Hip Pain Causes: Common Problems and Warning Signs

01The hip

The hip joint and surrounding tissues

The hip is a ball-and-socket joint where the thigh bone meets the pelvis. It is surrounded by muscles, tendons, ligaments and small fluid-filled sacs called bursae, which reduce friction where tissues glide over bone. Pain can arise from any of these structures, or from somewhere else entirely.

The NHS notes that hip pain may be caused by a sudden injury or a longer-lasting problem such as arthritis, and advises not trying to diagnose the cause yourself. Mayo Clinic adds that hip pain can be caused by arthritis, injuries or other conditions, and that the location of the pain offers clues, though not a diagnosis.

02Location

Groin, lateral and referred pain

Mayo Clinic explains that:

• pain on the inside of the hip or in the groin typically suggests a problem within the hip joint itself
• pain on the outer side of the hip, upper thigh or outer buttock typically relates to the muscles, ligaments, tendons or bursae around the joint
• pain can also be referred from another area, such as the lower back

These are general patterns, not rules. Pain on the outer hip is not always bursitis, and you cannot reliably tell whether pain comes from muscle or bone just by where it hurts. Nerve problems such as sciatica or a trapped nerve in the thigh, and an inguinal hernia, can also cause pain felt around the hip.

03Arthritis

Arthritis and inflammatory conditions

Arthritis is one of the most common causes. The NHS describes these patterns in adults:

• Osteoarthritis: usually over 45, with pain worse when walking and stiffness after moving.
• Rheumatoid arthritis: pain and stiffness worse after not moving, for example on waking.
• Joint infection (septic arthritis): a hot, swollen hip with a high temperature or feeling hot, cold or shivery.

Mayo Clinic also lists psoriatic arthritis, synovitis (inflammation of the joint lining) and sacroiliitis among causes. The NHS advises seeing a GP if you have hip stiffness lasting more than 30 minutes after waking up, which can be a sign of an inflammatory condition.

04Soft tissues

Tendons, bursae and muscle injuries

Problems in the soft tissues around the hip are frequent, especially after exercise. The NHS links pain, swelling or bruising after intense or repetitive exercise to a sprain, strain or tendonitis, and describes bursitis as pain that may spread to the upper thigh and feel worse when moving or lying on your side.

Mayo Clinic’s list of injuries also includes a hip labral tear, a tear of the ring of cartilage around the socket. Our guides on hip bursitis, hip flexor strain and snapping hip look at some of these problems in more detail.

05Serious causes

Fracture, infection and other serious causes

Some causes of hip pain are serious and need prompt treatment. The NHS highlights a hip fracture, suggested by severe pain and being unable to walk after a fall or injury, and joint infection. Mayo Clinic adds dislocation, bone infection (osteomyelitis), avascular necrosis, in which the bone loses its blood supply, osteoporosis and, rarely, cancer affecting the bone, including cancer that has spread to the bone and leukemia.

Most hip pain is not caused by these conditions, but they are the reason why certain symptoms should never be managed at home. Children with hip pain or a limp need a separate assessment: the NHS has separate information for children, and conditions such as juvenile idiopathic arthritis and Legg-Calve-Perthes disease are specific to younger people.

07Assessment

Clinical history and selected tests

The NHS recommends seeing a GP if hip pain stops you doing normal activities or affects your sleep, is getting worse or keeps coming back, has not improved after 2 weeks of home treatment, or causes stiffness for more than 30 minutes after waking. In the UK, many areas also allow self-referral to community musculoskeletal services for physiotherapy.

Assessment starts with your history and an examination. Treatment depends on the cause, and the NHS notes that a specialist may arrange a scan when needed. It helps to describe where exactly the pain is, what brings it on, how far you can walk, whether it wakes you at night and whether it started after an injury.

08Self-care

Adapting activity without forcing painful movements

For minor hip pain, both sources suggest self-care. The NHS advises keeping moving if you can without overdoing it, applying an ice pack wrapped in a towel for up to 20 minutes every 2 to 3 hours, using simple painkillers or anti-inflammatory gels, wearing comfortable shock-absorbing shoes, trying gentle hip stretches, avoiding carrying heavy things and avoiding low chairs. Losing weight can help if you are overweight.

Mayo Clinic suggests limiting activities that involve bending the hip or putting direct pressure on it, avoiding sleeping on the painful side and long periods of sitting, and using a warm bath or shower before gentle stretching. Our guides on hip pain when walking and hip pain while sleeping cover specific situations. In our physiotherapy practice in Bilbao we offer individual rehabilitation for adults after assessment (consultations are in Spanish).

09Sources

Where the sources differ

The NHS and Mayo Clinic agree on the main causes and warning signs, but they present them differently:

• Approach. The NHS links typical symptom patterns to likely causes in adults, while Mayo Clinic gives a long list of possible causes and explains what pain location suggests. Both stress that a professional should make the diagnosis.
• Activity. The NHS says it is best to keep moving if you can, without overdoing things; Mayo Clinic focuses on rest from activities that bend or press on the hip. In practice, the right balance depends on the cause and how you respond.
• Medicines. Both mention nonprescription painkillers and skin creams or gels; Mayo Clinic names products. We mention only the groups, and they are not suitable for everyone.
• Treatment. Only the NHS describes the treatment pathway: stronger painkillers, exercises, physiotherapy, occupational therapy and walking aids, steroid injections and specialist referral. Some people with a damaged hip joint may eventually need a hip replacement if other treatments do not help.

10Summary

In summary

Hip pain has many causes. Groin pain often points to the joint, outer hip pain to the surrounding soft tissues, and pain can also come from the lower back. Osteoarthritis, bursitis, strains and tendinitis are common; fractures, joint infection and other serious conditions are less common but need urgent care.

Most hip pain improves with sensible activity, ice, simple pain relief and exercise. Before an appointment, keep a short record of where the pain is, which activities and distances you tolerate, how you sleep and any recent changes. Seek emergency help after a fall with severe pain or inability to bear weight, and urgent help for a hot, swollen hip, fever or sudden severe pain. Not everyone with hip pain needs surgery.