Hip pain

Hip pain can come from the hip joint or from nearby muscles, tendons, and other tissues. It may also be “referred” from the lower back, meaning the problem begins elsewhere but the pain is felt around the hip.

The location provides clues but does not confirm the cause. Pain from the joint is often felt in the groin or front of the thigh. Pain over the outer side may involve the tendons that attach near the hip. Buttock pain may come from muscles, the pelvis, or the lower back.

Hip pain can begin suddenly after an injury or develop gradually. Your age, activities, health conditions, and ability to walk all help determine what it may mean.

Hip pain may be a dull ache, sharp pain, burning sensation, or feeling of pressure. You may notice stiffness after resting or reduced movement when putting on shoes, climbing stairs, or getting into a car.

Other possible features include:

• Pain in the groin, outer hip, buttock, or upper thigh
• Pain when walking, running, lying on one side, or standing up
• Limping or difficulty putting weight on the leg
• Clicking, catching, or a feeling that the joint may give way
• Swelling, warmth, or tenderness
• Pain that travels from the back into the buttock or leg

Clicking without pain is common and is not always a sign of damage.

Common causes include muscle strains after unusual activity, sport, or lifting. Tendon irritation can cause pain during movement or when lying on the affected side. Greater trochanteric pain syndrome causes pain over the outer hip, usually involving the nearby tendons and sometimes a fluid-filled cushion called a bursa.

Osteoarthritis becomes more likely with age or after previous joint injury. It happens when the joint’s cartilage and other structures change over time. It may cause groin pain, stiffness, and reduced movement.

Pain may also come from the lower back. Irritated nerves can cause pain, tingling, or numbness extending into the buttock or leg.

Less common causes include inflammatory arthritis, a tear in the cartilage rim around the joint, hip impingement, a stress fracture, or reduced blood supply to the top of the thigh bone. In children and teenagers, hip conditions can sometimes cause knee or thigh pain instead of obvious hip pain.

Urgent causes include a broken bone, a dislocated joint, or an infection in or around the joint. These are more likely after significant injury or when pain occurs with fever, marked warmth, swelling, or inability to stand.

Call emergency services or go to an emergency department after a major injury if the hip looks out of shape, the leg appears shortened or turned, or you cannot move or feel the leg normally. A cold, pale, or numb foot also needs emergency care.

Seek emergency care for hip or back pain with new loss of bladder or bowel control, numbness around the genitals or buttocks, or rapidly worsening leg weakness.

Arrange same-day urgent assessment if:

• You cannot put weight on the leg, especially after an injury
• The hip is hot or swollen and you have a fever or feel unwell
• A child has sudden hip pain, limps, or refuses to walk
• Pain is severe and began suddenly without a clear reason

Book a routine appointment if pain lasts more than about two weeks, keeps returning, is getting worse, or affects sleep or everyday walking. Earlier review is sensible if you have cancer, take medicines that weaken the immune system, or have recently had hip surgery.

A healthcare professional will ask where the pain is, how it began, and what makes it better or worse. They may ask about injuries, exercise, fever, stiffness, medicines, and other joint or back symptoms.

The examination may include watching you walk and checking movement, strength, tenderness, and the nerves and circulation in your leg. Your back and knee may also be examined because problems there can feel like hip pain.

Imaging is not always needed. An X-ray may be used after an injury or when arthritis is suspected. Ultrasound can assess some tendons and fluid collections. MRI provides more detail and may be considered when a fracture, cartilage injury, or other condition is still suspected despite normal X-rays. Blood tests may help when infection or inflammation is possible.

Treatment depends on the cause and how much the pain affects you. A mild strain may improve with relative rest, while arthritis or a tendon problem may benefit from a structured exercise plan.

For recent, mild pain without urgent features:

• Reduce activities that clearly worsen the pain, but avoid prolonged bed rest
• Use a wrapped cold pack for short periods after a new injury
• Try gentle movement within a comfortable range
• Return to activity gradually rather than pushing through sharp pain
• Use supportive footwear and avoid low chairs if standing is difficult

Heat may feel better for longer-lasting stiffness, but do not place it directly on the skin.

Non-prescription pain medicines may help some people. Acetaminophen and anti-inflammatory medicines are not suitable for everyone. Check with a pharmacist or clinician if you have kidney or liver disease, stomach ulcers, heart problems, take blood thinners like warfarin or apixaban, are pregnant, or use other medicines.

Physiotherapy may improve strength, movement, and activity tolerance. Depending on the cause, treatment may also include an injection, walking aid, treatment for inflammatory disease, or surgery. Fractures and joint infections need prompt medical treatment rather than home care alone.

Pain from a mild strain may settle over days to a few weeks. Tendon problems often improve more gradually and may flare if activity increases too quickly. Osteoarthritis can cause symptoms that come and go over a longer period.

Improvement is not always steady. A return of mild discomfort after activity does not necessarily mean further damage, but severe or worsening pain should be reviewed.

If symptoms persist, follow-up can help reassess the cause, adjust exercises or pain relief, and decide whether imaging or specialist care is needed.

Why is hip-joint pain often felt in the groin?

The hip joint sits deep beneath the groin. Signals from the joint are therefore often felt at the front of the hip or upper thigh rather than over the outer side.

Can hip pain come from my back?

Yes. Lower-back joints, muscles, or nerves can produce pain in the buttock and hip area. Tingling, numbness, or pain extending below the knee makes nerve involvement more likely, but an examination is needed to tell.

Should I keep exercising?

Gentle movement is usually better than complete rest for mild, non-urgent pain. Reduce activities that cause sharp pain or a lasting flare. A physiotherapist can help if you are unsure how to adjust exercise safely.

How should I sleep with outer hip pain?

Avoid lying directly on the painful side. When lying on the other side, a pillow between the knees may reduce strain. A pillow under the knees may be more comfortable when lying on your back.