What Causes Hip Pain? Treatment, Diagnosis and More

The joint between your femur (thigh bone) and pelvis makes your hip joint.

Where the two bones meet is called a ball and socket joint and includes cartilage, tendons, nerves, and muscles. 

Having pain in your hip can be very troublesome as it makes most movement painful and can decrease your quality of life. Several problems can arise from the different parts of your joint and cause pain. 

This article goes over the types of hip symptoms you may be experiencing and what could be causing them.

Next, it covers identifying the cause of your hip pain and what the treatment plan could be.

Lastly, this article discusses how to manage hip pain and when it’s time to talk to your medical provider about it. 

Hip Pain Symptoms

Researchers estimate that about 10% of the general population suffers from hip pain, and that percentage increases with age. 

Symptoms depend on what the issue is that is causing you pain. You may feel pain in your:

• Groin area
• Thigh
• Buttocks
• Outside your hip
• Inside the hip

You might notice that your pain increases when sitting or standing in certain positions or with activity. Sometimes there is also a loss of range of motion. 

Many people who have hip pain also experience lower back and leg pain. 

Causes of Hip Pain

The cause of your hip pain can be coming from a problem with your muscles, tendons, cartilage, bones, or nerves. In addition, there may be a fracture, inflammation, infection, or strain. 

Here are some common causes of hip pain:

Arthritis

Arthritis is inflammation of a joint. There are several types of arthritis; the main two that cause pain in the hips are osteoarthritis and rheumatoid arthritis.

Typically, pain from arthritis is felt in the groin or front part of the hip.

Osteoarthritis primarily affects the finger, knees, and hips. Injury can cause it, but it is usually due to age.

Rheumatoid arthritis is an autoimmune disorder that causes joint pain. It can also be accompanied by a fever and feeling tired. 

To learn more about arthritis, click here. 

Injuries and Overuse

The hip bone is structurally very stable; however, athletics, overuse, and falls can sometimes result in hip pain. 

Bursitis is when the fluid-filled sac that sits between your bones gets inflamed. Overuse or injury is usually the cause. Walking, driving, getting up from a chair, and climbing stairs generally trigger the pain.   

Tendonitis is when the tendon (the fibrous band that connects your muscles to your bones) is inflamed due to overuse or improper use. Sports is a common cause.

Strains happen when a muscle or tendon is stretched or torn by twisting or pulling movements. They can happen suddenly or over time. Common hip strains are hamstring, flexor, and groin strains. 

Hip fractures usually occur in older adults when they experience a fall but can also occur in younger people with trauma. The pain is sudden and requires an emergency medical assessment. Many times, surgery is needed to fix the fracture. 

Pinched nerves

The term “pinched nerve” refers to nerve injury by compression, stretching, or constriction.

Several nerves in the hip cause a tremendous amount of pain when “pinched.”

Sciatica is when the largest nerve in your pelvis is inflamed. Your sciatic nerve is responsible for controlling the muscles in your lower leg and back of the knee.

It also provides feeling to most of your leg. Symptoms vary from mild tingling or numbness to severe pain shooting down the leg.

Cancer

Several common cancers (breast, prostate, kidney, and lung) tend to spread (metastasize) to the bones, including the hips. When cancer affects the hips, it frequently causes pain and difficulty walking.

The pain can be dull at first and gradually becomes more intense.

Other problems

Avascular necrosis is when a decrease in blood flow to the hip joint causes the bone to break down. This condition causes pain and trouble with moving your hip. 

Osteoporosis is when your bones become thin and fragile from decreased bone density. This condition is more common in older women.  

Snapping hip syndrome is a condition brought on by overuse of the hip joint (common in dancers) that causes an audible snapping when moving the hip. This condition may or may not cause pain.

Diagnosis

Finding the cause of the hip pain can sometimes be difficult because of the many moving parts but is necessary for correct treatment. 

Your medical provider will first perform a physical exam of your hip and ask you questions about your symptoms. There are several physical tests your provider can have you do to pinpoint where the problem is.

To confirm what is causing your pain, your medical provider may order imaging tests such as x-ray, ultrasound, or MRI.

X-ray 

When there is the possibility of a fracture or dislocation, an x-ray is useful.

CT Scan

Computed tomography (CT) scan is mainly used when there is a possibility of a bone tumor. 

Ultrasound 

Ultrasound is useful for looking at any fluid-filled area, such as a cyst or an area of swelling.

MRI 

Magnetic resonance imaging (MRI) is excellent when searching for causes related to nerves, muscles, tendons, and soft tissue.

Blood Tests 

Blood tests help determine if infection—versus inflammation—is causing the pain. 

Treatments and Relief

How you treat hip pain depends on what is causing the pain.

For example, if your pain stems from overuse of the joint, resting the joint and icing can be best. 

In some cases, your medical provider may have you modify some of your activities and use crutches for a period of time. 

Drugs

Non-steroidal inflammatory drugs (NSAIDs) are the primary treatment for most hip pain.

NSAIDs have been shown to effectively and safely treat pain from arthritic and inflammatory conditions. 

On a very limited basis, opioids are sometimes used to treat hip pain, but this is usually for severe cases such as a hip fracture or dislocation.

Creams or ointments rubbed on the skin over the joint can sometimes bring relief to hip pain.  

Physical therapy

Sometimes rest is needed before starting physical activity.

When cleared by your provider, you may be referred to a physical therapist. 

The physical therapist can help you strengthen your back and core muscles and any other muscles that could help bring more stability to your hip joint. 

Occupational therapy

When you are experiencing hip pain, some daily activities such as getting dressed and putting on socks can be a challenge.

Occupational therapy (OT) can teach you how to do your daily activities in a modified manner to help you remain as independent as possible. OT is also helpful after surgery while you recover.  

Steroid injections

Steroid injections in the hip joint can relieve hip pain caused by bursitis, arthritis, injury, overuse, or a labral tear. 

Usually, pain relief takes effect a couple of days after the injection and for some people, the relief lasts for weeks or even months.

Sometimes two injections are required to feel the full effects. 

Surgery

Some situations such as severe arthritis, a muscle/tendon tear, or a fracture require a surgical procedure. 

Managing Hip Pain

As long as your hip pain is not from a major injury or pain that is so severe that you are unable to move, stand, or walk, you can try some management tips at home. 

Exercise

Warm up and gently stretch your quadriceps and hamstrings before exercising. 

If you are a runner, make sure your shoes are well made and fit correctly.

Also, try running on a smooth surface such as a track and avoid running on cement or downhill. 

If running and biking are too painful, try swimming instead, as it has less impact on your joints. 

You may also need to consider decreasing your amount of exercise for a while to let your hip rest. 

Reducing Strain

To reduce the strain on your hip, take note of what activities aggravate it and try to avoid those. Also, make sure the shoes you wear have good support and cushion. 

Avoid laying on the painful side and put a pillow between your knees for better hip alignment when sleeping. 

If you are overweight, ask your provider how to start losing weight safely to decrease the amount of pressure on your hips. 

Standing for extended periods can aggravate hip pain if the surface you are standing on is not cushioned. Also, try to balance your weight evenly between your legs when standing. 

When To Seek Medical Attention

Seek emergency help if you have a severe fall or other injury and you are:

• Unable to move your hip
• Unable to bear weight on your leg
• Having extreme pain in your hip
• Having bleeding or bad bruising
• Experiencing new urinary symptoms
• Experiencing numbness

Let your primary medical provider know if:

• You’ve tried to treat your hip pain, but it is still painful after one week
• You develop a fever or rash
• You have pain in other joints as well
• You start having trouble walking normally or climbing stairs

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