Hip Pain When Walking: Causes, Relief and When to See a Doctor

01Groin

Pain in the groin or front of the hip

• Osteoarthritis: groin pain and stiffness, worse after walking and in the morning, with difficulty putting on socks and shoes. Common after 50.
• Femoroacetabular impingement and labral tears: in younger, active people; pain with deep bending, twisting and long walks, sometimes with clicking.
• Hip flexor strain: pain at the front of the hip after sprinting, kicking or a sudden increase in activity; see hip flexor strain.
• Stress fracture: deep groin pain that builds with walking or running in people who have increased their training or have weak bones.

02Outer hip

Pain on the outside of the hip

Pain on the bony point at the side of the hip, which can spread down the outside of the thigh, is often caused by gluteal tendinopathy, sometimes with trochanteric bursitis. It is common in women over 40, runners and people who have increased walking. It hurts when walking, climbing stairs, standing on one leg, crossing the legs and lying on that side at night.

See hip bursitis and hip pain while sleeping.

03Buttock

Pain in the buttock

• Lower back problems: a disc or joint in the lower back can refer pain to the buttock and hip; if it goes below the knee with tingling, it is likely sciatica; see sciatica stretches.
• Sacroiliac joint pain: pain over the dimple at the back of the pelvis.
• Piriformis syndrome: deep buttock pain worse with sitting; see piriformis syndrome.
• Hamstring tendinopathy: pain at the sitting bone, worse with sitting and walking uphill.

04Sitting

Hip pain when sitting

Pain when sitting points to a different set of causes: hip impingement and labral problems often hurt with low chairs and deep bending, while buttock pain when sitting suggests piriformis, hamstring tendon or lower back problems. Sitting with crossed legs can aggravate outer hip pain.

Choose a higher chair, keep the knees slightly lower than the hips, avoid crossing your legs and stand up regularly.

05Other

Other causes to consider

• Circulation problems, causing buttock or thigh pain when walking that eases with rest.
• Inflammatory arthritis, with morning stiffness lasting more than 30 minutes.
• Hernias, causing a groin lump.
• In children: irritable hip after a virus, Perthes disease or a slipped growth plate in teenagers.

06Relief

What you can do now

• Keep walking within comfort, but split long walks into shorter ones.
• Use a walking stick in the hand opposite the painful hip if needed.
• Avoid standing on one leg with the hip dropped, crossing your legs and very low chairs.
• Use heat or ice for 15 to 20 minutes, whichever eases the pain.
• Take simple painkillers if appropriate.
• Wear cushioned, supportive shoes.

07Exercises

Exercises and physiotherapy

Strengthening is the core treatment for most hip pain. A physiotherapist will tailor exercises to the cause, such as gluteal strengthening for tendinopathy, joint mobility and strength for arthritis and core and hip control for impingement. Typical exercises include bridges, sit-to-stand, side-lying leg lifts, step-ups and balance work.

For osteoarthritis, structured exercise programmes reduce pain and improve walking. Weight loss, if relevant, also reduces load on the hip. See hip mobility exercises and tight hip flexors.

08Assessment

How hip pain is assessed

A doctor or physiotherapist asks where and when it hurts, examines how you walk and tests hip movement and strength, the tendons on the outside of the hip and the lower back. An X-ray helps confirm osteoarthritis, while an MRI or ultrasound is used when a labral tear, tendon problem or stress fracture is suspected.

10Summary

Key points to remember

• Groin pain suggests the hip joint; outer hip pain suggests tendons or bursa.
• Buttock pain is often referred from the lower back.
• Strengthening exercises and load management help most hip pain.
• A fall with inability to walk or a child with a limp needs urgent assessment.