Hip Pain Explained: Common Causes from Arthritis to Injuries

ByWeence

Hip pain can disrupt work, exercise, sleep, and daily tasks like getting in the car or putting on shoes. Understanding what causes hip pain—from arthritis to sports injuries—helps you choose safe self-care, know when to see a clinician, and discuss the right tests and treatments. This guide is for anyone with new or long-standing hip pain, caregivers, athletes, pregnant individuals, and older adults aiming to stay active and independent.

Hip pain can significantly impact various aspects of your life, including work, physical activity, sleep, and even simple daily tasks such as getting into a car or putting on shoes. This guide aims to provide valuable insights into the causes of hip pain, ranging from arthritis to sports injuries, enabling you to make informed decisions about self-care, recognize when to seek medical advice, and engage in productive conversations regarding appropriate tests and treatments. It is designed for individuals experiencing new or chronic hip pain, caregivers, athletes, pregnant individuals, and older adults who wish to maintain an active and independent lifestyle.

Understanding Hip Pain

The hip is a large ball-and-socket joint where the femoral head fits into the acetabulum of the pelvis. Smooth articular cartilage and the labrum, a ring of cartilage, facilitate motion. Various factors can contribute to hip pain, including inflammation, injury, and degenerative conditions.

Common Causes of Hip Pain

  • Arthritis: Osteoarthritis and rheumatoid arthritis are common causes of hip pain, leading to inflammation and joint stiffness.
  • Injuries: Sports injuries, fractures, or strains can cause acute pain and discomfort in the hip region.
  • Bursitis: Inflammation of the bursae, small fluid-filled sacs that cushion the hip joint, can lead to pain during movement.
  • Labral Tears: Damage to the labrum can cause instability and pain, especially during physical activities.
  • Tendinitis: Inflammation of the tendons around the hip joint can result in pain and limited mobility.

When to See a Clinician

If you experience persistent hip pain, swelling, or difficulty moving the joint, it is essential to consult a healthcare professional. Additional symptoms that warrant a visit include:

  • Severe pain that does not improve with rest
  • Inability to bear weight on the affected leg
  • Signs of infection, such as fever and warmth around the joint

Self-Care Tips

For mild to moderate hip pain, consider the following self-care strategies:

  • Rest: Avoid activities that exacerbate the pain.
  • Ice: Apply ice packs to reduce swelling and discomfort.
  • Compression: Use elastic bandages to help minimize swelling.
  • Elevation: Keep the hip elevated to reduce inflammation.
  • Gentle Stretching: Incorporating light stretching and strengthening exercises can improve flexibility and support joint health.

FAQs

What are the most common treatments for hip pain?

Treatment options may include physical therapy, medications for pain relief, corticosteroid injections, and in severe cases, surgical interventions such as hip replacement.

Can I prevent hip pain?

While not all hip pain can be prevented, maintaining a healthy weight, staying active, and engaging in regular low-impact exercises can help reduce the risk.

Is hip pain normal during pregnancy?

Many pregnant individuals experience hip pain due to hormonal changes and increased weight. Consult a healthcare provider for safe management options.

What exercises are safe for hip pain?

Low-impact exercises, such as swimming, walking, and stationary cycling, are generally safe. Always consult a healthcare professional before starting a new exercise regimen.

Understanding Hip Pain

The hip is a large ball-and-socket joint where the femoral head fits into the pelvis’s acetabulum. Smooth articular cartilage and the labrum (a ring of cartilage) allow motion and stability. The joint is surrounded by the joint capsule and synovium, cushioned by fluid-filled bursae. Nearby are powerful muscles and tendons (gluteals, hip flexors, adductors) and structures like the iliotibial band. Because nerves and tissues in the lower back, pelvis, and thigh are interconnected, pain felt “in the hip” can originate from the hip itself or be “referred” from the spine or pelvis.

