Hip pain might seem like a minor inconvenience at first, but when it keeps coming back, makes walking difficult, or interrupts your sleep, your body may be telling you that something needs attention.
A viral social media image showing a person holding their hip suggests that hip pain is a clear sign of an underlying problem. While the message encourages people to pay attention to their health, the truth is that hip pain can have many different causes.
Sometimes, the problem is as simple as muscle strain after physical activity. Other times, discomfort around the hip may be associated with arthritis, tendon irritation, nerve problems, or a condition affecting the lower back.
The location of the pain, when it occurs, and whether it spreads into other areas can provide useful clues.
But here’s something many people don’t realize: pain that feels like it’s coming from the hip doesn’t always originate in the hip joint itself.
Understanding the possible causes can help you recognize when home care may be reasonable and when medical attention is necessary.
Why Does Your Hip Hurt?
The hip is one of the body’s largest weight-bearing joints.
It connects the thigh bone, called the femur, to the pelvis and allows movements such as walking, climbing stairs, sitting, and bending.
The hip joint is surrounded by muscles, tendons, ligaments, nerves, and fluid-filled sacs called bursae.
Pain can develop when any of these structures become irritated, injured, or affected by disease.
Hip pain may be felt in several places:
- Front of the hip or groin: Sometimes associated with problems inside the hip joint.
- Outside of the hip: Often linked to tendons and other soft tissues around the greater trochanter.
- Buttock or back of the hip: May originate from muscles, the sacroiliac region, or the lower back.
- Thigh or knee: Hip problems can sometimes cause referred pain in these areas.
The precise location can help guide an evaluation, but it cannot establish a diagnosis on its own.
1. Hip Osteoarthritis
One of the most common causes of persistent hip pain in adults is osteoarthritis.
Osteoarthritis develops when changes in the joint’s cartilage and surrounding structures affect how smoothly the hip moves.
Over time, the joint may become painful and stiff.
Common Symptoms
- Deep pain in the groin or front of the hip
- Stiffness after sitting or resting
- Difficulty putting on shoes or socks
- Pain when walking longer distances
- Reduced range of motion
- Discomfort that may extend toward the thigh or knee
Symptoms often develop gradually.
Although osteoarthritis becomes more common with age, younger people can also develop it, especially after previous injuries or in the presence of certain joint abnormalities.
What Can Help?
Treatment may include appropriate exercise, physical therapy, weight management when relevant, and medications recommended by a healthcare professional.
In severe cases, hip replacement surgery may be considered.
2. Greater Trochanteric Pain Syndrome
If your pain is located on the outside of your hip, particularly when lying on that side, greater trochanteric pain syndrome may be one possible explanation.
This condition commonly involves irritation or injury of the tendons attached around the greater trochanter, a bony prominence on the upper thigh bone.
It is sometimes casually called hip bursitis, although tendon problems are frequently involved.
Typical Symptoms
- Tenderness on the outside of the hip
- Pain when lying on the affected side
- Discomfort while climbing stairs
- Pain after prolonged walking
- Symptoms when standing on one leg
Treatment often focuses on reducing aggravating activities and gradually strengthening the muscles that support the hip.
3. Muscle Strain or Overuse
Hip pain can develop after exercise, lifting, running, or an unfamiliar physical activity.
The muscles around the hip may become strained when they are stretched or loaded beyond their current capacity.
Signs of a Muscle Strain
- Pain after physical activity
- Tenderness in a particular muscle
- Discomfort with certain movements
- Mild swelling in some cases
- Muscle tightness or weakness
Many mild strains improve with appropriate rest from aggravating activities and gradual return to movement.
However, severe pain, substantial weakness, or difficulty bearing weight requires medical evaluation.
4. Sciatica and Lower Back Problems
Sometimes, what feels like hip pain actually comes from the lower back.
The sciatic nerve originates from nerve roots in the lower spine and travels through the buttock and down the leg.
When a nerve root becomes irritated or compressed, pain can radiate into the buttock, thigh, or lower leg.
Possible Symptoms
- Burning or shooting pain
- Tingling or pins-and-needles sensations
- Numbness in the leg
- Pain that worsens during certain positions
- Discomfort extending below the knee
- Muscle weakness in more significant cases
Sciatica can be associated with a herniated disc or other spinal conditions.
Not all buttock pain is sciatica, and not all hip pain originates from the spine.
New bladder or bowel dysfunction, numbness around the groin or saddle area, or rapidly progressive leg weakness requires emergency medical assessment.
5. Hip Bursitis
Bursae are small fluid-filled sacs that reduce friction between moving tissues.
Inflammation of a bursa can cause localized pain.
Around the hip, the trochanteric bursa is one structure that may become irritated.
Symptoms can include tenderness and discomfort during movement or when pressure is applied to the affected area.
However, many cases previously described as isolated bursitis are now recognized as part of greater trochanteric pain syndrome.
Accurate diagnosis helps guide appropriate treatment.
6. Hip Labral Tear
The labrum is a ring of cartilage around the edge of the hip socket.
It helps stabilize the joint.
A tear can develop after an injury or in association with structural changes in the hip.
Possible Warning Signs
- Deep groin pain
- Clicking or catching sensations
- Pain when twisting or pivoting
- Stiffness
- Discomfort during sports or prolonged sitting
Not every labral tear causes symptoms.
Imaging findings must be interpreted alongside the patient’s history and physical examination.
Treatment depends on the severity of symptoms and may include rehabilitation or, in selected cases, surgery.
7. Femoroacetabular Impingement
Femoroacetabular impingement, often shortened to FAI, occurs when the shape of the hip bones causes abnormal contact during certain movements.
This can contribute to pain and sometimes affect the labrum or cartilage.
