How Getting rid of pelvic pain and hip joint - #20255
Hello doctor I am a 22-year-old male. About one month ago, I started to feel pain in my right leg, specifically near the hip/pelvic area. The pain is localized and does not radiate down the leg or into the foot. I feel pain only during certain movements, not all the time. Movements that cause pain: When I am lying down, my left leg extended, and I pull my right leg toward my body, then rotate my right foot outward (to the right) and let the leg fall to the right side, as if trying to touch the floor. When I am standing and rotate my upper body backward while keeping my right foot fixed on the ground. When I am lying down, pull my right leg toward my body, place my right foot next to my left leg, bend the knee, and contract the gluteal (buttock) muscle. Important notes: I do not feel pain while walking, standing normally, or sitting. The pain appears only with specific rotational or stretching movements. A doctor told me it might be a muscle tear in the pelvic/hip muscles, but I am not convinced because the pain is very movement-specific. Other opinions suggested tendon involvement or a hip joint issue, but nothing is certain. A hip X-ray was done and showed no abnormalities. I used to sit on the floor in a W-sitting position, but with one leg turned outward (V-shape) — the same leg that is painful. I stopped this sitting position, but the pain did not improve. Concern: Medical examinations and imaging in my country are expensive (around 75 USD per visit), and I currently cannot afford further tests, so I am seeking guidance. Thank you for your time and advice. Does this presentation suggest hip labral injury or femoroacetabular impingement (FAI)? Could this be related to gluteal tendinopathy or hip flexor/adductor strain rather than a muscle tear? Is an MRI necessary, or can this be managed conservatively without imaging? What movements or exercises should I avoid right now? Are there home exercises or stretches that are safe to try? How long should I wait before symptoms are expected to improve?
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Doctors’ responses
This is NOT likely a serious hip joint disease
Most consistent with rotational stress–related soft tissue or capsular irritation
MRI not needed now
Conservative care is appropriate
Avoid provocative movements
Gentle strengthening is key
Expect improvement in 4–8 weeks
Hello,
This pattern suggests likely soft-tissue / tendon / muscle strain or possibly hip labrum irritation or femoroacetabular impingement (FAI), but nothing severe since daily activities are painless.
Most likely causes Gluteal tendinopathy / hip stabilizer strain Hip flexor or adductor strain
Less likely but possible: early hip labral irritation or mild FAI (since rotation provokes pain)
🛑 MRI is helpful only if pain is persistent or worsening. Since you can function normally, conservative treatment is reasonable first.
Avoid painful positions: deep hip rotation, twisting, extreme stretching, “W” or “V” sitting. Rest from heavy exercise / sports for now. Ice or warm compress. Gentle hip-strengthening later (glute bridges, core strengthening) only when pain reduces.
if Pain worsens or You develop clicking/locking of hip or Pain starts during walking or Numbness, weakness, fever, trauma history consult a orthopedic surgeon in person
Expected recovery
Soft-tissue injuries usually improve in 4–8 weeks with rest and proper care. If not improving by then, MRI or specialist review may be needed.
I trust this helps Thank you
Hello Yousif Thanks for describing your symptoms so clearly. Based on your age, the location of pain (right hip/pelvic area), and the fact that it’s triggered only by certain rotational or stretching movements—not by walking, standing, or sitting—the most likely cause is a muscle or tendon strain around the hip joint, possibly involving the hip flexors, rotator muscles, or the gluteal muscles.
This kind of pain is common after minor injuries, overuse, or awkward movements, and usually isn’t serious if there’s no swelling, redness, numbness, tingling, or weakness.
What This Means - The pain is likely due to a mild strain or irritation of the muscles/tendons around your hip. - Since it’s not constant and doesn’t radiate, it’s less likely to be a nerve issue or something serious like a fracture.
What You Can Do 1. Rest: Avoid movements that trigger the pain for a few days. 2. Ice: Apply an ice pack (wrapped in a cloth) to the painful area for 10–15 minutes, 2–3 times a day. 3. Gentle Stretching: After a few days, gentle hip stretches can help, but don’t push into pain. 4. Pain Relief: If needed, you can use paracetamol for pain (as per package instructions), but avoid self-medicating with stronger drugs. 5. Monitor: Watch for any new symptoms like swelling, redness, fever, numbness, or weakness
Rx- Diclofenac gel - apply on affected area thrice a day Tab Zerodol sp - once a day after food for 7 days Tab Neurobion forte - once a day after food for a month Tab vit d3 - once a week for a month
Most mild muscle strains improve within 1–2 weeks with rest and care
Thank you
Hello dear See I can suggest some preventive measures In addition to that tests must be done to rule out of abnormalities are three Mri pelvis Pelvic USG Crp Esr You can follow below precautions for improvement Physiotherapy exercises especially stretching excercise twice a day for 1 month Voveron xr 50 mg twice daily accordingly if required Diclofenac sodium gel topical application twice a day for 15 days Crave bandage only on emergency In case of no improvement consult orthopedic surgeon in person for better clarity Also share the report with concerned physician only Regards
Hello Yousif, thank you for sharing your concern. Based on your symptoms, this is most likely a gluteal tendon / deep hip rotator strain (tendinopathy), commonly caused by prolonged W-sitting or externally rotated sitting postures. This fits well because your pain appears only with specific rotational movements, while walking, sitting, and rest are painless, and the X-ray is normal.
A hip labral tear or FAI is unlikely at this stage since those usually cause groin pain, clicking, locking, or pain during daily activities, which you do not have.
MRI is NOT required now. Conservative treatment is appropriate.
What to do: - Avoid W-sitting, cross-leg sitting, twisting on a planted foot - Ice the painful area 15 min, 2–3× daily for 7–10 days - Paracetamol if needed for pain - Start gentle exercises after pain reduces (glute squeezes, side-lying leg lifts, pelvic tilts)
Avoid: - Forcing painful hip rotation - Deep stretching or sudden twisting movements
Recovery: - Improvement expected in 2–6 weeks - Seek further evaluation only if pain worsens, starts during walking, or persists beyond 6–8 weeks
Overall, this condition usually resolves without MRI or surgery with proper rest and rehabilitation.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Medicine
The symptoms you describe could indeed suggest several possible conditions including hip labral injury, femoroacetabular impingement (FAI), gluteal tendinopathy, or hip flexor/adductor strain. The specificity of your pain with certain movements points to potential issues involving soft tissues rather than the joint itself, given the clear X-ray results. While an MRI would provide more detailed information on soft tissue involvement, it may not be necessary immediately if you prefer to manage this conservatively first.
For conservative management, avoiding movements that provoke pain is crucial; this means staying away from activities that involve the rotational or extreme flexion motions you mentioned trigger discomfort. In terms of exercises, gentle hip stretching that doesn’t cause pain might be beneficial, but avoid any aggressive stretching or strengthening against resistance until the pain subsides. Simple home exercises could include gentle hip flexor and gluteal stretches, performed within a pain-free range. Also consider engaging in non-painful activities like walking or swimming to maintain overall fitness without stressing the hip.
A structured period of rest combined with these modifications may help reduce symptoms over time. However, if there’s no improvement within 6-8 weeks, or if the pain worsens, seeking reassessment would be wise. It’s important to rule out more serious conditions that could require different interventions. In the meantime, over-the-counter pain relief or anti-inflammatories, if tolerated, could help manage symptoms. But preventing exacerbation by avoiding known triggers is key. Always keep your current means and comfort level in mind with these guidelines, ensuring choices align with your personal health scenario.
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