What You Need to Know About Hip Pain

The hip seems like a simple ball-and-socket joint but in reality, it’s a remarkably complex structure held together by a series of interconnecting ligaments and over 20 muscles¹Neumann DA. Kinesiology of the hip: a focus on muscular actions. J Orthop Sports Phys Ther. 2010;40(2):82-94. doi: 10.2519/jospt.2010.3025 spanning from the low back and buttocks all the way to the inner thigh (groin).

Any disruption within this complex system can lead to hip pain. In fact, nearly one in four people experience hip pain at some point in their lives from conditions such as hip impingement and/or hip osteoarthritis.²Murphy LB, Helmick CG, Schwartz TA, et al. One in four people may develop symptomatic hip osteoarthritis in his or her lifetime. Osteoarthritis Cartilage. 2010;18(11):1372-1379. doi:10.1016/j.joca.2010.08.005

See Your Visual Guide to Hip Anatomy

This guide provides in-depth explanations of the types, causes, symptoms, and treatments of hip joint pain.

Why the Hips Hurt

The hips are weight-bearing joints, constantly under stress. Everyday activities like walking increase forces up to 6-8 times the body weight on these joints.³Knapik DM, Salata MJ. Hip injuries in the contact athlete. Operative Techniques in Sports Medicine. 2019;27(3):145-151. doi:https://doi.org/10.1053/j.otsm.2019.04.007

This constant stress, combined with prolonged sitting, a sedentary lifestyle, wear and tear, and even knee and ankle conditions can cause pain in the hip joint and/or the surrounding muscles and tendons.

The joints are also prone to traumatic injury from sports, athletic activities, and falls.

Hip Pain Location

Upper front part of the thigh and inner thigh (groin): This "classic hip pain zone” often points to problems within the joint or hip muscles, such as hip osteoarthritis, hip labral tears, frozen hip, hip impingement and hip flexor pain.

Side of the hip: Pain in this area indicates inflammation of soft tissues around the hip, such as the iliotibial band (IT band syndrome) and the hip’s bursae (hip bursitis).

Back of the hip: Pain in this region is referred from nearby joints and muscles. Common causes include piriformis syndrome, sacroiliac (SI) joint dysfunction, lower back issues and sciatica, and hamstring muscle and tendon injuries.

3 Types of Hip Pain

There are 3 general categories of hip pain based on how the symptoms start and how long they last:

1. Acute pain: Comes on suddenly, lasts for a few days or weeks, and is considered a normal response of the body to mild trauma, such as an overstretched tendon or ligament. The pain gradually subsides as the body heals with rest and self-care treatments.
2. Subacute pain: Lasts between 6 weeks and 3 months and is usually mechanical in nature, such as muscle strain or mild labral tear. A diagnostic workup is advisable if the pain does not improve and/or continues to worsen and limits one’s ability to participate in activities of daily living, sleeping, and working.
3. Chronic pain: Lasts over 3 months, occurs due to progressive damage to the joint tissues, such as hip osteoarthritis or severe labral tears, and is usually moderate-to-severe in nature. Chronic hip pain requires a thorough medical workup to determine the exact source of the pain.

Depending on the underlying cause, acute hip pain can become chronic if it’s left untreated. In general, hip joint problems related to the labrum and joint cartilage tend to become chronic without treatment and can accelerate other osteoarthritic conditions affecting the surrounding areas, such as the lower back and pelvis.

Read more about Hip Osteoarthritis on Arthritis-health.com

How It Starts or Flares

The pain usually develops over time and may be dull and achy or sharp and stabbing and affects one or both hips. It may remain constant or flare during specific activities or movements.

Hip symptoms are typically aggravated by weight-bearing activities, such as prolonged standing, climbing stairs, or walking; or high-impact activities, such as running. For some people, lying on the affected side aggravates the pain.

How Long Does Hip Pain Last?

Several factors influence the duration of hip pain, including:

• The underlying cause: Different conditions causing hip pain have varying healing timelines.
• Accurate diagnosis: Early and correct identification of the source of pain allows for targeted treatment.
• Treatment initiation and approach: Promptly starting a treatment plan that addresses the specific cause, such as medication, physical therapy, joint alignment, injections, or a combination, significantly shortens the recovery time.

In general, acute pain from a minor sprain or strain injury typically resolves within days or weeks, and chronic pain from arthritis may last for months or years and require ongoing treatment.

When Hip Pain Is Serious

Certain red-flag symptoms and signs of hip pain indicate serious medical conditions and require urgent evaluation. These symptoms include:

• Sudden and severe hip joint pain
• Inability to bear weight on the affected hip
• Inability to walk due to hip weakness
• Redness or swelling around the hip joint
• Fever or chills accompanying hip pain
• Recent unexplained weight loss – losing weight without intention, or weight loss not due to changes in diet and exercise

These serious symptoms may indicate medical emergencies such as aortoiliac arterial insufficiency (severe blood clots in the lower abdominal and pelvic arteries), septic arthritis, osteonecrosis, and tumors. These conditions may be life-threatening or cause permanent damage to the hip joint if they are not treated in time.

Additionally, people who experience pain symptoms after a trauma (such as a car accident or sports injury) are advised to see a doctor.

Medical attention is also warranted for hip pain that interferes with daily activities, mobility, and sleep, or if there are other troubling symptoms.

Hip pain is diagnosed and treated by doctors who specialize in musculoskeletal conditions, such as physiatrists, sports medicine specialists, physical therapists, orthopedic surgeons, rheumatologists, and chiropractors.