Hip pain is a common symptom that can be described as aching, sharp, or burning. It can range in intensity from mild to severe.
There are many possible causes of hip pain. They include serious ones, like a fracture or joint infection, and less serious causes, like bursitis. Your healthcare provider can diagnose the cause and help to plan your treatment. Pneumatic Elbow
This article presents information about the potential causes of hip pain. It will help you to learn more about these conditions and the measures used to achieve the best outcomes possible.
Note: Hip pain in children is assessed differently than in adults. This article focuses on hip pain in adults.
The hip is a large "ball-and-socket" joint. The "socket" is a bone in your pelvis called the acetabulum and the "ball" is the head of your femur. It is the upper part of the long bone in your leg.
The hip joint is held in place by ligaments and covered in cartilage, a smooth, white tissue that allows the hip to move with ease. Fluid-filled sacs called bursae provide cushioning to prevent friction between muscles, tendons, and bones in the hip joint.
The hip also contains a network of muscles that enable movement and support. These include:
Problems with any of these structures can contribute to hip pain.
There are common patterns of hip pain. The location of your hip pain—anterior, lateral, or posterior—and how the pain feels can help your healthcare provider pinpoint the problem.
Hip pain while walking can be caused by conditions that affect the muscles, tendons, or the hip bone's blood supply. For example, snapping hip syndrome can be caused by tendons getting caught on a prominent area of bone in the hip area.
Hip pain is common in pregnancy. That's because of the many changes taking place in the body, such as changes in your muscles and bones. One study found that pain is most common during the third trimester.
Seek immediate medical care for hip pain that is:
Moderate hip pain should be evaluated by a healthcare provider if accompanied by:
Mild hip pain that lasts longer than six weeks should also be evaluated.
Anterior hip pain affects the inside of your hip and groin area.
Osteoarthritis of the hip occurs when the cartilage in the hip joint slowly wears away over time. The cartilage can break down due to advancing age or because of a prior hip injury. This can cause bones of the joint to begin to rub on each other.
With hip osteoarthritis, pain may be dull, aching, or sharp, and the pain and stiffness can get worse with activity and improve with rest.
The main symptom of hip arthritis is mild to severe pain in or around the hip. It can be described as aching, sharp, burning, throbbing, or dull.
Inflammatory arthritis may affect the hip, resulting in dull, aching pain.
This type of hip pain often will ease with activity.
A hip fracture, which is a break in the upper quarter of the thigh bone, causes deep pain. You feel it in the outer part of the upper thigh or groin area. These breaks can happen after a fall or a direct blow to the hip.
Stress fractures of the hip can develop due to recurrent physical pressure, and are most common in female athletes who have the "female athlete triad."
This triad includes three health conditions:
Steroid drug use, a history of smoking, and other medical conditions that can weaken the bone, like cancer or osteoporosis, are also risk factors for hip stress fractures.
With a stress fracture, you may feel a gradual onset of pain that gets worse when bearing weight on the legs and hips. A traumatic fracture causes sudden and severe pain.
Bursitis is an irritation or inflammation of the bursa. These are small, fluid-filled sacs that serve as a cushion between joints, muscles, and tendons. The iliopsoas bursa, located on the inner or groin side of your hip, causes anterior hip pain if inflamed.
Iliopsoas bursitis is most common in runners or soccer players. It causes anterior hip pain that may spread to the front of the thigh or into the buttock. Sometimes, you may feel a snapping, catching, or popping in the hip with this type of bursitis.
There are a few types of hip bursitis. Iliopsoas bursitis causes pain in the front of the hip that spreads down the front of the thighs or toward the buttocks. Outer hip pain passing down along the thigh and knee may be trochanteric bursitis.
A hip strain refers to a stretch or tear of a muscle, its nearby tendon, or both. Hip flexor muscles, such as the iliopsoas muscle or rectus femoris muscle, are often involved in a hip strain.
A hip flexor strain can be caused by overuse, as is the case with cyclists or soccer players. It also may result from trauma, such as a direct hit during a contact sport. In addition to anterior hip pain, these strains can cause swelling, limited movement, and muscle weakness.
Osteonecrosis of the hip is the death of bone cells, and it can cause destruction of the hip joint. It may occur due to insufficient blood supply to the hip bone. Many cases are due to corticosteroid drug use and excessive alcohol use.
Though rare, it can cause hip pain and groin pain that gets worse with walking, pain in the thighs, buttocks, and/or knees.
Your hip labrum is a band of cartilage-like tissue that runs around the outer rim of your hip socket. It helps to support the joint and deepen the socket. Overuse or an injury to your hip can cause a tear in your labrum, with pain that gets worse with weight-bearing.
