Hip Pain

Hip pain is a common issue that can result from a variety of causes, such as injuries, arthritis, bursitis, or conditions affecting your muscles, tendons, or ligaments. It may also stem from structural abnormalities, repetitive strain, or overuse. The location and intensity of your hip pain can provide clues about the underlying problem. 

Hip pain treatment ranges from rest, gentle exercises, and medications to physiotherapy and, in severe cases, surgical intervention. Identifying hip pain causes early and following a tailored treatment plan can help alleviate symptoms and restore your mobility.

What is hip pain?

Hip pain refers to discomfort or pain experienced in or around your hip joint, one of the largest and most essential joints in your body. Your hip joint connects your thigh bone (femur) to your pelvis, and plays a crucial role in movement, weight support, and balance.

Sometimes, hip pain radiates to areas like your lower back or groin or it can be referred from a problem in another area of your body, such as your lower back. It may fluctuate - worsening during movement and easing with rest or being more pronounced during certain times of the day, such as first thing in the morning or at night, especially when lying on the affected side.

What causes hip pain? 

Hip pain can result from a variety of conditions, including arthritis, hip injuries such as fractures, labral tears, and dislocations, as well as bursitis and structural issues. For athletes who engage in activities involving significant hip movement such as dancing and gymnastics, the risk of hip injuries and associated pain may be higher.

Injury 

Injuries to your hip joint can disrupt its normal function and lead to significant pain. They are often caused by:  

• Repetitive strain from overuse  
• Sports-related incidents 
• Traumatic events like falls or car accidents 

Common hip injuries that result in pain include:

• Muscle strains, particularly hip flexor strains 
• Iliotibial (IT) band syndrome
• Labral tears in the hip joint
• Bone fractures
• Hip dislocations.  

Arthritis

Arthritis is a condition that leads to joint pain and inflammation, with hip arthritis being particularly common. It often results in symptoms such as swelling, stiffness, and discomfort. 
Several forms of arthritis can contribute to hip pain, including:  

• Osteoarthritis – where the cartilage that cushions your joint gradually wears down, leading to friction between your bones. This friction causes pain, swelling, and stiffness.
• Rheumatoid arthritis - your immune system attacks the lining of your joint, causing inflammation and joint damage, which contributes to discomfort.
• Ankylosing spondylitis - leads to inflammation in your spine and pelvis which can affect your hip joint and cause pain and reduced mobility.

Bursitis

Bursitis refers to the painful swelling and inflammation of a bursa - a small, fluid-filled sac that acts as a cushion between your bones and surrounding tissues such as muscles, tendons, or ligaments. Bursae reduce friction and help facilitate smooth movement. When a bursa in your hip becomes irritated, it can swell and lead to hip pain, a condition known as hip bursitis.

The location of the pain depends on the specific bursa involved. The two most common types of hip bursitis are:

• Trochanteric bursitis - occurs in the bursa located near your greater trochanter, the bony point at the outer side of your hip. It often causes pain on the outside of your hip or upper thigh.  
• Iliopectineal bursitis - affects the bursa near the front of your hip, causing pain in your groin or front of your thigh area.  

Hip bursitis can result in symptoms such as:

• Tenderness or aching in the affected area.
• Pain that worsens with movement or pressure (e.g., lying on the painful side).  
• Swelling or a feeling of tightness near your hip joint.  

The pain can interfere with daily activities, making treatment and management essential for relief.

Structural conditions

Conditions that affect the shape of your hips, often referred to as “structural abnormalities”, can lead to hip pain by altering the way your joint functions. These abnormalities change the natural alignment of your hip joint, which may cause excessive wear and tear on your bones, cartilage, and soft tissues over time.

Examples include:

• Femoroacetabular impingement (FAI or hip impingement) - occurs when the bones of your hip joint have irregular shapes, causing them to rub against each other during movement. Over time, this can lead to joint damage, pain, and even arthritis.
• Developmental dysplasia of the hip (DDH) - happens when your hip socket is too shallow or the femoral head (thigh bone) doesn’t fit properly into the socket. As a result, your joint may become unstable, leading to pain, inflammation, or damage over time.

The onset of hip pain from these conditions varies from childhood to later in life when the joint experiences increased stress or damage. Addressing structural issues early can help manage symptoms and prevent further complications.

What causes back and hip pain?

Lower back and hip pain often occur together and can be caused by various factors, including poor posture, injuries, or strain from overuse. Conditions such as arthritis, herniated disks, and obesity may also contribute to back and hip pain by placing added stress on your joints and surrounding tissues. Fortunately, treatment is often effective, addressing both the root cause and providing relief from discomfort.

