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Hip Joint Stiffness Symptoms, Causes & Common Questions

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Last updated January 24, 2022

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Understand hip joint stiffness symptoms, including 6 causes & common questions.

Stiff hip quiz

Take a quiz to find out what's causing your stiff hip.

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Hip joint stiffness symptoms

When a hip joint becomes stiff, painful, and hard to move, it is difficult to leave it be and work around it. The back and the knees, especially, end up taking on extra strain and can be severely affected. Even staying completely still may not provide relief.

However, there are effective treatments and therapy for most conditions that cause stiffness and pain in the hip. Your medical provider can refer you to a specialist if needed.

Hip joint stiffness may also be called ankylosis of the hip.

Common characteristics of hip joint stiffness

Hip joint stiffness can commonly be described by the following details.

  • Difficulty with movement: You may have trouble forcing the hip joints to flex or move, especially after sitting or lying down for a while.
  • Varying pain levels: Pain may range from mild to severe, and may be felt in the groin and thigh as well as the hip.
  • Inflammation: Heat and swelling in the hip joint may occur.
  • Spreading symptoms: Other joints, especially the neck and back, may also be affected.
  • Pain with exercise: This pain may be severe enough to interfere with walking. However, it may worsen after resting and improve with mild exercise. Although, heavy exercise usually causes pain as well.

Duration of symptoms

Your hip joint stiffness may be short- or long-term depending on the cause.

  • Acute form: If there is a sudden severe injury, the pain will happen immediately and stiffness will continue after healing.
  • Chronic form: Symptoms come on gradually, following a minor injury or the onset of disease, and may continue for years with little change even when treated.

Who is most often affected?

People who are most likely to experience hip stiffness include the following:

  • People who have had a hip joint injury or disease
  • People who have had a total hip replacement
  • Anyone over age 50
  • Anyone with Down syndrome

When is it most likely to occur?

Hip joint stiffness is more likely to occur in the morning or after getting up if you were seated for a long time.

Is hip joint stiffness serious?

Hip joint stiffness may vary in severity depending on the cause.

  • Not serious: Mild stiffness that occurs after heavy exercise, but goes away after a day or two of rest is not serious.
  • Moderately serious: Increasing pain and stiffness, even with treatment indicates a moderately serious condition.
  • Serious: Any suspicion of a hip fracture is considered serious.

Hip joint stiffness causes

Many conditions can cause the symptom of hip joint stiffness. We've listed several different causes here, in approximate order from most to least common.

Joint damage

Abnormal fusing and stiffening of a joint can occur due to the body's attempt to protect it after damage. Injury or disease processes can cause this to occur in the hip.

Cartilage wear or destruction

Destruction of the cartilage lining the joint can occur due to:

  • Wear-and-tear: This is especially likely if there is some slight malformation of the joint that predisposes it to wear.
  • Inflammation: This may be caused by any of several types of autoimmune disease.

Damage to the hip bursa

The hip joint is formed by the ball at the top of the thigh bone that fits into the socket of the pelvic bone. The outside of the ball has a tendon, the iliotibial band, running down it. There is a bursa, or cushion, under the iliotibial band.

  • Injury: The bursa may become injured through direct trauma, leading to a condition called bursitis.
  • Tight iliotibial (IT) band: The bursa is pressed against the bone, causing inflammation, pain, and difficulty moving. Prolonged sitting and a lack of fitness can leave the band short and tight instead of stretched and flexible. Pain and stiffness may travel to the knee, where the iliotibial band attaches at its other end.

Surgery

Stiffness may follow hip replacement surgery due to the following below. However, even with successful surgery, some stiffness may remain.

  • Wear of replacement parts: If this occurs, another replacement may be needed.
  • Additional bone growth: In a few patients, an overgrowth of bone may form around the replacement parts. Further treatment or surgery will be needed.

Formation of scar tissue

Formation of fibrous scar tissue in the soft tissues around the hip joint can lead to stiffness and may be caused by:

  • Traumatic injury
  • Damage following a disease process
  • Inflammation from autoimmune disease

Rare and unusual causes

Certain rare causes of hip joint stiffness may include the following:

  • Down syndrome: Tightness and tension in the hips may be compensation for muscle weakness commonly found elsewhere in the body in people with Down syndrome.
  • Inflammation from unknown causes: Sudden, severe inflammation of hip joints and muscles can even sometimes spread to the neck and shoulder.
  • Tumors: A cancerous growth within any joint can cause swelling and stiffness.

We've listed some specific conditions that can cause hip joint stiffness, along with how to identify each of them.

This list does not constitute medical advice and may not accurately represent what you have.

Septic arthritis

Septic arthritis is also called infectious arthritis. "Arthritis" simply means inflammation of a joint. In septic arthritis, the inflammation is caused by a bacterial, viral, or fungal infection. The most common agent is Staphylococcus aureus, or staph.

These agents reach the joints either from another infection in the body, or from a traumatic injury that contaminates the wounded joint.

Risk factors include existing joint disease or injury; a weakened immune system; and damaged skin. All of these things allow infectious agents to get a foothold.

Symptoms include severe pain in the affected joints, along with redness and swelling. The knees are most often affected but septic arthritis can occur in any joint.

The infection can damage cartilage and bone very quickly, so anyone with these symptoms should see a medical provider as soon as possible.

Diagnosis is made through a sample of the joint fluid; blood tests; and x-ray or CT scan of the joint.

Treatment involves draining the infected fluid from the joint, either with a needle or with surgery, followed by antibiotics.

