What is snapping hip syndrome?

Snapping hip syndrome is a condition in which you hear or feel a snapping sound in the hip while rotating your hip, running, walking, or while getting up from the chair.  Movement of the muscles or tendons over a bony protrusion in the hip region gives rise to the snapping sound, which can occur in the back, front, or side of the hip.  Usually it is painless and harmless, however, in some instances it can become painful with muscle weakness.  People who are involved in sport or dance where they have to repeatedly bend are most vulnerable and it may affect their performance.  Sometimes, the syndrome can lead to bursitis, a painful swelling of the fluild-filled sacs called bursae that cushion the hip joint

Causes

The most common cause of snapping hip syndrome is tightness in the muscles and tendons surrounding the hip.  Sometimes, a loose piece of cartilage, a cartilage tear or pieces of broken cartilage or bone in the joint space can lead to the snapping sound.  This may also lock the hip causing disability along with the pain.  However, this is less common.

Diagnosis

A detailed medical history and physical exam will be performed to evaluate the exact cause of the snapping.  You may be asked to reproduce the snapping sound by moving your hip in different directions.  Imaging tests may be ordered by your doctor to rule out bone and joint problems

Treatment

Rest and activity modification may be the initial recommendation followed by conservative therapeutic modalities:

Home Remedies

• Applying ice to affected area

• Using Non-Steroidal Anti-Infllammatory (NSAIDs) medications

• Avoid repetitive hip movements by changing your activities

Consult your doctor if the discomfort persists even after following the home remedies

Physical Therapy

You may be prescribed specific physical therapy exercises to strengthen and stretch the musculature surrounding the hip.  You may be guided by a physical therapist.  Particular tendon stretching exercises such as iliotibial band stretch and iliopsoas muscle stretch will be indicated depending on the type of snapping you experience.

Corticosteroid Injection

You may be recommended for a corticosteroid injection into the affected bursa to reduce the pain and inflammation in the hip joint in case you have associated hip bursitis

Surgical Treatment

Surgery is recommended when conservative approaches do not have an effect in resolving the snapping hip syndrome (which is rare).  The type of surgery will depend on the factors that cause snapping hip.  Surgical procedures include:

• Hip Arthroscopy – This procedure is used to address the snapping that is refractory to conservative treatment.  During the procedure, the entire hip joint is visualized and all pathologies are addressed including torn labrum.  During this  “minimally-invasive” procedure, small poke-hole incisions are made to gain access to the hip joint using a small camera and specialized instrumentation.

• Open Procedure – In some rare cases, open surgery is necessary to gain better access to the hip problem.  An open incision of several centimeters will be made to resolve the issue of snapping hip.

Dr. Gupta will discuss the best surgical option depending on your situation.