Causes & Therapies for Pain Radiating From Hip to Knee

Pain in Hip Down to Knee

Hip pain that radiates down to the knee can be very uncomfortable. Your knee and hip joints are the largest joints in your body; they support your body's weight and they work together to give you the mobility that is sometimes taken for granted.

The hip is a ball-and-socket joint that helps you move your legs with a wide variety of motions that you use throughout the day, like going up and down stairs. It has a wide range of motion and is very stable if the knee joint works properly. The joint, which sits atop the femur, is called the femoral head, and the socket created by the hollow of your pelvis is called the acetabulum. Surrounding the joint is the fibrous capsule sleeve that holds the bones together.

The knee is an incredibly complex joint that goes through a tremendous range of motion. It has many muscles that cross the knee joint to help control its movement while walking, running, squatting, or going up and down stairs. All of this movement occurs while supporting your body weight. The internal components of the knee include several strong ligament structures that prevent excessive shearing motions. Likewise, we have several strong muscles that cross the outside of the knee joint including the quadriceps, hamstrings, and gastrocnemius muscles.

Potential Causes of Pain Radiating from Hip to Knee

Most hip pain is caused from overworking the muscles either by repetitive stress or overdoing exercises. The pain is caused by inflammation of the soft tissues and tendons of the hip. Usually this pain is relieved in a few days. Prolonged hip pain can be the cause of a specific condition. When the hip joint is injured, pain can be felt in the groin all the way down to the knee. Sometimes knee pain is the only sign that the hip is injured - this is called referred pain.

A slipped lumbar disc in your lower back can also cause pain that is felt in your hip. With a lumbar disc injury, your knee and leg may also feel weak. Spinal stenosis is the narrowing of your spinal cord and nerves, which can cause isolated hip pain felt along with a numb feeling in the knees and legs. A sprain in your lower back, or a lumbosacral sprain, is an injury to the ligaments in your lower back. Pain from this injury accumulates to one side of the spine around the hip, making it difficult to bend or twist.

Joints located on either side of the spine are called sacroiliac joints and are often noted by how their meeting place forms dimples on people's backs. These joints are formed to absorb tremendous amounts of stress from the lower extremities. When these joints are injured (like in a sacroiliac sprain), referred pain can be felt in the hip and radiates down to knee pain. Pelvic fractures are most common in the elderly who slip and fall, but these can also be a source of hip pain in many people who are involved in high-energy accidents, such as motor vehicle crashes, cycling accidents, or a fall from a great height.

Piriformis syndrome is another back injury that can cause pain within the hip. The piriformis muscles is located near the buttock region and piriformis syndrome is the spasming of the muscle. The spasm causes pain in the hip almost like an injury to the sciatic nerve, and can radiate down into the knee, causing it to be weakened. Hip tendonitis and bursitis is the inflammation and degeneration of the soft tissues surrounding the hip muscle and joint. Tendonitis is the inflammation of the tendons, and bursitis is the inflammation of the bursa - the soft sac of fluid acting as a cushion between moving structures. The pain often occurs suddenly and results in redness and swelling. In severe cases, the pain can become so intense that the joint has the inability to move.

All these hip pain causes can be treated with conservative, therapeutic treatments.

Home Treatments

At home the first step is always PRICE: protect, rest, ice, compress, and elevate. Reduce the stress and strain to the knee. Over the counter nonsteroidal anti inflammatory drugs (NSAIDs) as recommended by your doctor can help reduce pain and inflammation. Ice helps block the knee pain and reduce inflammation.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options, as well. Pain management is not usually required unless stronger medications or joint injections are involved in treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. Nerve conduction velocity (NCV) testing may be utilized in cases that also involve muscle, sensory or reflex loss.

Conservative Treatments

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

Iliotibial band Syndrome is common in runners who develop the injury because of weakness and poor stabilization of the leg and hip muscles. Specific knee exercises are given to increase strength and endurance. Proprioception exercises help teach the muscles how to work together again to stabilize the knee during walking or running.

When these treatments are incorporated into a treatment plan, patients heal faster and are less likely to have long-term pain, soft tissue fibrosis, or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.

Improve Movements to Eliminate Hip Pain

The back, hip, and lower extremity work as a comprehensive unit allowing for many of the repetitive tasks you complete at home, work, and during recreational activities. Injuries to one area of the musculature often indicates that additional damage has been incurred by adjacent muscles.

Many therapeutic exercises can help restore proper strength and endurance to the leg muscles. Isometric exercises are often the initial treatment exercises, followed by single plane rubber band exercises for the hip, knee, and ankle: flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable the surface, the more effort and stabilization is required of all the lower extremity muscles.

Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.

Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.