A 38-year-old, female retail associate presents to the primary care office with a chief complaint of severe right hip pain and swelling. The patient notes that the pain occurred suddenly the night before, shortly after she ate dinner. She says the hip pain grew progressively worse and the patient was unable to sleep through the night. She also complains of chills and having difficulty walking.

Very troubling statistics emerged from the 2004 Surgeon General’s Report on Bone Health and Osteoporosis. It costs $18 billion to care for the 1.5 million bone fractures from osteoporosis that occur each year in the United States. Osteoporosis accounts for 2.6 million trips to a physician’s office, 800,000 trips to the emergency room, 500,000 hospitalizations and results in approximately 180,000 people being placed in nursing homes each year.

Hip pain is not exclusive to those with osteoporosis or the hip fractures in the elderly population. Many women have hip, pelvis, and sciatic nerve pain, especially during pregnancy or after childbirth due to the stretching of tendons and separation of the hips that occurs. Some people have genetic predispositions to hip dysplasia, which requires surgery. Hip pain from osteoarthritis can often feel like siatica. Car accidents or major falls can also cause damage to the hip joint and muscles, which may require surgery.