In femoroacetabular impingement (FAI), bony growths develop around the hip joint. These growths can limit hip motion and eventually cause hip osteoarthritis and tears of the labrum.
The symptoms include an aching or sharp pain in the groin area that moves toward the outside of the hip. Often, you can feel the pain when you stand up after sitting for a long time. Stiffness and limping are also common.
It's uncommon, but sometimes the hip joint can be infected. This is called a septic joint.
Rarely, bone cancer that begins in the bone (primary cancer) or has spread from somewhere else in the body (metastatic) can cause bone pain.
Usually, the pain starts off being worse at night, and as the tumor grows, the pain often becomes constant. It can cause swelling around the hip, along with weight loss and fatigue. A hip fracture may occur because the bones are weakened.
Lateral hip pain refers to pain on the side of the hip.
Trochanteric bursitis causes sharp lateral hip pain that often spreads down into the thigh and knee. The pain is usually worse at night when sleeping on the affected hip. It also gets worse with activity, like walking or running.
Over time, the pain may evolve into a deep aching pain that spreads over a larger area of the hip. You may notice swelling or you might start to limp with the affected leg.
Snapping hip syndrome causes a snapping or popping sensation, possibly with lateral hip pain when walking or getting up from a chair. The actual "snapping" is due to one or more tight muscles, tendons, or other soft tissue moving over a bony structure within your hip.
One commonly affected "tight" or irritated tissue is the iliotibial band (IT band). This thick collection of connective tissue starts at the hip and runs along the outer thigh. The snapping sound comes from where the IT band passes over the upper part of the thigh bone.
This condition is most common in people who engage in sports or activities that involve frequently bending at the hip. For this reason, it also is known as "dancer's hip."
Posterior hip pain affects the outside of the hip or buttock area, usually due to a problem with the muscles, tendons, or ligaments that surround the hip joint, rather than the actual joint itself.
Muscle strains are small tears that are usually caused by a quick twist or pull to the muscle. When this affects the hamstring muscles around the hip joint, it causes buttock pain and/or pain in the back of the hip.
The sacroiliac (SI) joints on each side of the body connect the lower spine to the pelvis.
Various problems with the SI joint, including arthritis of the joint, infection of the joint, and injury to the joint ligaments, may cause posterior hip pain that may spread out from the hip and down the back of the leg. The sharp or burning pain is often worse with standing and walking.
Piriformis syndrome, also called deep gluteal syndrome, occurs when the sciatic nerve (a large nerve that branches off from your lower back into your hip, buttock, and leg) becomes irritated or compressed by the piriformis muscle. This muscle is deep within the buttock, near the top of the hip joint.
The burning or aching pain of this syndrome usually begins in the posterior hip and buttock region and moves down the back of the thigh.
A medical history and physical exam by a healthcare provider are essential for a proper diagnosis. Your healthcare provider will likely order imaging tests or blood tests.
A healthcare provider will ask you questions about your pain.
Your healthcare provider will view and press on a few "landmark" sites within your hip, leg, lower back, and abdomen. They may also perform a neurological exam to assess muscle weakness and reflexes.
It's likely they will move your hip around to evaluate its range of motion, look at the way you walk (your gait), and check your overall posture and ability to bear weight.
They may also perform more specific tests, such as the FABER test, straight leg test, leg roll test, or Trendelenburg test.
The FABER test (its name stands for flexion, abduction, and external rotation) is used to diagnose some hip problems, such as hip osteoarthritis or hip labrum tear.
You'll be lying flat on your back for this test while the provider flexes your leg and then puts your ankle from the same side as the affected hip just above the kneecap on the opposite leg. They'll press down on the knee from the affected side in order to lower the leg.
The test is positive if pain occurs at the hip joint, or if the knee and leg from the affected side cannot be lowered into a parallel position with the opposite leg.
Imaging tests may be needed to confirm or support a diagnosis for your hip pain.
Blood tests may be ordered in some specific circumstances. For instance, your healthcare provider will likely order a white blood cell count, blood cultures, and a test for inflammatory markers in the blood if an infected joint is suspected.
A hip aspiration, which uses a needle to remove synovial fluid from the hip joint, is usually taken to both diagnose and treat septic arthritis.
Some conditions that don't involve the hip can cause hip pain and may be considered during an evaluation of hip pain.
A kidney stone can cause severe pain in the flank area between the top of your hip and the bottom of your ribcage in your back. The pain may spread out to your groin or inner thigh.
