Hip pain: symptoms and relief

Living with hip pain

Hip pain can creep up slowly or follow an injury. You might feel a deep ache in the groin when you walk, stiffness when you stand after sitting, or a sharp pinch when you bend or twist your hip. Some people struggle to lie on one side because of outer hip pain, while others feel a pulling pain in the front of the hip when they lift the leg.Hip osteoarthritis is a major cause of pain and disability around the world and becomes more common with age and higher body weight.⁵ ⁶ ¹³

At the same time, many younger and middle aged adults have hip pain from femoroacetabular impingement syndrome (where femoroacetabular impingement syndrome (bones have abnormal shapes, causing them to rub and pinch during movement, damaging the joint), labral problems, or gluteal tendinopathy on the outer hip.⁴ ⁷ ⁸ ¹⁴ ¹⁵

The encouraging news is that for many people, symptoms improve with education, targeted exercise, and sensible activity changes, and surgery is usually reserved for specific situations.² ³ ⁵ ⁶ ⁷

What are the symptoms of hip pain?

Hip problems can cause pain in different places, not just “on the hip bone.” Common symptoms include:

• Deep aching pain in the groin or front of the hip, especially when walking, getting out of a chair, or putting on socks and shoes
• Stiffness after rest, for example in the morning or after sitting, that usually eases within about 30 minutes in osteoarthritis⁵
• Pain on the outer side of the hip that worsens when lying on that side, standing for long periods, climbing stairs, or standing on one leg, often seen in greater trochanteric pain syndrome (irritation or degeneration of tendons or inflammation of the fluid sac around the bone) or gluteal tendinopathy⁷ ⁸ ¹⁵
• Clicking, catching, or a feeling of “pinching” in the front of the hip when bending, twisting, or squatting, common in femoroacetabular impingement syndrome and labral problems⁴ ¹⁴
• Pain that comes on with running or impact and is felt deep in the groin or hip, sometimes with a very tender spot on the upper thigh bone, which can suggest a femoral neck stress injury¹¹ ¹²
• A very painful, hot, stiff hip where movement is extremely limited, which can signal infection or septic arthritis that needs urgent care¹⁰
• Pain that spreads to the thigh, buttock, or knee, or that feels like it is coming from the lower back or sacroiliac joint

What causes hip pain?

Hip pain usually comes from a mix of joint health, tendon capacity, bone stress, and how much load your hip is taking day to day. Understanding the main cause helps guide safe and effective treatment.

Key causes and risk factors include:

Hip osteoarthritis (HOA)

• Wear and tear changes in the cartilage and joint structures over time.
• Risk rises with age, female sex, higher body weight, previous hip injury, hip dysplasia, and certain bone shapes.⁵ ⁶ ¹³
• Physical inactivity and poorer metabolic health can increase risk and severity.⁵ ⁶ ¹³

Femoroacetabular impingement (FAI) and labral cartilage injury

• FAI syndrome happens when specific bone shapes at the top of the femur or the pelvic socket, combined with certain movements, irritate the labrum and cartilage.
• Cam or pincer morphology (bone shape variations) are common on scans in people with and without symptoms, so it is called a syndrome only when symptoms, physical findings, and imaging all match.⁴ ¹⁴
• Often seen in people who play cutting, pivoting, or kicking sports.⁴

Greater trochanteric pain syndrome (GTPS) / gluteal tendinopathy

• Irritation or degeneration of the gluteus medius and minimus tendons (buttocks muscles) and nearby bursae on the outer hip.
• More common in women aged 40 to 60, especially around menopause, and in those with hip abductor weakness or more hip adduction during walking or running.⁷ ⁸ ¹⁵

Femoral neck stress injury

• Bone stress reaction or stress fracture in the neck of the femur from repeated impact loads that exceed the bone’s ability to adapt.
• Risk factors include sudden training load spikes, low energy availability, vitamin D deficiency, and previous stress fracture. Tension side lesions have higher risk of non-union and loss of blood supply to the femoral head.¹¹ ¹²

Inflammatory and septic arthritis or infection

• Inflammatory arthritis can cause hip joint pain and stiffness.
• Septic arthritis is a joint infection that can rapidly damage cartilage and is more likely with diabetes, immune suppression, recent hip injection, or prosthetic joints. It is a medical emergency.¹⁰

Referred pain

• Problems in the lumbar spine, sacroiliac joint, or abdomen can refer pain into the hip or groin, so these areas need to be checked in a full assessment.¹ ⁴ ⁵

When should I see a doctor for hip pain?

Many hip aches from overuse or mild osteoarthritis flare ups improve with time, load changes, and exercise. Still, some patterns need urgent assessment because they can signal serious problems.

