Hip Pain
Hip pain affects millions of people, interfering with daily activities from walking to sleeping. As one of the body's largest weight-bearing joints, the hip is susceptible to various conditions ranging from simple muscle strains to severe arthritis requiring joint replacement. Pain may be felt in the groin, outer hip, buttock, or even knee, making diagnosis challenging. Understanding the location, timing, and nature of hip pain helps determine whether it's a minor issue that will resolve with rest or a serious condition requiring immediate medical attention.
⚠️ Seek Immediate Medical Care For:
- Sudden severe hip pain after a fall
- Inability to move hip or bear weight
- Hip appears deformed or out of position
- Severe pain with leg shortened or turned outward
- Signs of infection (fever, red, hot joint)
- Numbness or tingling in leg
- Loss of bladder or bowel control
- Severe pain at rest or night
- Rapid swelling of hip area
- Pain with chest symptoms or shortness of breath
Understanding Hip Pain
The hip joint is a ball-and-socket joint where the thighbone (femur) meets the pelvis. This complex structure includes bones, cartilage, ligaments, tendons, and muscles, all working together to provide stability and movement. The joint is surrounded by fluid-filled sacs (bursae) that reduce friction and cushion the area.
Hip pain can originate from structures within the joint (like cartilage or bone) or from surrounding soft tissues. Sometimes, pain felt in the hip actually comes from the lower back or other areas, making accurate diagnosis essential for proper treatment.
Common Causes
Arthritis
- Osteoarthritis (wear and tear)
- Rheumatoid arthritis
- Psoriatic arthritis
- Post-traumatic arthritis
- Septic arthritis (infection)
- Avascular necrosis
Soft Tissue Problems
- Hip bursitis
- Tendinitis
- Muscle strains
- IT band syndrome
- Hip flexor strain
- Snapping hip syndrome
Structural Issues
- Hip labral tears
- Hip impingement (FAI)
- Hip dysplasia
- Stress fractures
- Hip fractures
- Bone spurs
Other Causes
- Sciatica
- Herniated disc
- Piriformis syndrome
- Referred pain from back
- Groin hernia
- Bone cancer (rare)
Pain Location and What It May Mean
Groin Pain
- Often indicates hip joint problems
- Arthritis
- Labral tears
- Hip impingement
- Stress fractures
Outer Hip Pain
- Usually soft tissue problems
- Bursitis (most common)
- IT band syndrome
- Muscle strains
- Referred pain from back
Buttock Pain
- Often from spine or sacroiliac joint
- Sciatica
- Piriformis syndrome
- Sacroiliac dysfunction
- Referred pain from hip
Front of Hip/Thigh
- Hip flexor problems
- Femoral nerve issues
- Hip arthritis
- Muscle strains
Hip Pain by Age Group
Children and Adolescents
- Hip dysplasia
- Legg-Calvé-Perthes disease
- Slipped capital femoral epiphysis
- Sports injuries
- Growing pains
Young Adults
- Sports-related injuries
- Hip impingement
- Labral tears
- Muscle strains
- Early arthritis
Middle Age
- Early osteoarthritis
- Bursitis
- Tendinitis
- Overuse injuries
- Weight-related stress
Older Adults
- Advanced osteoarthritis
- Hip fractures
- Avascular necrosis
- Spinal stenosis effects
- Osteoporosis complications
Associated Symptoms
Hip pain often occurs with:
- Stiffness: Especially morning or after sitting
- Limping: Altered gait pattern
- Clicking/popping: May indicate structural issues
- Swelling: Around hip or groin
- Weakness: Difficulty lifting leg
- Limited range of motion: Can't move hip normally
- Night pain: Disrupts sleep
- Locking: Hip gets stuck in position
- Radiating pain: To knee or back
Medical Evaluation
Physical Examination
- Gait assessment
- Range of motion testing
- Strength testing
- Special tests (FABER, log roll)
- Palpation for tenderness
- Leg length measurement
Diagnostic Tests
- X-rays: Show bones, joint space, arthritis
- MRI: Detailed soft tissue imaging
- CT scan: Complex bone problems
- Ultrasound: Fluid, soft tissue evaluation
- Bone scan: Fractures, infection
- Hip injection: Diagnostic and therapeutic
- Blood tests: Inflammation, infection markers
Treatment Options
Conservative Care
- Rest and activity modification
- Ice/heat therapy
- Weight loss if needed
- Physical therapy
- Assistive devices (cane, walker)
- Gentle stretching
Medications
- NSAIDs
- Acetaminophen
- Muscle relaxants
- Corticosteroid injections
- Hyaluronic acid injections
- Disease-modifying drugs
Therapies
- Physical therapy
- Aquatic therapy
- Manual therapy
- Acupuncture
- Massage therapy
- Chiropractic care
Surgical Options
- Hip arthroscopy
- Hip resurfacing
- Total hip replacement
- Hip fracture repair
- Core decompression
- Osteotomy
Exercises for Hip Health
Strengthening Exercises
- Hip bridges
- Clamshells
- Side-lying leg lifts
- Standing hip abduction
- Mini squats
- Step-ups
Stretching Exercises
- Hip flexor stretches
- Piriformis stretches
- IT band stretches
- Hamstring stretches
- Figure-4 stretch
- Butterfly stretch
Low-Impact Activities
- Swimming
- Water walking
- Stationary cycling
- Elliptical machine
- Tai chi
- Yoga
Prevention Strategies
- Maintain healthy weight: Reduces joint stress
- Stay active: Regular low-impact exercise
- Strengthen hip muscles: Core and hip exercises
- Proper form: During exercise and activities
- Good posture: Standing and sitting
- Appropriate footwear: Supportive shoes
- Avoid overuse: Gradual activity increases
- Fall prevention: Home safety measures
- Bone health: Calcium, vitamin D
Living with Chronic Hip Pain
- Activity modification: Find pain-free alternatives
- Home modifications: Raised toilet seats, grab bars
- Sleep positioning: Pillows between knees
- Pain management: Multiple strategies
- Support groups: Connect with others
- Regular monitoring: Track symptoms
- Mental health: Address emotional impact
- Plan ahead: For potential surgery
When to Consider Hip Surgery
Surgery may be recommended when:
- Conservative treatments have failed
- Pain significantly limits daily activities
- Night pain disrupts sleep regularly
- X-rays show severe joint damage
- Quality of life is severely affected
- Unable to work due to hip pain
- Structural problems need correction
- Hip fracture requires repair