From the Guidelines
The inability to flex the left hip is most likely caused by a condition such as hip flexor strain, osteoarthritis, labral tear, hip impingement, or nerve compression, and the best initial diagnostic approach is an MRI, as it is highly sensitive and specific for detecting many abnormalities involving the surrounding soft tissues, according to the American College of Radiology 1.
Diagnosis
To determine the underlying cause of the inability to flex the left hip, a thorough physical examination and imaging studies are necessary. The following steps can be taken:
- Physical examination to assess hip range of motion, strength, and pain
- Imaging studies, such as X-rays and MRI, to evaluate the hip joint and surrounding soft tissues
- Possibly, nerve conduction studies to rule out nerve compression
Treatment
Treatment depends on the underlying cause, but often begins with conservative measures, including:
- Rest, ice, compression, and elevation (RICE protocol)
- Physical therapy, including stretching and strengthening exercises for the hip flexors, quadriceps, and core muscles
- Pain management with NSAIDs, such as ibuprofen (400-800mg three times daily with food) or naproxen (500mg twice daily)
- For more severe pain, muscle relaxants or corticosteroid injections may be prescribed
Surgical Intervention
If conservative treatments fail after 6-8 weeks, surgical intervention might be necessary, especially for structural issues like labral tears or severe arthritis. The type of surgery and recovery time will depend on the underlying cause and treatment approach. It is essential to note that hip flexion problems can stem from issues in the lower back, pelvis, or hip joint itself, and each requires specific treatment approaches, as highlighted in the American College of Radiology guidelines 1.
From the Research
Diagnosis of Inability to Flex the Left Hip
- The diagnosis of inability to flex the left hip can be complex and may involve various causes, including intra-articular and extra-articular etiologies 2.
- A comprehensive physical examination, including tests such as hip flexion, abduction, adduction, and extension strength, log roll test for hip pain, internal rotation and flexion range of motion, and Thomas test for flexion contracture, can help diagnose the cause of hip pain and inability to flex the hip 3.
- Imaging tests, such as radiography, ultrasonography, or magnetic resonance imaging, may also be necessary to confirm the diagnosis 2.
Possible Causes of Inability to Flex the Left Hip
- Intra-articular causes, such as labral tears, femoroacetabular impingement, or osteoarthritis, can cause hip pain and limited mobility, including inability to flex the hip 2.
- Extra-articular causes, such as hip flexor injuries, gluteus medius tendinopathy or tear, bursitis, or iliotibial band friction, can also cause hip pain and limited mobility 2.
- Other possible causes, such as osteonecrosis of the femoral head, can also lead to hip pain and limited mobility, including inability to flex the hip 4.
Treatment Options for Inability to Flex the Left Hip
- Treatment options for inability to flex the left hip depend on the underlying cause and may include physical therapy, pain management, and surgical intervention 2.
- Platelet-rich plasma (PRP) therapy has been shown to be effective in treating osteoarthritis and other conditions that may cause hip pain and limited mobility, including inability to flex the hip 4, 5.
- Muscle strength imbalances, particularly bilateral extensor imbalance, may be a predictor of total hip arthroplasty and should be addressed through physical therapy and exercise 6.