Nonarthritic Hip Joint Pain
Publication Date: June 1, 2014
Last Updated: March 14, 2022
Recommendations
RISK FACTORS
Clinicians should consider the presence of osseous abnormalities, local or global ligamentous laxity, connective tissue disorders, and nature of the patient’s activity and participation as risk factors for hip joint pathology. (F)
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DIAGNOSIS/CLASSIFICATION – NONARTHRITIC HIP JOINT PAIN
Clinicians should use the clinical findings of anterior groin or lateral hip pain or generalized hip joint pain that is reproduced with the hip flexion, adduction, internal rotation (FADIR) test or the hip flexion, abduction, external rotation (FABER) test, along with consistent imaging findings, to classify a patient with hip pain into the International Statistical Classification of Diseases and Related Health Problems (ICD) categories of M25.5 Pain in joint, M24.7 Protrusio acetabula, M24.0 Loose body in joint, and M24.2 Disorder of ligament, and the associated International Classification of Functioning, Disability and Health (ICF) impairment-based categories of hip pain (b28016 Pain in joints) and mobility impairments (b7100 Mobility of a single joint; b7150 Stability of a single joint). (C)
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DIFFERENTIAL DIAGNOSIS
Clinicians should consider diagnostic categories other than nonarthritic joint pain when the patient’s history, reported activity limitations, or impairments of body function and structure are not consistent with those presented in the Diagnosis/Classification section of this guideline or when the patient’s symptoms are not diminishing with interventions aimed at normalization of the impairments of body function. (F)
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EXAMINATION – OUTCOME MEASURES
Clinicians should use a validated outcome measure, such as the Hip Outcome Score (HOS), the Copenhagen Hip and Groin Outcome Score (HAGOS), or the International Hip Outcome Tool (iHOT33), before and after interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions in individuals with nonarthritic hip joint pain. (A)
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EXAMINATION – PHYSICAL IMPAIRMENT MEASURES
When evaluating patients with suspected or confirmed hip pathology over an episode of care, clinicians should assess impairments of body function, including objective and reproducible measures of hip pain, mobility, muscle power, and movement coordination. (B)
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INTERVENTION – PATIENT EDUCATION AND COUNSELING
Clinicians may utilize patient education and counseling for modifying aggravating factors and managing pain associated with the nonarthritic hip joint. (F)
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INTERVENTION – MANUAL THERAPY
In the absence of contraindications, joint mobilization procedures may be indicated when capsular restrictions are suspected to impair hip mobility, and soft tissue mobilization procedures may be indicated when muscles and their related fascia are suspected to impair hip mobility. (F)
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INTERVENTION – THERAPEUTIC EXERCISES AND ACTIVITIES
Clinicians may utilize therapeutic exercises and activities to address joint mobility, muscle flexibility, muscle strength, muscle power deficits, deconditioning, and metabolic disorders identified during the physical examination of patients with nonarthritic hip joint pain. (F)
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INTERVENTION – NEUROMUSCULAR RE-EDUCATION
Clinicians may utilize neuromuscular re-education procedures to diminish movement coordination impairments identified in patients with nonarthritic hip joint pain. (F)
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Recommendation Grading
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Overview
Title
Nonarthritic Hip Joint Pain
Authoring Organization
American Physical Therapy Association
Publication Month/Year
June 1, 2014
Last Updated Month/Year
June 27, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
Describe evidence-based practice, including diagnosis, prognosis, intervention, and assessments of outcomes for musculoskeletal disorders. Classify and define common musculoskeletal conditions using the World Health Organization's terminology related to impairments of body function and body structure, activity limitations, and participation restrictions. Identify interventions supported by current best evidence to address impairments of body function and structure, activity limitations, and participation restrictions associated with common musculoskeletal conditions. Identify appropriate outcome measures to assess changes resulting from physical therapy interventions in body function and structure as well as in activity and participation of the individual. Provide a description to policy makers, using internationally accepted terminology, of the practice of orthopaedic physical therapists and hand rehabilitation. Provide information for payers and claims reviewers regarding the practice of orthopaedic and hand therapy for common musculoskeletal conditions. Create a reference publication for clinicians, academic instructors, clinical instructors, students, interns, residents, and fellows regarding the best current practice of orthopaedic physical therapy and hand rehabilitation
Target Patient Population
Patients experiencing non-arthritic hip joint pain
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Emergency care, Hospital, Operating and recovery room, Outpatient
Intended Users
Physical therapist, occupational therapist, nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Diagnosis, Rehabilitation, Prevention, Management, Treatment
Diseases/Conditions (MeSH)
D025981 - Hip Injuries, D006621 - Hip Joint, D006620 - Hip Fractures
Keywords
hip pain, nonarthritic hip pain, joint pain