Pain above the right hip is often thought to be due to appendicitis, kidney and ovarian-related problems in females. However, there are a host of possible causes of pain in this region. Contrary to popular belief the kidney is not located just above the hip. A number of other organs are located in this region and most of the time right hip pain may be due to a problem with one or more of these organs.
Right hip pain like pain anywhere in the body is a symptom of an underlying problem. We usually associated the severity of the pain with the seriousness of the condition, however this may not always be accurate. Sometimes minor conditions can present with intense pain while very serious and even life-threatening conditions can be relatively harmless.
When evaluating pain at or above the right hip, it is important to look at the organs in this area. A combination of abdominal and pelvic organs lies here since both these cavities are continuous with each other. The pain may not always emanate from an organ exactly at the location of the pain since it can radiate from lower down or higher up or be referred by organs elsewhere in the body.
Organs in the right lower quadrant (RLQ) of the abdomen includes:
- Cecum and ascending colon of large intestine
- Small intestine
- Ovary and fallopian tube (females)
It is important to remember the hip bone itself as the internal lining (peritoneum), abdominal muscles, fascia and skin. We tend to focus on the internal organs when sometimes the pain may actually be arising from the surface (abdominal wall).
Causes of Right Hip Pain
Due to the close proximity of organs in the abdominal and pelvic cavity, it is not always possible to isolate a specific organ when pain occurs at a particular region. Therefore the most common conditions of the nearest organs to this area needs to be considered. Pain may arise from the hip joint itself or the pelvic bone but there are also other possible conditions as discussed below. Abdominal wall pain is one of the common but often neglected causes of right hip pain. The pain may arise with trauma to the abdominal wall or with muscle strain. The pain is typically superficial and aggravated with movement or touch.
The vermiform appendix is a tube-like structure that protrudes from the cecum of the large intestine. The exact function of this appendix is unclear. When the appendix becomes inflamed the condition is known as appendicitis. An infection is often responsible and is primarily due to bacteria. Appendicitis can lead to the appendix rupturing which may then leak the intestinal contents into the abdomen resulting in peritonitis and even septicemia.
The ureter can become infected as a result of a bladder infection (cystitis) or kidney infection (pyelonephritis). These urinary tract infections are uncommon. As a result of the infection, pain is typically present along with alterations of urinary habit like frequent urination, persistent urge to urinate, offensive smelling urine and blood in the urine. The risk is that the infection can rapidly spread to involve most of the urinary organs and affect the body’s ability to expel wastes through urine.
Kidney stones are not uncommon but often they are small and pass out unnoticed. However, a larger stone may get lodged in the ureter which is a thin narrow tube that carries urine from the kidney to the bladder. Although the body attempts to push out these stones with urine, when it obstructs an area it may cause localized inflammation with pain. An obstructed ureter may not always cause significant disruptions with urine output since the other kidney can compensate.
The small intestine is long and relatively narrow as compared to the large intestine. Obstructions may occur for a number of reasons. It can be due to a foreign body that was ingested, large gallstone (ileus), adhesions and strictures. The obstruction may prevent normal bowel activity and the movement of food and fluids. Apart from pain at the region of the obstruction, there may also be constipation (sometimes a watery diarrhea can occur), changes in appetite, vomiting and malaise (feeling of being unwell).
Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) is a condition in women where the male hormone levels are elevated and is usually associated with multiple cysts in one or both ovaries. It is marked by a difficulty falling pregnant and intense pain which should not be confused with the pain and discomfort of normal ovulation. In fact many women with PCOS do not ovulate. Depending on the level of male hormones there may be other features like the abnormal growth of hair on the face (hirsutism).
Endometriosis is a condition where endometrial tissue normally found inside the uterus grows at other sites. It usually stays in the lower abdominal or pelvic region. This tissue can cause intense pain especially in responses to the changes of female hormones during the menstrual cycle. Depending on where the endometrial tissue grows outside of the uterus, there can be a range of signs and symptom beyond the gynecological features.
Diverticulitis is a condition mainly seen in the elderly. Abnormal pouches form in the bowels, mainly the large intestine, that are known as diverticula. These pouches may become inflamed and the condition is then referred to as diverticulitis. While diverticula itself may not need to be treated, diverticulitis often requires medical treatment. There may be a range of gastrointestinal symptoms that also arise like fever, constipation or diarrhea, blood in the stool and nausea.
Malignant tumors are always a concern and may be the cause of right hip pain when it occur in the right ovary, cecum or ascending colon as well as in parts of the small intestine. Ovarian and colon cancer are by far more common and of greater concern to most people. Pain is not always an early symptom and often a person may notice other symptoms preceding it like loss of weight, malaise and changes in appetite. Sometimes there are no symptoms and it is discovered incidentally during diagnostic investigations for other reasons.