Pain in any part of the body is distressing and it is true with the abdomen. Abdomen is a vital organ consisting of stomach, liver, pancreas, gallbladder, intestine (small and large), kidneys and bladder. Any disturbance or disruption of normal functions in these organs can cause considerable pain in the abdomen. Abdominal pain largely gets resolved within short duration. However there are occasions when conditions are serious and pain is intense. Appendicitis is the term that comes to our mind if there is intensifying pain in the right side of the abdomen. That is not the case all the time and there are instances where pain may resemble that of appendicitis. Hence it is good that we understand about the nature of pain in the right hip region, its causes and available treatment.
Hip Region and Its Organs :
Femur bone (thigh bone) and the pelvic bone fuse together at the hip region. Hip joint is formed with the femur and 3 other bones namely, the ilium, the ischium and the pubis. It is ball and socket shaped and is vulnerable of dislocation during a fall or injury. The femur bone has a ball shaped knob at the anterior end that sits on a socket formed by the fusion of hipbone. Articular cartilage would form a cushion like layer on the femoral head which is kept lubricated by the fluid made from the joint lining called synovial membrane. Only due to the presence of cartilage the bone movement is flexible. In addition to this there are ligaments, muscles and tendons that hold the bones intact thus preventing dislocation.
Often the pelvic bones are referred as hip region and more particularly the ilium (uppermost part) or iliac crest is known as hip. Some of the organs present in the right lower quadrant are :
- Vermiform appendix
- Cecum of large intestine
- Colon (ascending portion)
- Right ureter
- Right ovary with fallopian tubes (women)
Causes of Pain Above The Right Hip :
Some of the major causes of pain above the right hip region are discussed here :-
Any problem in the reproductive system or in the gastrointestinal tract can cause considerable pain above the right hip. The intensity of pain may vary depending on the underlying medical issue and on the site. Some of the factors given below are only common causes of pain but it is wise to seek professional help if there is persistent pain for more than couple of days.
- Abdominal Wall
The wall is the protective covering for the organs of the abdominal cavity and is made of fat, muscles, skin, fascia and peritoneum. Any blow to the abdominal wall and factors like hernia, muscle strain and infection of the peritoneum can cause significant pain in the abdomen region above the right hip. The area becomes warm and tender to touch due to pain and inflammation. It is not necessary that pain in the right hip portion is due to complications in the inner organs alone.
Appendix is a small pouch like portion that protrudes from the large intestine, more particularly on the cecum area. When this appendix region gets inflamed (appendicitis) or develops swelling due to infection it can get ruptured inside freely emptying the pus like fluid in the abdomen. Sometimes an abscess can form in the appendix which has to be removed surgically. Appendicitis can occur suddenly but is a serious condition requiring immediate medical help. Some of the symptoms of appendicitis are abdominal pain (right hip portion), nausea, vomiting, diarrhea or constipation, loss of appetite and difficulty in passing gas. The pain would begin as dull pain and steadily increase in intensity as time passes. It can cause excruciating pain in the right hip with abdominal swelling.
There are several bags or pouch like structure called diverticula in the wall of the abdomen and sometimes they get inflamed in the large intestine region. Often they do not cause any symptoms however when there is any infection in these pouches it can cause considerable pain in the right hip. Some of the symptoms of diverticulitis are fever, nausea, vomiting, constipation or diarrhea, a feeling of fullness in the abdomen and dull aching pain in the abdomen.
Any problem in the stomach or intestine region can lead to infection causing gastroenteritis. Stomach flu is one of the major causes of gastroenteritis caused by virus. Bloating sensation, persistent diarrhea, nausea, vomiting and mild to moderate fever and excessive gas formation are some of the signs of gastroenteritis.
Stomach ulcers are the common cause of pain over right hip. Perforated ulcers can form in the stomach or duodenum and sometimes the ulcers tear up leaking the contents into the abdomen. Symptoms of peptic ulcer include pain radiating towards the back, mild to moderate fever, fatigue, difficulty in breathing, distension of abdomen and fatigue. It may cause continuous hiccups in some people.
- Obstruction In The Intestine
Blockage or obstruction can occur in the small intestine or large intestine blocking the flow of bowels. Number of factors can cause intestinal obstruction. Some of the symptoms of intestinal obstruction include diarrhea, constipation, abdominal distention, a feeling of bloated stomach, vomiting (if the block occurs in the small intestine), and bowel sounds.
- Kidney Stones
Some particles of urine get crystallized forming a stone. Sometimes these stones get bundled together forming a hard mass in the kidney. These stones get trapped inside the kidney or bladder causing pain in the right hip region. Back pain, burning pain while urinating, nausea, vomiting and frequent urination is some of the symptoms of kidney stones.
- Urinary Tract Infection
Urinary tract infection is quite common in women and infection can occur in any part of the tract. Often the infection would progress till the bladder and in some cases it may affect the ureters and kidneys also. UTI can cause symptoms like pain while urinating, foul smell in the urine, intense urge to urinate and passing small amounts of urine number of times.
Tumors can develop in the colon or rectum due to various factors. Cancer can originate in the colon or sometimes it occurs elsewhere and spread to the colon. Colon cancer can be serious and cause symptoms including loss of weight, fatigue, change in bowel habits, blood leakage in bowel, and constipation in addition to persistent pain in the abdomen.
- Polycystic Ovarian Syndrome
One or more cysts can form in the ovaries causing intense pain and discomfort. Often this kind of pain is confused for abdominal pain. Increase in male hormones and other factors cause PCOS and it can cause symptoms like excess of hair growth in face and other parts of the body, significant pain in the right hip region and bulging abdomen.
If the endometrial tissue of the uterus grows at other regions it causes endometriosis. This condition can cause intense pain during monthly periods.
Based on the symptoms and physical examination, the doctor may requests for ultrasound scan of the abdomen and imaging tests to identify the cause.
Treatment for pain over the right hip region depends on the cause. In most of the cases medications and small lifestyle changes can reduce the intensity of pain. In severe cases surgical intervention may be required.