You should book a medical or physical therapy review if:

• Hip pain lasts more than 4 to 6 weeks and is not improving
• Pain limits your walking distance, work, or daily activities
• You wake at night because of hip pain or cannot lie on one side
• You are unsure whether your hip pain is coming from the joint, outer hip tendons, lower back, or pelvis

How is hip pain treated?

Treatment depends on the cause, but most people start with education, activity changes, and exercise based rehabilitation. Surgery and injections are usually reserved for specific cases after a good trial of conservative care.

Typical hip injury treatment options

Education and activity modification

• Short-term reduction of the biggest triggers, like hard sprinting, cutting, or maximal kicking, followed by a gradual return with better pacing and load control.¹

Exercise-based rehabilitation

Hip osteoarthritis

• Strong guidance supports land based exercise that combines hip and leg strengthening, neuromuscular training, and aerobic activity, along with weight management when body mass index is high. ^{5 6 13}
• Exercise can reduce pain and improve function with moderate effect sizes and is recommended for all people with osteoarthritis, whatever their age or weight. ^{5 6 13}

FAI syndrome and labral pain

• First line care includes education, activity modification, hip and trunk strengthening, and movement retraining to reduce positions that provoke impingement. ⁴
• Trials show that both structured physiotherapy and arthroscopic surgery improve symptoms. In carefully selected patients, surgery can provide greater improvement at 12 months, but not everyone needs or benefits from it. ^{2 3}

GTPS / gluteal tendinopathy

• A major trial (LEAP) found that education plus specific hip abductor strengthening gave better global improvement at 52 weeks than a single corticosteroid injection or a wait and see approach. ^{7 8}
• Programs focus on reducing compressive positions, then progressively loading the gluteal tendons with exercises such as side lying or standing hip abduction and lateral chain strengthening. ^{7 8 15}

Medications

• Short courses of non steroidal anti inflammatory drugs like (ibuprofen) or simple pain relief can help during flares when used safely.
• Guidelines highlight that paracetamol has limited benefit on its own for osteoarthritis and chronic opioids should be avoided where possible ^{5 6}

Injections

• For hip osteoarthritis, ultrasound guided corticosteroid injections can give short term pain relief and can support participation in exercise, but the effect is usually temporary. Hyaluronic acid injections are generally not recommended in clinical guidance. ^{5 6 9 16}
• For gluteal tendinopathy, steroid injections may help short term but have worse long term results than education plus exercise.
• A platelet-rich plasma injection is a therapeutic treatment derived from your blood that can reduce tendon inflammation. ⁷

Surgery

FAI syndrome and labral pain

• Hip arthroscopy can reshape bone and treat labral cartilage damage. Randomised trials show larger improvements in patient reported scores at 12 months compared with best conservative care in selected patients, but both groups improve. ^{2 3 4}
• Decisions about surgery should consider age, activity goals, imaging findings, and response to rehabilitation.

End stage hip osteoarthritis

• A total hip replacement is considered when hip pain and stiffness significantly limit life and work despite comprehensive non operative care. ^{5 6}

Femoral neck stress fracture

• Tension side and displaced fractures usually need surgical fixation. Even some compression side injuries require strict protection (using crutches) and close monitoring. ^{11 12}

Septic arthritis

• Requires urgent joint aspiration, intravenous antibiotics, and often operative washout to protect the joint and reduce systemic risks. ¹⁰

Recovery time varies widely. Many people with gluteal tendinopathy improve over 8 to 12 weeks, with continued gains over the year.⁷ ⁸ Osteoarthritis tends to fluctuate over years, but exercise and weight management can produce meaningful improvements and often delay or reduce the need for surgery.⁵ ⁶ ¹³ People with FAI syndrome may improve with physiotherapy alone or proceed to surgery after a focused conservative block.² ³ ⁴

[Diagnosis & Treatment →]

Sword's approach

Sword Health helps people manage pain and movement issues with expert-guided AI care you can use from home. Our model combines clinical support with modern technology, designed to work around your life.

Sword makes recovery easier and more accessible. You get high-quality care at home, guided by clinicians and supported by smart technology.

• Care that adapts to your progress in real time
• Licensed experts guiding every step
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• Proven results for pain relief, movement, and satisfaction

Clinical insight

Modern hip care has shifted away from a “wait until it is bad enough for surgery” mindset. For hip osteoarthritis, guidelines from NICE, AAOS, and OARSI all stress that education, strengthening, neuromuscular training, and weight management should be offered early and tailored to individual goals, with injections seen as short term tools rather than solutions.^5,6,9,13 Many people can delay or avoid surgery for years with this approach.