Most hip pain, whether it is a sore outer hip, a groin ache or pain in the buttock, responds well to targeted exercise and a few sensible changes to how you sit, stand and sleep. Where you feel the pain and what sets it off tell us a lot about the cause.
At Tylurs com, our physiotherapists pinpoint the likely source of your pain, explain it in plain language and build a programme that fits your life.
Key takeaways
- Where you feel hip pain, outer hip, groin or buttock, is a strong clue to its cause.
- Outer hip pain is usually the gluteal tendons, once called trochanteric bursitis.
- Strengthening and avoiding positions that squash the tendons help most people.
- Being unable to bear weight after a fall, or a child with a painful limp, needs urgent help.
Common symptoms of hip pain
Hip problems can show up in several ways. People most often describe:
- Ache or tenderness on the outside of the hip
- Pain when lying on your side at night
- Groin pain when walking or putting on socks
- Stiffness after sitting or first thing in the morning
- Deep ache in the buttock
- Pain on stairs or standing on one leg
What causes hip pain?
The hip is a deep ball-and-socket joint wrapped in strong muscles and tendons, close to the lower back and pelvis. These are the causes we see most often.
Gluteal tendinopathy and trochanteric bursitis
Outer hip pain is very often greater trochanteric pain syndrome (GTPS): irritation of the gluteal tendons that attach your buttock muscles to the side of the hip, sometimes with a nearby bursa. It used to be called trochanteric bursitis, but the tendons are now thought to be the main source. It is most common in women from middle age, and lying on that side, stairs and crossing your legs typically aggravate it by squeezing the tendons against the bone.
Hip osteoarthritis
Osteoarthritis usually causes pain in the groin or front of the thigh, sometimes spreading to the knee, with stiffness after rest. Many people first notice it when putting on socks or getting out of a car becomes awkward. Symptoms often go up and down rather than steadily worsening.
Impingement and referred pain
In femoroacetabular impingement (FAI), the ball and socket pinch together at the end of deep movements, causing groin pain in younger, active adults. Lower back problems can also cause buttock or outer hip pain even when the hip is healthy; our guide to lower back pain explains more.
Hip pain symptoms by location
Only an assessment can confirm the cause, but location is a helpful clue.
| Where it hurts | Often made worse by | Common causes |
|---|---|---|
| Outer hip, tender to press | Lying on that side, stairs, crossing your legs | Gluteal tendinopathy or GTPS |
| Groin or front of the hip | Walking, putting on socks, deep squats | Hip osteoarthritis, FAI, groin strain |
| Buttock | Long sitting or bending, often with back stiffness | Referred pain from the lower back |
| Down the thigh towards the knee | Varies with the source | Hip osteoarthritis, sciatica |
Hip problems are sometimes felt mainly in the knee, especially in children and teenagers. If your knee hurts most, see our page on knee pain.
How we assess your hip
We ask when the pain began, where you feel it and how you are sleeping, then watch you walk, stand on one leg and squat, test hip and trunk strength, and check the lower back for referred pain. Most people do not need a scan: NICE advises diagnosing osteoarthritis from symptoms and examination in people aged 45 or over. Our guide to a first physiotherapy appointment shows how that session runs.
Physiotherapy treatment for hip pain
Exercise sits at the heart of treatment for almost every type of hip pain. At the Tylurs com physiotherapy clinic, your programme depends on what is driving symptoms and how irritable they are.
Strengthening the gluteal muscles
Your buttock muscles hold the pelvis level with every step. With gluteal tendinopathy we often start with gentle holds, such as pressing the side of your leg against a wall, then progress to bridges, sit-to-stands, step-ups and single-leg work. Some popular exercises, like side-lying leg lifts, can aggravate an irritated tendon, so we choose ones that load it without squashing it.
Exercise for hip osteoarthritis
NICE recommends tailored therapeutic exercise for everyone with osteoarthritis: strengthening the buttocks and thighs, keeping the joint supple, and walking, cycling or swimming. Pain may increase a little at first, but regular exercise is still good for your joints.
Hands-on care and walking aids
Joint mobilisation and soft tissue work can make exercise more comfortable, used alongside exercise. A walking stick in the opposite hand can reduce load during a flare-up, and our balance and falls prevention service helps if pain is affecting your steadiness.
Everyday changes that ease hip pain
- Avoid crossing your legs, and keep your knees roughly hip-width apart.
- Stand evenly on both feet rather than hanging on one hip.
- Choose higher chairs over very low, soft seats.
- Take shorter, more frequent walks, going easy on hills and stairs during flare-ups.
- Sleep on your back, or on the pain-free side with a pillow between your knees.
How long does hip pain take to improve?
Minor strains often settle within a few weeks. Gluteal tendinopathy usually needs three months or more of consistent exercise and load changes. Hip osteoarthritis is long term, but symptoms fluctuate and exercise can reduce pain. The NHS suggests seeing a GP if hip pain has not improved after two weeks of home treatment or is disturbing your sleep. If you need a hip replacement, the Tylurs com team can support your rehabilitation before and after surgery.
When to seek urgent medical help
- Being unable to stand or bear weight after a fall, or a leg that looks shorter or turned outwards, may be a hip fracture.
- A hot, swollen hip with a high temperature can signal joint infection and needs same-day help.
- A child or teenager with hip, thigh or knee pain and a limp needs urgent medical assessment.
- Numbness around the genitals or bottom, or bladder or bowel changes, need emergency care.
- Calf pain, swelling and warmth after hip surgery can signal a blood clot.
Book physiotherapy for hip pain
You do not have to keep putting up with a hip that disturbs your sleep or shortens your walks. Our physiotherapists work out where your pain is coming from and progress your exercises until your hip feels strong again. You can also browse other conditions we treat.
Book your hip assessment and get a clear plan for moving more comfortably.
Hip pain: frequently asked questions
Why does my hip hurt more when I lie on my side?
Lying on the painful side presses the gluteal tendons against the bony point of the hip, while lying on the other side lets the top leg drop across your body and squeeze the same tendons. Try lying on your back, or on your good side with a pillow between your knees.
Is pain in the groin a sign of hip arthritis?
It can be. Hip osteoarthritis typically causes groin or front-of-thigh pain, with stiffness after rest and difficulty putting on socks. But groin pain can also come from hip impingement, a muscle strain, a hernia or the lower back. A physiotherapist or GP can examine you and work out the likely cause.
Should I keep walking if my hip hurts?
In most cases, yes. Staying active keeps the hip muscles strong and the joint moving, while long rest leaves you weaker and stiffer. Try shorter, more frequent walks on flatter ground, with a walking stick if needed. If walking makes pain steadily worse from week to week, ask for an assessment.
Which hand should I hold a walking stick in for a painful hip?
Hold the stick in the hand opposite your painful hip. If your right hip hurts, use the stick in your left hand and move it forward with your right leg, which takes load off the sore side. Check the height too: your elbow should be slightly bent when holding the handle.
References
Sources reviewed by our physiotherapists for this guide:
