A hip problem can be hard to deal with, both for the child who has
the problem and to the parent or caregiver. A child who has a hip problem may
feel pain in the hip, groin, thigh, or knee. A child in pain may limp or be
unable or unwilling to stand, walk, or move the affected leg. A baby in pain
may cry, be fussy, and have other signs of pain. Hip problems may be present at birth
(congenital) or may develop from injury, overuse, inflammation, infection, or tumor growth.
To better understand hip problems, it may be helpful to know how the hip works. It is the largest ball-and-socket joint in
the body. The thighbone (femur) fits tightly into a cup-shaped socket
(acetabulum) in the pelvis. The hip joint is tighter and more stable than the
shoulder joint but it does not move as freely. The hip joint is held together
by muscles in the buttock, groin, and spine; tendons; ligaments; and a joint
capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint
and let the tendons and muscles glide and move smoothly. The largest nerve in
the body (sciatic nerve) passes through the pelvis into the leg.
Hip problems may develop from overuse,
infection, or a problem that was present from birth (congenital). Oddly enough,
a child who has a hip problem often feels pain in the knee or thigh instead of
the hip. Hip problems that affect children include:
An inflammatory reaction, such as transient or toxic synovitis. This generally occurs
after the child has had a cold or other upper respiratory infection. This is
the most common cause of hip pain in children.
A slipped capital femoral epiphysis. This occurs when
the upper end of the thighbone (head of the femur) slips at the growth plate
(epiphysis) and does not fit in the hip socket correctly.
An inward twisting of
the thighbone (femoral anteversion). This condition causes the knees and feet
to turn inward. The child will have a “pigeon-toed” appearance and may have a
Developmental dysplasia of the hip (DDH). This condition is caused by a problem in the development of the
hip joint. The top of the femur does not fit correctly into the hip socket
(acetabulum) so the femur can partially or completely slip out of the
In rare cases, cancer of
the bone, such as osteosarcoma.
Treatment for a hip problem depends on the location, type,
and severity of the problem as well as the child’s age, general health, and
activity level. Treatment may include first aid measures; application of a
brace, cast, harness, or traction; physical therapy; medicines; or
Severe pain (8 to 10): The pain
is so bad that the child can’t stand it for more than a few hours, can’t sleep,
and can’t do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.
Moderate pain (5 to 7): The pain is bad enough to disrupt the child’s normal activities and
sleep, but the child can tolerate it for hours or days.
Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
Symptoms of infection may
Increased pain, swelling, warmth, or redness in or
around the area.
Red streaks leading from the area.
Pus draining from the area.
Certain health conditions and medicines weaken the immune system’s ability to fight off infection and
illness. Some examples in children are:
Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
which are used to treat a variety of conditions.
after organ transplant.
Chemotherapy and radiation therapy for
Not having a spleen.
If there is a difference between the child’s hips, you may notice that:
One leg looks shorter than the
There are more folds of skin on the inside of one thigh than
on the other.
One hip joint seems to move differently than the
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Call your doctor now to discuss the symptoms and
arrange for care.
If you cannot reach your doctor or you don’t have
one, seek care in the next hour.
You do not need to call an
You cannot travel safely either by driving
yourself or by having someone else drive you.
You are in an area
where heavy traffic or other problems may slow you down.
Seek Care Today
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
Call your doctor today to discuss the symptoms
and arrange for care.
If you cannot reach your doctor or you don’t
have one, seek care today.
If it is evening, watch the symptoms and
seek care in the morning.
Home treatment may help relieve your
child’s hip pain, swelling, and stiffness. If your child will cooperate, use
the following tips. If your child becomes upset or will not cooperate, do not
force your child.
Rest. Have your child rest and protect the sore
hip. Have your child stop, change, or take a break from any activity that may
be causing pain or soreness.
For sleep, put your child on the side that does not have a
Gently rub your child’s hip to relieve pain and
help blood flow.
If the swelling is gone, heat can be put on the area. Your child can carefully
begin normal activities. Moist heat with a hot water bottle or warm towel may feel good to your child.
Medicine you can buy without a prescription
Try a nonprescription
medicine to help treat your child’s fever or pain:
Talk to your child’s doctor before switching back and
forth between doses of acetaminophen and ibuprofen to treat a fever. When you
switch between two medicines, there is a chance your child will get too much
Be sure to follow these
safety tips when you use a nonprescription medicine:
Carefully read and follow all labels on
the medicine bottle and box.
Give, but do not exceed, the maximum
Do not give your child a medicine if he or she
has had an allergic reaction to it in the past.