Hip pain may be a result of referred pain from the low back or it may be a result of abnormality about the hip joint. Groin pain is a particularly important type of hip pain that warrants further investigation. Patients with femoroacetabular impingement (FAI) have hip bones that do not fit together due to their abnormal shape. The hip is a joint known as a ball-and-socket where the ball, the femoral head, fits into the socket, formed by the acetabulum. This joint is covered in cartilage that allows the joint to move smoothly and keeps the bones from grinding. FAI occurs when excess bone develops around the joint, which forces the hip bones to rub against each other, which eventually wears down the cartilage and causes a labral tear. This is seen among dancers, runners, cyclists and other athletes with repetitive hip flexion activities.
There are three types of FAI, pincer, cam, and combined. The pincer impingement is caused by an extension of extra bone over the socket. When the ball joint is not round, it cannot fit correctly into the socket causing cam impingement. Because of the shape of the femoral head, a bumpy area forms on the ball that grinds and wears down the cartilage inside the socket. Combined impingement is when both pincer and cam impingements are in the hip bone.Cam FAI is found more often in males, while pincer impingement is usually found in females. A study was presented in October 2014 that shows a relation between sex and impingement types. Cohorts of 50 men and 50 women who had symptomatic FAI and were to undergo surgery. Results showed that the females suffering from FAI, who were assessed using various outcome measures had a greater disability prior to surgery. They also had greater flexion and rotation of the hips, while having less cam impingement.
The males that were studied showed more likely to have acetabular cartilage lesions, and labral tears much larger than those in females. Males were also about two times more likely than females to have pincer impingement as a result as having combined FAI impingement. The conclusion of the study showed that while females had a greater disability, they also have lesser abnormalities. Males, on the other hand, had less disability, but with more pronounced abnormalities and combined FAI.
Those suffering from FAI have hip pain in the groin area. A dull ache or sharp stabbing pain that occur with movement is common, especially with twisting and pivoting. Over the counter medications such as ibuprofen or other NSAIDS can help relieve pain and inflammation, along with rest and less activity. If pain does not decrease from home remedies, a doctor or orthopedic surgeon should be consulted. FAI that is not treated can cause more damage over time.
There are different treatment types for FAI, such as changing daily activities, NSAIDS, prescription medicines, and physical therapy. If these methods do not help, hip arthroscopy may be needed. In fact, physical therapy may at times cause the FAI symptoms to flare. The surgeon makes small incisions into the damaged area, and inserts an arthroscopic camera to assess the extent of the damage in the hip. The surgeon can clean the damage from the site and trim any bumps or ridges on the femoral head or acetabulum. For more severe cases, open hip surgery will be needed to alleviate the issue.