Hip Pain: What Causes It and What to Do About It

Medically Reviewed By Angela M. Bell, MD, FACP
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Hip pain can be minor and temporary, or it may result from a serious or progressive condition. Your doctor can advise you on the appropriate treatment and help you prevent recurrences. Read on to learn more about common causes of hip pain. This article also discusses how doctors diagnose the underlying condition and the treatments available.

Causes

An overhead shot of a women sitting on the floor and stretching her hips
Photography by Studio Taurus/Stocky United

Hip pain can result from a variety of conditions.

Injuries

Hip fractures are among the most common hip injuries in older adults. Symptoms include:

  • pain
  • swelling
  • one leg appearing deformed or shorter than the other
  • inability to bear weight

Hip pain can also be caused by connective tissue injuries. These include tears to the tendons or labrum. The labrum is the layer of cartilage lining your hip socket.

Connective tissue injuries can sometimes occur due to overuse. These injuries can affect active people, such as gymnasts, dancers, or runners. They include:

  • iliotibial band syndrome, or inflammation of the tendon running from the outside of the hip to the knee
  • gluteus maximus and gluteus medius tendon tears, which can cause pain on the side of the hip
  • labral tears

Soft tissue injuries also include muscle strains, sprains, or tears.

Bone deformities

Femoroacetabular impingement is a deformity of the hip joint. It causes the ball of the hip to pinch against the cup of the hip. It occurs when a bump on the ball of your femur contacts an overgrowth on the edge of your hip socket.

Bursitis

Bursitis is inflammation in the bursae, the fluid-filled sacs that cushion your joints. It is sometimes called greater trochanteric pain syndrome. Bursitis can result from:

  • injury
  • repeated microtraumas from running or similar exercises
  • weakness of the gluteal muscles, or the muscles of the buttocks

In some cases, the cause of bursitis may be unknown.

Learn more about the causes of hip bursitis.

Osteoarthritis

Osteoarthritis is a degenerative condition that can affect the cartilage and bone in the hip joint. It is the most common form of arthritis.

Learn more about the causes and risk factors for hip osteoarthritis.

Piriformis syndrome

Piriformis syndrome occurs when the sciatic nerve is compressed by the piriformis muscle of the buttocks. It causes pain deep in the buttock area with shooting pains down the affected leg.

Avascular necrosis

Avascular necrosis refers to the death of bone tissue in the head of the femur. It is caused by poor blood flow to the area. Risk factors can include tobacco or alcohol use, long-term use of corticosteroid medications, and obesity.

Referred or radiated pain

Lumbar spine issues can cause pain that radiates to the hip area. This can occur when there is narrowing of the spinal canal, which can lead to a compressed nerve.

Sciatica is one example of this type of pain. It causes shooting pains down the leg.

Diagnosis

To make a diagnosis, your doctor will look at your medical history and ask questions about your symptoms.

These may include questions about what makes your pain better or worse. They may also ask about any events that preceded your hip pain, such as a fall.

Your doctor may then perform a physical examination to assess your:

  • nerve function
  • circulation
  • weight-bearing ability
  • mobility

They may also move your leg into different positions to see whether certain movements cause pain.

Your doctor may order imaging scans, such as an X-ray, ultrasound, or MRI. These can help them see fractures or damage to other tissues in your hip area.

Treatments

Treatment for hip pain will depend on the cause. Hip pain caused by an acute condition may require different treatment than pain from a chronic condition.

Treatment methods may be surgical, medical or conservative.

Conservative treatment

Conservative treatments are most helpful when there is no structural damage to your hip. Your doctor may recommend these treatments if they believe you will heal on your own with minimal support.

According to a 2020 review, conservative treatment has a success rate of up to 90% for greater trochanteric pain syndrome.

Types of conservative treatment to relieve hip pain include:

With physical therapy, the goal is to improve strength and flexibility of muscles, ligaments, and tendons in your hip.

In addition to physical treatments, some medications may also help reduce hip pain. These can include:

  • Topical medications: These include medications containing nonsteroidal anti-inflammatory medications (NSAIDs), menthol, or capsaicin.
  • Oral medications: These can include:
    • NSAIDs
    • duloxetine, an antidepressant with known pain-relieving effects
    • tricyclic antidepressants or anticonvulsant medications to help with nerve pain
    • opioids, used only for short periods in severe cases
  • Injectable medications: These include anesthetics and corticosteroids.

Surgery

Several surgical procedures are available to help with structural damage in the hip. They include:

  • Nerve ablation: This involves using radiofrequency signals to destroy the nerves causing pain.
  • Tendon or ligament repairs: Surgery may involve stitches to repair a tear or placement of an artificial or donated ligament or tendon.
  • Open reduction/internal fixation (ORIF): This procedure involves exposing the bone through an incision and installing hardware such as plates or screws.
  • Joint-salvaging procedures: These involve replacing diseased bone with bone grafts or an artificial material that stimulates new bone growth. Your doctor may recommend this kind of procedure for avascular necrosis.
  • Hip arthroplasty: This involves the replacement of the ball of your femur, your hip socket, or both. Total hip arthroplasty is when both parts are replaced. Hip hemiarthroplasty is when only one part is replaced. Hip arthroplasty can offer significant improvement in pain and function.

Outlook

The outlook for someone with hip pain depends on the cause. For some people, conservative therapies alone may provide relief and functional improvement. Others may require more intensive care.

It is important to follow the treatment plan you discuss with your doctor. This is the best way to ensure pain relief and restore hip function.

Risk factors

Risk factors for hip pain can include the following:

  • obesity
  • female sex assigned at birth
  • high activity causing overuse injuries
  • older age
  • history of accident or injury
  • history of spine problems
  • alcohol or tobacco use

Prevention

Not all causes of hip pain are preventable. However, there are some steps you can take to help prevent hip pain. These include:

  • Avoiding falls: Minimizing the risk of falls is key to preventing fractures. Some ideas include:
    • removing loose rugs
    • clearing pathways in your home
    • turning lights on before walking at night
    • installing grab bars in the bathroom
    • staying active to maintain strength and balance
    • ensuring stair rails are sturdy and secure
  • Maintaining a moderate weight: Obesity is a risk factor for hip pain. Working with a dietitian or exercise specialist can help you maintain a moderate weight.
  • Preventing overuse injuries: Stretching, warming up, and increasing exercise slowly may help prevent overuse injuries.

When to see a doctor

Contact your doctor about hip pain if you have:

  • sudden onset of pain
  • severe pain
  • inability to bear weight on the affected leg
  • pain after a fall or accident
  • pain accompanied by leg deformity, such as one leg appearing shorter than the other

You should also contact your doctor if you experience a fall. They can help you create a fall prevention plan.

Summary

Some causes of hip pain are temporary and manageable with certain lifestyle changes. Others may require medications or surgery.

Contact your doctor if your hip pain is severe, sudden, or follows an accident or injury. They can determine the cause of your hip pain and help you create a treatment plan.

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Medical Reviewer: Angela M. Bell, MD, FACP
Last Review Date: 2023 Feb 3
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