Many people wonder if surgery for snapping hip is really that necessary. Snapping hip syndrome usually causes a hip pop, click, or snap that can be heard and seen but is not painful. People who experience hip pain can typically bring their symptoms under control using non-surgical treatments.
If non-surgical treatments don't work, surgery for snapping hip may be recommended.
Snapping hip syndrome is identified by a snapping sensation and usually an audible popping noise when the hip is extended and flexed. The syndrome occurs most often among people between 15 to 40 years old and affects females slightly more frequently than males.
Snapping hip syndrome has three primary reasons. The most common reason involves the iliotibial band, or IT band, a thick, wide tendon that runs over the outside of your hip joint. Snapping hip syndrome happens when the iliotibial band snaps over the bony prominence outside the hip joint. Patients with this snapping hip syndrome may also develop trochanteric bursitis from the irritation of the bursa in this region.
The second cause of snapping hip syndrome is the iliopsoas tendon, which could catch on a bony prominence of the pelvis and result in a snap when the hip is flexed. When the iliopsoas tendon is the reason for snapping hip syndrome, patients often experience no problems other than the annoying snapping. Lastly, the third and least likely reason for snapping hip syndrome involves a labral tear in the hip joint or cartilage. This snapping hip usually causes pain and might be disabling. In addition, a loose piece of cartilage could cause the hip to catch or lock up.
In most cases, snapping is due to the movement of a muscle or tendon over a bony structure in the hip.
The most common site is outside the hip, where a band of connective tissue called the iliotibial band passes over part of your thigh bone that juts out -- known as the greater trochanter. When standing up straight, this band is behind the trochanter. However, when you bend your hip, the band moves over and in front of the trochanter. It may cause a snapping noise.
The iliopsoas tendon, connecting to the inner part of your upper thigh, could also snap with hip movement.
Another area of snapping is where the ball at the top of the thigh bone fits into the socket in the pelvis to create the hip joint. The snapping happens when the rectus femoris tendon, which runs from inside the thighbone up through your pelvis, moves back and forth across the ball when your hip is bent and straightened.
Less commonly, a cartilage tear or bits of broken bone or cartilage in the joint space could cause snapping, or a loose piece of cartilage can cause the hip to lock up. It can cause pain and disability. In this case, surgery for snapping hip may be recommended.
People with snapping hip syndrome most commonly experience pain if:
The snapping tendon or muscle becomes irritated and inflamed. During snapping, the tendon or muscle is uncomfortably strained and stretched as it pulls over a bony protrusion and afterward snaps as the tension is released. This process could lead to muscle or tendon irritation, damage, and pain if done repeatedly over time.
The snapping leads to painful hip bursitis. The snapping muscle or tendon can irritate a nearby bursa, a lubricating, fluid-filled structure that typically reduces friction between bone and soft tissue. This irritation could cause a bursa inflamed, a condition known as hip bursitis.
For some people, the snapping sensation and hip bursitis result in painful symptoms.
Snapping hip syndrome could affect anyone, but certain individuals are at higher risk:
A person with snapping hip syndrome could usually snap a hip at will. They can make a hip snap with a particular movement, such as standing up from a seated position, walking, kicking, or rotating a leg out.
Below are non-surgical treatments typically recommended to alleviate pain due to snapping hip syndrome:
People with snapping hip syndrome are recommended to avoid the motions that cause the popping, snapping or clicking sensation. Resting limits joint irritation and lets the affected muscle, tendon, or bursa heal. If walking causes an inner snapping, the patient might be advised to walk with the affected leg rotated out a bit, as this might minimize hip snapping.
COX-2 inhibitors or Non-steroidal anti-inflammatory drugs (NSAIDs) may ease inflammation and hip pain.
A licensed physical therapist could help loosen tension and encourage healing in the muscles and tendons that cause internal and external snapping. A physical therapist may use:
A physician may recommend steroid injection if the snapping hip syndrome's pain interferes with day-to-day life. Using medical imaging (for example., ultrasound), a steroid injection could be made into the hip bursa or the thin sheath surrounding the tendon. (Injections aren't made directly into the tendon because corticosteroids can weaken tendons).
Sometimes, a physician may suggest surgery for snapping hip to relieve snapping hip syndrome symptoms. The recommended surgery will depend on the underlying cause of snapping the hip.
IT band release is sometimes advised for people with persistent and painful inner hip snapping syndrome. During surgery for snapping hip, your physician makes strategic incisions in the iliopsoas tendon to lengthen it, decreasing tension and the chance of hip snapping.
Iliopsoas tendon release is sometimes advised for people with persistent and painful inner hip snapping syndrome. During surgery, your physician makes strategic incisions in the iliopsoas tendon to lengthen it, decreasing tension and the chance of hip snapping.
Arthroscopic hip debridement might be appropriate if the snapping hip is caused by a cartilage injury that has led to loose cartilage caught in the socket joint and hip's ball. The surgeon makes a tiny incision to reach the hip joint cavity and remove debris.
Acetabular labrum repair might be recommended if x-rays and MRI show a tear to the ring of cartilage around the acetabulum or hip's socket. This surgery is usually done arthroscopically so that only small incisions are needed.
Note that before treatment can start, an accurate diagnosis must be made. The hip is a complex joint found deep within the body, so diagnosing hip problems could be challenging. A doctor will start by interviewing the patient and conducting a physical exam. Medical imaging, like X-rays and MRIs, may be ordered.
To diagnose snapping hip syndrome, a doctor must rule out other conditions that could cause similar symptoms. These conditions include but aren't limited to:
Once the diagnosis is decided, treatments, both non-surgical and surgery for snapping hip, could be recommended.