Key Symptoms and What They Mean

  • Groin pain (deep ache): Often points to problems inside the joint (e.g., osteoarthritis, labral tear, femoroacetabular impingement [FAI], avascular necrosis).
  • Outer hip pain/tenderness: Common with greater trochanteric pain syndrome (trochanteric bursitis and/or gluteal tendinopathy), worse with lying on that side.
  • Buttock pain: May reflect sacroiliac (SI) joint issues, piriformis syndrome, or referred pain from the lumbar spine.
  • Sharp catching/clicking: Suggests labral tear or FAI.
  • Stiffness/limited range of motion: Seen in osteoarthritis or inflammatory arthritis.
  • Pain with stairs, rising from a chair, or prolonged sitting: Common in FAI, labral tears, and tendinopathy.
  • Night pain, fever, redness, warmth: Raise concern for septic arthritis or other serious causes.
  • Sudden severe pain after a fall; leg shortened or rotated: Concerning for hip fracture or dislocation.
  • Numbness/tingling, pain radiating below the knee: Often from lumbar radiculopathy (sciatic nerve irritation).

Common Causes: From Arthritis to Injuries

Hip osteoarthritis (OA) is the most common cause of chronic hip pain. Cartilage wear leads to stiffness, deep groin pain, and reduced motion, often worse with weight-bearing and better with rest. Inflammatory arthritides such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis can affect the hip at younger ages, causing morning stiffness and systemic symptoms.

Greater trochanteric pain syndrome (GTPS) includes trochanteric bursitis and gluteus medius/minimus tendinopathy. People typically feel side-of-hip pain, worse with lying on that side or climbing stairs.

Labral tears and femoroacetabular impingement (FAI) occur when bone shapes on the femoral head/neck or acetabulum pinch the labrum. This causes groin pain, clicking, and pain with flexion and rotation; common in young adults and athletes.

Tendinopathy and muscle strains (hip flexors, adductors, hamstrings) cause localized pain with resisted movement or stretch, often after sudden increases in training.

Stress fractures of the femoral neck (often from repetitive impact or low bone density) present with groin pain that worsens with activity; some are high risk for complete fracture and require urgent care.

Acute hip fractures (usually from falls in older adults with osteoporosis) and dislocations (often from high-energy injuries) require emergency treatment.

Septic arthritis is a joint infection with rapid onset pain, fever, and inability to bear weight; it can quickly damage the joint and is a medical emergency.

Avascular necrosis (osteonecrosis) results from disrupted blood flow to the femoral head (risk factors include corticosteroid use, alcohol misuse, sickle cell disease), causing deep hip/groin pain and progressive collapse of the femoral head.

Crystalline arthropathies like gout or pseudogout can rarely affect the hip, causing sudden, severe pain and inflammation.

Other Sources of Hip-Area Pain (Referred Pain)

Pain felt in the hip may originate elsewhere:

  • Lumbar spine: Disc herniation, spinal stenosis, and facet arthropathy can radiate to the buttock, lateral thigh, or groin.
  • Sacroiliac joint dysfunction or inflammation can cause buttock and posterior hip pain, often worse with prolonged standing or single-leg stance.
  • Pelvic/abdominal conditions: Inguinal or femoral hernias, endometriosis, ovarian cysts, testicular disorders, kidney stones, and appendicitis can refer pain to the groin/hip.
  • Vascular claudication: Poor blood flow to the legs can cause exertional hip/buttock pain relieved by rest.

Red Flags: When to Seek Immediate Care

  • Inability to bear weight after an injury or sudden severe hip pain.
  • Fever, chills, and a hot, swollen, intensely painful hip (possible infection).
  • A leg that looks shortened, rotated, or a “pop” with deformity (possible fracture/dislocation).
  • Severe night pain, unexplained weight loss, or history of cancer.
  • Progressive leg weakness, numbness, or loss of bladder/bowel control (possible nerve/spine emergency).
  • Hip pain after long-term high-dose steroids or heavy alcohol use with sudden worsening (possible avascular necrosis).