Common Symptoms
- Groin discomfort during deep bending
- Pain while squatting
- Reduced hip flexibility
- Discomfort during sports
- Pain with prolonged sitting
Having an anatomical shape associated with impingement does not automatically mean someone has a painful condition.
A diagnosis requires symptoms and clinical findings, sometimes supported by imaging.
8. Sacroiliac Joint-Related Pain
The sacroiliac joints connect the lower spine to the pelvis.
Pain in this region may be felt around the buttock, lower back, or back of the hip.
It may worsen during certain movements, prolonged standing, or transitions between sitting and standing.
Because symptoms can overlap with lower back and hip conditions, identifying the true source may require a careful physical examination.
9. Inflammatory Arthritis
Not all arthritis is caused by age-related joint changes.
Inflammatory conditions can affect the hip and surrounding joints.
Examples include rheumatoid arthritis and certain forms of spondyloarthritis.
Symptoms That May Suggest Inflammation
- Significant stiffness after waking
- Pain that improves somewhat with movement
- Symptoms affecting multiple joints
- Persistent swelling in other joints
- Fatigue or other systemic symptoms
These patterns are not specific enough to confirm inflammatory arthritis, but they may justify further evaluation.
Early diagnosis and appropriate treatment can help prevent complications.
10. Hip Fracture or Stress Fracture
A hip fracture can occur after a fall or other injury, particularly in people with weakened bones.
Stress fractures may develop after repeated loading, especially in athletes or people with reduced bone strength.
Warning Signs
- Significant hip or groin pain
- Pain with weight-bearing
- Difficulty walking
- Pain following a fall
- Persistent pain that worsens with activity
A fracture may sometimes occur without an obvious major injury.
If you cannot bear weight, have severe pain after a fall, or suspect a hip fracture, seek urgent medical care.
Do not attempt to walk through severe pain.
11. Avascular Necrosis of the Femoral Head
Avascular necrosis, also called osteonecrosis, occurs when blood supply to part of a bone becomes disrupted.
In the hip, it can affect the femoral head.
Over time, the affected bone may weaken and the joint surface may collapse.
Possible Symptoms
- Deep groin or hip pain
- Pain with walking
- Progressive stiffness
- Discomfort at rest in more advanced cases
Risk factors may include previous hip injury, prolonged or high-dose corticosteroid exposure, heavy alcohol use, and certain medical conditions.
Early stages may not be visible on ordinary X-rays.
Persistent unexplained hip pain deserves assessment, especially in someone with relevant risk factors.
12. Pain Referred From Other Parts of the Body
The hip region is anatomically complex.
Pain can sometimes originate outside the hip joint.
Possible sources include:
- Lumbar spine disorders
- Nerve irritation
- Pelvic conditions
- Certain abdominal problems
- Knee or lower-limb biomechanical problems
This is why a healthcare professional may examine the back, abdomen, pelvis, and lower limbs rather than focusing exclusively on the painful hip.
What Does the Location of Hip Pain Tell You?
The location of discomfort may provide useful clues.
| Pain location | Possible causes |
|---|---|
| Front of hip or groin | Osteoarthritis, labral problems, hip flexor strain |
| Outside of hip | Greater trochanteric pain syndrome, tendon irritation |
| Buttock or back of hip | Lumbar spine problems, sacroiliac-related pain, muscle disorders |
| Pain extending down the leg | Nerve irritation or referred pain |
| Deep hip pain after a fall | Possible fracture or other injury |
These are general patterns, not diagnostic rules.
A medical assessment is needed to determine the cause.
Why Does Hip Pain Get Worse at Night?
Nighttime hip pain can be particularly frustrating because it interferes with sleep.
Possible explanations include pressure on irritated tissues while lying on one side, joint stiffness, or symptoms associated with certain inflammatory conditions.
Pain from greater trochanteric pain syndrome commonly worsens when lying on the affected side.
Osteoarthritis can also cause nighttime discomfort, particularly when more advanced.
However, persistent pain at rest or at night, especially when accompanied by fever, unexplained weight loss, or a history of cancer, deserves medical assessment.
When Is Hip Pain a Medical Emergency?
Most hip pain is not life-threatening, but certain symptoms require immediate attention.
Seek emergency medical care if you experience:
- Severe hip pain after a fall or injury
- Inability to stand or bear weight
- A visibly deformed leg or hip
- Fever with a severely painful, hot, or swollen joint
- Sudden major weakness or loss of sensation
- New bladder or bowel dysfunction with back or leg symptoms
- Numbness around the groin or saddle region
A painful joint associated with fever can indicate an infection, which requires urgent treatment.
Do not delay evaluation when these warning signs are present.
How Doctors Diagnose Hip Pain
A healthcare professional will usually begin by asking questions about your symptoms.
These may include:
- When did the pain begin?
- Where exactly does it hurt?
- Was there an injury?
- Does the pain spread down your leg?
- Is it worse with walking, sitting, or lying down?
- Do you have numbness, weakness, or fever?
- Does the pain interfere with daily activities?
The physical examination may assess walking, joint movement, strength, tenderness, and nerve function.
Imaging Tests
Depending on the suspected cause, investigations may include:
X-rays: Useful for assessing fractures, arthritis, and certain structural abnormalities.
MRI: May help evaluate bone marrow changes, stress fractures, labral injuries, or soft-tissue problems.
Ultrasound: Can help assess certain tendons, bursae, and other superficial structures.
CT scans: Sometimes used for more detailed bone assessment.
Blood tests may be appropriate when infection or inflammatory disease is suspected.
Not everyone with hip pain needs imaging.
The decision depends on symptoms, examination findings, and clinical risk factors.