It's also common for hip problems to cause pain in other parts of your body due to referred or radiated pain. For example, a problem in your hip joint might lead to pain in your groin, down the front of your leg, or in your knee. In some cases, knee pain might be the only noticeable symptom of an underlying hip issue. Understanding the interconnected nature of back, hip, and referred pain is essential for pinpointing the source of discomfort and ensuring appropriate treatment.

Hip joint pain causes can vary between men and women due to anatomical and lifestyle differences. What can cause hip pain in women is often linked to conditions such as hip dysplasia, osteoporosis, hormonal changes that affect bone health, and gynaecological factors like endometriosis or pregnancy-related strain. In men, hip pain is more commonly associated with sports-related injuries, such as strains or impingement, and conditions like osteoarthritis. 

Causes of hip pain at night

Hip pain at night can stem from various causes, often disrupting sleep and comfort. Common causes include:

• Sleep position or mattress – if you sleep on your side this may put pressure on your hip joint, while an unsupportive mattress can create sore pressure points. Adjusting sleep positions, changing your mattress, or using a pillow for alignment can help. 
• Osteoarthritis - causes joint inflammation and pain, often felt in your groin, thigh, or buttocks. The pain may worsen after periods of inactivity or in the morning.  
• Bursitis - inflammation of the bursae, fluid-filled sacs in your hip, can lead to pain on the outer side of your hip, especially after overuse or prolonged sitting.  
• Gluteal tendinopathy - tendon inflammation near your hip can cause discomfort, particularly during movement or at night.  

Addressing these causes with proper treatment, such as adjusting sleep habits, physiotherapy, or medication, can help alleviate nighttime hip pain and improve sleep quality.

Sudden hip pain without injury 

Sudden hip pain without an injury can have several causes, including:  

• Bursitis - inflammation of the fluid-filled bursae that cushion joints, often triggered by overuse or prolonged strain, can lead to sudden hip pain.  
• Tendinitis - overexertion during physical activity may cause inflammation in your tendons around the hip, resulting in tender, burning pain. 
• Muscle strain - overuse or overstretching can strain or tear hip or groin muscles, making movement painful. An example is hip pain after running often from overstretching.
• Arthritis – although arthritis typically develops gradually, its symptoms including joint inflammation and cartilage breakdown can sometimes appear suddenly, causing pain and limiting hip movement.  

These conditions may emerge unexpectedly and require attention to ease discomfort and prevent further complications.

How to tell if hip pain is muscular or in the joint

Understanding the exact location of your hip pain can provide valuable clues about the underlying cause, helping determine whether it’s muscular or in your joint itself, which can guide appropriate treatment. 

Pain that is close to the surface above or around your hip, thigh, or buttock usually stems from soft tissue problems like muscles, ligaments, and tendons.

Deeper pain within your hip joint or groin often originates from bones or cartilage within the joint itself. So, if you’re wondering where hip arthritis pain is felt, this means it is in or around your hip joint, groin area, buttock or front thigh.

Hip pain treatment

While many cases of hip pain can be managed at home with rest and over-the-counter pain relief, if you have persistent or severe pain that impacts your daily activities you should visit a healthcare provider.

By identifying the root cause of hip pain, appropriate treatment can help alleviate discomfort and restore mobility.

Exercise and physiotherapy for hip pain 

Gentle exercises can be highly effective in easing hip pain by improving flexibility, strength, and range of motion. Simple activities like stretching and low-impact movements are often recommended to alleviate stiffness and discomfort. For tailored support, a physiotherapist can play a key role in managing hip pain by developing a specific program based on your condition. 

Physiotherapists are trained specialists who use a combination of strengthening exercises, posture improvement techniques, and manual therapies such as massage and manipulation to help reduce pain and restore hip mobility. Whether your hip pain is short-term or a long-standing issue, a physiotherapist will guide you through exercises to prevent stiffness, enhance joint movement, and strengthen muscles. They may also provide practical advice on walking techniques, using walking aids, and reducing strain on the hip joint to support long-term recovery and improved quality of life.  

RICE Method to ease hip pain 

The RICE method is a simple and effective way to manage hip pain at home following strain or injury. Here's how it works: 

• Rest - avoid activities that caused or worsen the pain to prevent further strain on your hip. Resting allows the injured area to begin healing.  
• Ice - apply an ice pack or cold compress for 10 to 15 minutes every hour on the first day of the injury. After that, continue icing every 3 to 4 hours. Be sure to wrap the ice in a towel or cloth to protect your skin. 
• Compression - use a compression bandage, wrap, or clothing like compression shorts to reduce swelling and improve circulation around the hip. This helps alleviate pain and prevents additional strain.  
• Elevation - if possible, raise your hips and lower body above heart level using pillows or cushions to minimise swelling and promote blood flow.  

These steps can be an excellent first-line treatment to ease pain and inflammation. However, if the pain persists or worsens, you should see a healthcare professional for an evaluation and care advice.

Medication for hip pain 

Medications can play an important role in relieving hip pain and associated symptoms. Depending on the severity of your pain, your healthcare provider may recommend: 

• Over-the-counter options - nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, or naproxen can help reduce inflammation and alleviate pain. Acetaminophen (Tylenol®) is another common option for managing discomfort. However, it's important not to take any of these medications for more than 10 consecutive days without consulting your healthcare provider.
• Prescription medications - for more severe or persistent pain, you may be prescribed stronger pain relievers, anti-inflammatory medications, or even corticosteroid injections to reduce inflammation and provide targeted relief. 

Always follow your healthcare provider's advice when using medication to manage hip pain.

Hip surgery to relieve hip pain 

If you’re experiencing severe hip pain or specific conditions, there are several surgical options available to address the underlying issues and improve your mobility and quality of life. Your hip surgeon will advise on the most suitable option for you.

Day Case Joint Surgery 

Day case joint surgery involves minimally invasive procedures that allow patients to return home on the same day. These surgeries are designed to relieve joint pain and enable faster recovery with reduced hospital stays. They are ideal for individuals with good overall health and support systems at home.

Hip Arthroscopy

Hip arthroscopy is a minimally invasive "keyhole" surgery used to diagnose and treat hip problems such as labral tears, femoroacetabular impingement (FAI), or synovitis. Surgeons use a small camera and specialised tools to repair or remove damaged tissue, improving joint function and reducing pain. Recovery is typically quicker compared to open surgeries.

Hip Replacement

Hip replacement surgery involves replacing your damaged hip joint with artificial components made of metal, ceramic, or plastic. This procedure is commonly recommended if you have severe arthritis or joint damage. It can be performed as a total hip replacement or partial replacement, depending on the extent of the damage. 

Revision Hip Replacement  

Revision hip replacement is a more complex procedure performed when a previous hip replacement fails due to wear, loosening, infection, or other complications. Surgeons remove the old implant and replace it with new components, often reconstructing bone or soft tissue to ensure stability and functionality. 

When to call your doctor: How to tell if hip pain is serious

While hip pain is common, there are certain signs you should never ignore. You should seek medical attention if:  

• Your hip pain persists and interferes with your daily activities or forces you to avoid things you usually enjoy.  
• At-home treatments fail to provide relief after several days.  

You should seek urgent medical care if your hip pain is caused by an injury and includes any of the following:  

• A visible deformity in the hip or leg, or if your leg appears shortened.  
• Inability to move your leg or bear weight on it.  
• Intense, severe pain that does not subside.
• Sudden swelling around the hip joint.  
• Signs of infection, such as fever, chills, redness, or warmth in the affected area.  

Hip pain may indicate a serious condition or injury, so don’t hesitate to consult a healthcare provider for a proper diagnosis and treatment. 

How to prevent hip pain 

While it’s not always possible to prevent hip pain, especially if it’s caused by accidents or structural issues, there are steps you can take to reduce your risk and protect your hips, particularly during sports or physical activities:  

• Wear the right protective gear - using equipment designed for your activity can safeguard your hips against strain or injury.  
• Don’t ignore pain - if your hip hurts during or after activity, rest and avoid continuing until you’re pain-free.  
• Allow time for recovery - ensure your body gets adequate rest after intense physical activity to prevent overuse injuries.  
• Warm up and stretch - before exercising or playing sports, do a proper warm-up and stretch to prepare your muscles and joints for movement.
• Cool down and stretch - after physical activity, cool down with stretches to relax your muscles and maintain flexibility.

General safety measures to follow to further reduce your risk of injury:

• Keep your environment clear of clutter to avoid trips and falls.
• Use appropriate tools to reach high places. Never stand on unstable surfaces like chairs or countertops.
• Consider using a cane or walker if walking is difficult or if you’re at higher risk for falls.

These preventative actions can help maintain healthy hips and reduce the likelihood of pain or injury, keeping you active and comfortable for longer.