Diagnosis: Exams, Imaging, and Tests

Clinicians start with a detailed history (location, activities, injuries, morning stiffness, systemic symptoms) and physical exam. They assess gait, range of motion, tenderness sites, hip strength (e.g., Trendelenburg sign for gluteal weakness), and perform maneuvers such as FADIR (flexion–adduction–internal rotation) for FAI/labral pathology, FABER (flexion–abduction–external rotation) for hip or SI joint issues, log roll, and straight-leg raise to screen for lumbar radiculopathy.

Imaging typically starts with X-rays (standing anteroposterior pelvis and lateral views) to evaluate joint space, bone shape, and fractures. MRI is used for labral tears, stress fractures, early avascular necrosis, and soft-tissue injuries; MR arthrography may improve labral visualization. Ultrasound can assess bursitis, guide injections, and visualize some tendons. CT helps characterize complex fractures or bone anatomy.

Laboratory tests may include ESR/CRP (inflammation), CBC (infection), uric acid (gout), rheumatoid factor/anti-CCP (rheumatoid arthritis), or HLA-B27 (spondyloarthritis). If infection or crystal arthritis is suspected, joint aspiration for synovial fluid analysis and culture is essential.

Treatment: From Self-Care to Surgery

  • Self-care and activity modification:
    • Relative rest from painful activities; avoid high-impact loading during flares.
    • Ice for acute flares (10–15 minutes), heat for stiffness.
    • Short-term use of a cane in the opposite hand to offload the hip.
  • Medications:
    • Acetaminophen for pain relief (mind total daily dose; liver disease caution).
    • NSAIDs (e.g., ibuprofen, naproxen; topical diclofenac for lateral hip) for pain/inflammation; avoid combining NSAIDs and use cautiously with stomach, kidney, heart conditions, or anticoagulants.
    • In select cases, medications for inflammatory arthritis (DMARDs/biologics) guided by a rheumatologist; antibiotics for septic arthritis (with urgent surgical drainage).
  • Physical therapy:
    • Progressive strengthening of gluteus medius/minimus, hip abductors/extensors, and core.
    • Flexibility work for hip flexors, adductors, hamstrings; gait retraining; balance and neuromuscular control.
    • Graded return-to-activity plans to prevent re-injury.
  • Injections and procedures:
    • Corticosteroid injections for GTPS or hip OA flares; image guidance improves accuracy.
    • Consider platelet-rich plasma (PRP) for some tendinopathies (evidence mixed).
    • Diagnostic anesthetic injections can help localize the pain source.
  • Surgery (when conservative care fails or for urgent conditions):
    • Hip arthroscopy for labral repair, FAI decompression.
    • Open reduction and internal fixation (ORIF) for fractures; hemiarthroplasty or total hip arthroplasty (THA) depending on fracture type and patient factors.
    • Total hip replacement for advanced OA or avascular necrosis with collapse.
    • Core decompression for early avascular necrosis in selected patients.
    • Gluteal tendon repair or bursectomy for refractory GTPS.

Managing Pain Day to Day

  • Pace activities: alternate tasks, take short movement breaks, and use the 10% rule when increasing exercise volume.
  • Optimize posture and ergonomics: adjust chair height, use lumbar support, avoid prolonged sitting with hips flexed >90°.
  • Sleep comfortably: try side-lying with a pillow between knees or back-lying with a pillow under knees; avoid lying on the painful side during flares.
  • Footwear and surfaces: wear supportive shoes; consider cushioned insoles for impact activities.
  • Weight management: even modest weight loss can reduce joint load and pain.
  • Heat before activity, ice after; consider topical analgesics for focal pain.
  • Use assistive devices when needed (cane, trekking poles) to stay active safely.
  • Plan for flares: brief rest, ice, short course of NSAIDs if appropriate, and communication with your clinician if symptoms escalate.

Prevention and Hip-Healthy Habits

  • Strengthen hips and core: 2–3 sessions per week focusing on gluteal muscles, abductors, and extensors.
  • Maintain flexibility: regular stretching of hip flexors, hamstrings, and adductors; incorporate mobility drills.
  • Build gradually: increase running/walking mileage or load by no more than about 10% per week.
  • Cross-train: mix low-impact activities (cycling, swimming) to reduce repetitive stress.
  • Balance and fall prevention: practice single-leg balance; ensure home safety (good lighting, remove tripping hazards).
  • Bone health: adequate vitamin D and calcium intake; discuss osteoporosis screening if at risk.
  • Avoid tobacco and limit alcohol; both can harm bone and tendon healing.
  • Warm up before sports; cool down and recover adequately.

