The hip is a complex joint located deep within the body, so diagnosing hip problems can be challenging. A doctor will begin by interviewing the patient and performing a physical exam. If indicated, medical imaging, such as X-rays and MRIs, may be ordered.
To diagnosis snapping hip syndrome a doctor must rule out other conditions that can cause similar symptoms. These conditions include but are not limited to:
- Hip arthritis, a degeneration of the hip joint that may cause pain and limit movement.
- Meralgia paresthetica, a compression of the lateral femoral cutaneous nerve, causes pain and numbness on the thigh.
- Tumors in the hip that may change the biomechanics of the hip.
- Hip joint synovitis, or inflammation of the hip joint’s membrane lining, which causes swelling and symptoms that sometimes mimic those of snapping hip syndrome.
Once the diagnosis is decided then treatments can be recommended.
Non-Surgical Treatments for Snapping Hip Syndrome
Most people who experience a snapping hip have no other symptoms or pain. People who do have pain can typically bring their symptoms under control with non-surgical treatments.
Rest. People with snapping hip syndrome are advised to avoid the motions that cause the snapping, popping or clicking sensation. Resting limits joint irritation and allows the affected tendon, muscle or bursa to heal. If walking initiates inner snapping hip, the patient may be advised to walk with the affected leg rotated out a bit, as this may minimize hip snapping.
NSAIDs and COX-2 inhibitors. Taking non-steroidal anti-inflammatory drugs (NSAIDs) or COX-2 inhibitors for a limited period of time may ease inflammation and hip pain.
Physical therapy. A licensed physical therapist can help loosen tension and encourage healing in the muscles and tendons that cause external and inner snapping hip. A physical therapist may employ:
- Stretching. People with external hip snapping may benefit from stretching the IT band. People with inner hip snapping may benefit from stretching the hip flexors.
- Massage. Just as stretching can help loosen tendons and muscles, a deep tissue massage or trigger-point massage can help reduce muscle tension and reduce snapping hip symptoms.
- Retraining. Increasing an athlete’s physical awareness, improving posture, and modifying form can change the hip’s biomechanics and improve symptoms.
- Ultrasound. Tendon and muscle healing may get a boost from ultrasound, which uses high-frequency sound waves to stimulate soft tissues below the skin.
- Iontophoresis. This treatment uses a mild electrical current to administer an anti-inflammatory medicine (e.g. dexamethasone) through healthy skin and into the sore area. A doctor or physical therapist may recommend iontophoresis to a patient who does not tolerate injections or wants to avoid injections.
Steroid injections. A physician may recommend a steroid injection if the pain from the snapping hip syndrome interferes with daily living. Using medical imaging (e.g. ultrasound) a steroid injection can be made into the hip bursa or the thin sheath that surrounds the tendon. (Injections are not made directly into the tendon, because corticosteroids can weaken tendons).
If non-surgical treatments fail to relieve hip symptoms then a physician may recommend surgery.
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Surgical Treatments for Snapping Hip Syndrome
In some cases a physician may suggest surgery to relieve symptoms of snapping hip syndrome. What type of surgery is recommended will depend on the underlying cause of snapping hip.
- IT band release is sometimes recommended for people who have persistent and painful external hip snapping syndrome. During surgery the physician makes strategic incisions in the IT band to lengthen it, reducing IT band tension and the likelihood of hip snapping. If the patient has trochanteric bursitis, the surgeon may also remove the inflamed bursa during this procedure.
- Iliopsoas tendon release is sometimes recommended for people who have persistent and painful inner hip snapping syndrome. During surgery the physician makes strategic incisions in the iliopsoas tendon to lengthen it, reducing tension and the likelihood of hip snapping.
- Arthroscopic hip debridement may be appropriate if the snapping hip is caused by loose bodies caught in the hip joint. The surgeon makes a small incision to enter the hip joint cavity and remove debris.
- Acetabular labrum repair may be recommended if X-rays and MRI show evidence of a tear to the ring of cartilage around the hip’s socket, or acetabulum. This surgery is typically done arthroscopically, so that only small incisions are needed.
These surgeries have potential advantages and risks. Each surgery is elective, meaning a patient can weigh the pros and cons and decide whether to have it.