Meralgia paresthetica refers to compression of the lateral femoral cutaneous nerve, a sensory nerve that passes under the inguinal ligament in the groin area. Besides a burning pain in the upper-outer thigh, it can cause numbness and tingling.
This condition is most common in older adults and people who have diabetes. Obesity, pregnancy, and wearing tight pants or belts will also increase the risk of developing this condition.
Aortoiliac occlusive disease refers to a blockage of the aorta, the main blood vessel in your body, and the iliac arteries, which branch off from the aorta near your belly button. A blockage causes aching, cramping pain in the buttock, hip, and/or thigh.
This pain gets worse with exercise and will ease with rest. The condition is most often caused by atherosclerosis when plaque builds up in the blood vessel walls, causing them to narrow so much that blood flow to the legs and groin is impaired.
An irritated nerve in the lower spine can cause pain that feels like burning or tingling in or around the hip joint. This condition, called lumbar radiculopathy , can be diagnosed with an MRI of the lower spine.
The treatment of hip pain depends on the diagnosis. Common elements of a treatment plan include self-care, medication, physical therapy, and surgery.
Your healthcare provider may recommend a number of self-care strategies.
A few examples of these strategies include:
Medications, such as Tylenol (acetaminophen) or an over-the-counter nonsteroidal anti-inflammatory (NSAID), are used to ease hip pain related to osteoarthritis and femoroacetabular impingement.
Opioids, which are stronger drugs for pain, may be needed to treat pain from a hip fracture or an infected hip joint.
Other drugs may be needed, depending on your diagnosis. A disease-modifying anti-rheumatic drug (DMARD) can be used to treat rheumatoid arthritis. Intravenous (IV) antibiotics can be used to treat an infected joint.
Physical therapy is a cornerstone of the treatment for many causes of hip pain. It is meant to improve strength, flexibility, and mobility in your hip.
A physical therapist may use massage, ultrasound, heat, and ice to soothe inflammation. They may also offer guidance on returning to sports or other activities.
Surgery may be required for the treatment of a hip fracture. Sometimes worsening osteoarthritis may be treated with a total hip replacement. A hip arthroscopy may be used to repair a torn hip labrum.
You may not be able to prevent all causes of hip pain, but there are several things you can do to be proactive about it:
Hip pain is usually described by a location: anterior (front), lateral (side), or posterior (back). The site may help point to the cause.
Common causes include muscle strain or osteoarthritis, and less common reasons may specifically affect athletes or dancers, such as the snapping hip syndrome. Your healthcare provider will need to diagnose the condition to ensure the right treatment.
See a healthcare provider promptly if your hip pain is severe, comes on suddenly, or is associated with other symptoms, like a fever or swelling.
Lespasio MJ, Sultan AA, Piuzzi NS, et al.Hip osteoarthritis: a primer.Perm J. 2018;22:17–084.doi:10.7812/TPP/17-084
Arthritis Foundation. Anatomy of the hip.
Chamberlain R. Hip pain in adults: evaluation and differential diagnosis. Am Fam Physician. 2021;103(2):81-89.
Battaglia PJ, D'Angelo K, Kettner NW. Posterior, lateral, and anterior hip pain due to musculoskeletal origin: a narrative literature review of history, physical examination, and diagnostic imaging. J Chiropr Med. 2016;15(4):281–293. doi:10.1016/j.jcm.2016.08.004
Kesikburun S, Güzelüçük Ü, Fidan U, Demir Y, Ergün A, Tan AK.Musculoskeletal pain and symptoms in pregnancy: A descriptive study.Therapeutic Advances in Musculoskeletal Disease, 2018;10(12):229–234.doi:10.1177/1759720X18812449
U.S. National Library of Medicine: MedlinePlus. Hip pain.
American Academy of Orthopaedic Surgeons: OrthoInfo. Osteoarthritis of the hip.
Kim Y, Oh HC, Park JW, et al. Diagnosis and Treatment of Inflammatory Joint Disease. Hip Pelvis. 2017;29(4):211–222. doi:10.5371/hp.2017.29.4.211
American Academy of Orthopaedic Surgeons: OrthoInfo. Hip fractures.
Nemours: TeensHealth. Female athlete triad.