Special Populations: Athletes, Pregnancy, Older Adults

  • Athletes
    • Common issues: FAI, labral tears, adductor and hip flexor strains, femoral neck stress fractures.
    • Emphasize technique, hip/core strengthening, and gradual training progressions; consider gait or movement analysis.
    • Persistent groin pain with impact sports warrants evaluation for intra-articular pathology.
  • Pregnancy
    • Pelvic girdle pain and symphysis pubis dysfunction may cause groin and posterior pelvic pain due to hormonal ligament laxity.
    • Use pelvic support belts, gentle strengthening (gluteals/core), and low-impact exercise; avoid activities that provoke single-leg pain.
    • Red flags (fever, severe unilateral swelling, neurologic symptoms) need prompt care.
  • Older Adults
    • Higher risk of osteoarthritis, osteoporosis, and hip fractures after falls.
    • Prioritize balance training, home safety, vision/hearing checks, medication review, and bone-density management.
    • Outer hip pain from GTPS is common; respond well to targeted PT and activity modification.

Preparing for Your Appointment and Questions to Ask

  • Before you go:
    • Keep a symptom diary: onset, location, aggravating/relieving factors, night pain, red-flag symptoms.
    • List all medications and supplements, prior injuries/surgeries, and any systemic symptoms (fever, weight loss).
    • Bring prior imaging or reports; wear clothing that allows hip exam.
  • Questions to ask:
    • What is the most likely cause of my hip pain? What else could it be?
    • Do I need X-rays, MRI, or other tests now?
    • What activities are safe, and which should I avoid temporarily?
    • Which medications are appropriate for me, and what are the risks?
    • Would physical therapy help? What goals should therapy target?
    • When should we consider injections or surgery?
    • How will we monitor progress, and what is the expected recovery timeline?

FAQ

  • Is hip pain always from arthritis?
    Not always. While osteoarthritis is common, many causes exist, including bursitis, tendinopathy, labral tears/FAI, stress fractures, and referred pain from the spine or pelvis.

  • How can I tell if my hip pain is coming from my back?
    Back-related pain often radiates down the leg past the knee, with numbness, tingling, or weakness. Hip joint pain is more likely felt deep in the groin and with hip movement. A clinician can differentiate with exam maneuvers and imaging.

  • Do I need an MRI for hip pain?
    Not always. X-rays are often the first step. MRI is useful if X-rays are normal but symptoms suggest labral tears, stress fractures, early avascular necrosis, or persistent soft-tissue injury.

  • Are injections safe and effective?
    Corticosteroid injections can reduce inflammation and pain in conditions like GTPS and hip OA. Benefits are usually temporary. Injections should be spaced appropriately to minimize risks like tendon weakening or cartilage effects.

  • Can exercise make hip arthritis worse?
    The right exercise plan typically helps. Low-impact aerobic activity, strengthening (especially gluteals), and flexibility improve function and reduce pain. Avoiding high-impact during flares is wise, but prolonged inactivity can worsen stiffness and weakness.

  • When is hip replacement considered?
    Total hip arthroplasty is considered when pain and stiffness severely limit daily life, imaging shows advanced joint damage, and non-surgical treatments have not provided adequate relief.

  • What is a labral tear and how is it treated?
    The labrum is a cartilage rim that stabilizes the hip. Tears cause groin pain, catching, and clicking. Treatment begins with PT and activity modification; persistent cases or associated FAI may benefit from arthroscopic repair.

More Information

If this guide helped you understand your hip pain, share it with someone who might benefit. For personalized advice, discuss your symptoms and goals with your healthcare provider. Explore related, easy-to-understand health content and find local providers at Weence.com.

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