might include self mobilisation, stretching, strengthening and balance training. Core stability exercise often is useful for improving the position of the low back, pelvis and hip. Areas of severe muscle spasm may also benefit from massage or acupuncture. Foot orthotics, sitting advice and other ways to improve postural problems affecting the hip may be suggested. Functional neurological treatment and exercises are also often helpful.
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