Pisani P, Renna MD, Conversano F, et al. Major osteoporotic fragility fractures: Risk factor updates and societal impact. World J Orthop. 2016;7(3):171–181. doi:10.5312/wjo.v7.i3.171
Zapparoli FY, Riberto M. Isokinetic evaluation of the hip flexor and extensor muscles: a systematic review. J Sport Rehabil. 2017;26(6):556-566. doi:10.1123/jsr.2016-0036
An YS, Park S, Jung JY, Suh CH, Kim HA. Clinical characteristics and role of whole-body bone scan in multifocal osteonecrosis. BMC Musculoskelet Disord. 2019;20(1):23. doi:10.1186/s12891-019-2401-y
Pun S, Kumar D, Lane NE. Femoroacetabular impingement. Arthritis Rheumatol. 2015;67(1):17–27. doi:10.1002/art.38887
Long B, Koyfman A, Gottlieb M. Evaluation and management of septic arthritis and its mimics in the emergency department. West J Emerg Med. 2019;20(2):331–341. doi:10.5811/westjem.2018.10.40974
Mantyh PW. Bone cancer pain: from mechanism to therapy. Curr Opin Support Palliat Care. 2014;8(2):83–90. doi:10.1097/SPC.0000000000000048
Reid D. The management of greater trochanteric pain syndrome: A systematic literature review. J Orthop. 2016;13(1):15–28. doi:10.1016/j.jor.2015.12.006
American Academy of Orthopaedic Surgeons: OrthoInfo. Snapping hip.
Tyler TF, Fukunaga T, Gellert J. Rehabilitation of soft tissue injuries of the hip and pelvis. Int J Sports Phys Ther. 2014;9(6):785–797. PMID: 25383247
Moscote-Salazar LR, Alvis-Miranda HR, Joaquim AF, Amaya-Quintero J, Padilla-Zambrano HS, Agrawal A. Sacroiliac pain: a clinical approach for the neurosurgeon. J Neurosci Rural Pract. 2017;8(4):622–627. doi:10.4103/jnrp.jnrp_171_17.
U.S. National Library of Medicine: MedlinePlus. Piriformis syndrome.
Martin HD, Palmer IJ. History and physical examination of the hip: the basics. Curr Rev Musculoskelet Med. 2013;6(3):219–225. doi:10.1007/s12178-013-9175-x
Fujita K, Kabata T, Kajino Y, et al. Quantitative analysis of the Trendelenburg test and invention of a modified method. J Orthop Sci. 2017;22(1):81-88. doi:10.1016/j.jos.2016.09.007
Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. Am Fam Physician. 2014;89(1):27-34.
Bagwell JJ, Bauer L, Gradoz M, Grindstaff TL. The reliability of FABER test hip range of motion measurements. Int J Sports Phys Ther. 2016;11(7):1101-1105.
Annabell L, Master V, Rhodes A, Moreira B, Coetzee C, Tran P. Hip pathology: the diagnostic accuracy of magnetic resonance imaging. J Orthop Surg Res. 2018;13(1):127. doi:10.1186/s13018-018-0832-z
U.S. National Library of Medicine: MedlinePlus. Osteomyelitis.
Chung C, Stern PJ, Dufton J. Urolithiasis presenting as right flank pain: a case report. J Can Chiropr Assoc. 2013;57(1):69–75. PMID: 23483000
National Institute of Neurological Disorders and Stroke. Meralgia paresthetica.
Kita K. Leriche syndrome (Aortoiliac occlusive disease). J Gen Fam Med. 2017;18(5):297–298. doi:10.1002/jgf2.63
Tawa N, Rhoda A, Diener I. Accuracy of magnetic resonance imaging in detecting lumbo-sacral nerve root compromise: a systematic literature review. BMC Musculoskelet Disord. 2016;17(1):386. doi:10.1186/s12891-016-1236-z
Hsu JR, Mir H, Wally MK, Seymour RB; Orthopaedic Trauma Association Musculoskeletal Pain Task Force. Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury. J Orthop Trauma. 2019;33(5):e158–e182. doi:10.1097/BOT.0000000000001430
Köhler BM, Günther J, Kaudewitz D, Lorenz HM. Current Therapeutic Options in the Treatment of Rheumatoid Arthritis. J Clin Med. 2019;8(7):938. doi:10.3390/jcm8070938
Ross JR, Larson CM, Bedi A. Indications for Hip Arthroscopy. Sports Health. 2017;9(5):402–413. doi:10.1177/1941738117712675
National Institute on Aging. Falls and fractures in older adults: causes and prevention.
Higgs J, Derbyshire E, Styles K. Nutrition and osteoporosis prevention for the orthopaedic surgeon: A wholefoods approach. EFORT Open Rev. 2017;2(6):300–308. doi:10.1302/2058-5241.2.160079
By Laura Inverarity, DO Laura Inverarity, PT, DO, is a current board-certified anesthesiologist and former physical therapist.
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