Septic arthritis is also called infectious arthritis. "Arthritis" simply means inflammation of a joint. In septic arthritis, the inflammation is caused by a bacterial, viral, or fungal infection. The most common agent is Staphylococcus aureus, or staph.

These agents reach the joints either from another infection in the body, or from a traumatic injury that contaminates the wounded joint.

Risk factors include existing joint disease or injury; a weakened immune system; and damaged skin. All of these things allow infectious agents to get a foothold.

Symptoms include severe pain in the affected joints, along with redness and swelling. The knees are most often affected but septic arthritis can occur in any joint.

The infection can damage cartilage and bone very quickly, so anyone with these symptoms should see a medical provider as soon as possible.

Diagnosis is made through a sample of the joint fluid; blood tests; and x-ray or CT scan of the joint.

Treatment involves draining the infected fluid from the joint, either with a needle or with surgery, followed by antibiotics.

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Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.

Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.

Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.

Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.

If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.

Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.

There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.

Psoriatic arthritis

Psoriatic arthritis is a complication of psoriasis, which causes the skin to become thickened, red, and scaly. Arthritis may appear before or after the psoriasis appears.

Both conditions are autoimmune diseases, where the body attacks itself, and are thought to be caused by genetic and environmental factors.

Most susceptible are people from 30 to 50 years of age with a family history of the disease and who already have psoriasis.

Symptoms include the joints on one or both sides of the body becoming painful, swollen, and hot; swelling and deformity of the fingers and toes; pitted, flaking fingernails; foot pain in the heels and soles; and joint pain in the low back pain.

It is important to seek treatment, as psoriatic arthritis can permanently damage the joints, eyes, and heart.

Diagnosis is made through physical examination, x-rays, and MRI. Blood tests and joint fluid tests can confirm psoriatic arthritis.

Treatment includes over-the-counter, nonsteroidal anti-inflammatory drugs; anti-rheumatic medication; immunosuppressants; and steroid injections for the joints. Surgery to replace damaged joints may also be tried.

Polymyalgia rheumatica

Polymyalgia rheumatica (PMR) is a chronic condition that involves inflammation, aching pain, and morning stiffness. It affects muscles close to the middle of the body, including the shoulders, hips, and back. Its cause is not known, but it is more common in people over 50 years old.

You should consider visiting a healthcare provider within the next day to discuss your symptoms. PMR can be evaluated with a review of your symptoms and medical history. Your provider may also perform a blood test. Once diagnosed, it can be treated with prescription steroid medication, which can improve symptoms within one week.

Hip strain

Hip strain means that a muscle and/or a tendon that supports one of the ball-and-socket joints of the hip has become overstretched or torn.

Most hip strains occur during sports or other physical work, though they can happen while doing ordinary activities. Both the pelvic bones and the femur, or thighbone, are large weight-bearing bones. The tendons, which attach muscles to these bones, can be subject to strain during hard work and are most vulnerable when the person is out of condition or did not warm up before exercising.

An acute strain happens suddenly, usually after a fall or other injury. It may be very painful and swollen, and interfere with movement. A chronic strain comes on gradually after weeks or months of overuse and may only produce some discomfort.

Once a muscle or tendon has been strained, it is vulnerable to being injured again if not treated.

Diagnosis is made through patient history, physical examination, and x-rays.

Treatment involves rest; ice; nonsteroidal anti-inflammatory drugs to reduce pain and swelling; physical therapy; and sometimes surgery.

Hip arthritis

Arthritis of the hip is inflammation of one or more of the joints in the hip. Pain, swelling, and stiffness are the primary symptoms of arthritis. Hip arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people.

The goal of hip arthritis treatment is to relieve pain and maintain the function of the hip. Your doctor will be able to suggest a future course of action, such as pain medication, walking aids, or changing to more appropriate footwear.

Rarity: Common

Top Symptoms: hip pain, difficulty walking, pain in one hip, limping, groin pain

Symptoms that always occur with mild/moderate hip arthritis: hip pain

Symptoms that never occur with mild/moderate hip arthritis: severe hip pain

Urgency: Primary care doctor

Greater trochanteric pain syndrome

Greater trochanteric pain syndrome, also called trochanteric bursitis or GTPS, is an inflammation of the bursa of the greater trochanter.

Bursae are the small "cushions" between tendons, bones, and muscles. The greater trochanter is the larger of two bony knobs at the top of the thigh bone. Overuse, trauma, or infection can cause inflamed and irritated bursae around the greater trochanter.

Most susceptible are individuals with low back pain, osteoarthritis, and obesity.

Symptoms include chronic, persistent pain on the outside of the hip that radiates down the outside of the leg, sometimes to the knee.

The symptoms are similar to other conditions such as degenerative joint disease, and so a medical provider should be seen for an accurate diagnosis.

Diagnosis is made through physical examination and observation of simple movements.

Treatment largely involves managing the symptoms through weight loss, physical therapy, and over-the-counter nonsteroidal anti-inflammatory drugs. In some cases, corticosteroid injections into the hip work well to relieve pain, and surgery can sometimes help.

Fibromyalgia

Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

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Femoral stress fracture

Femoral stress fracture means there is a break in the femur, or thighbone. The femur is the largest and strongest bone in the body and is important for bearing weight. A femoral stress fracture usually occurs in the top of the bone where it connects to the pelvis.

Stress fractures happen from overuse and/or from weakness in the bone from disease, rather than from trauma. Those in heavy physical training, such as athletes and military trainees, are vulnerable to femoral stress fracture. But anyone suffering from malnutrition or osteoporosis is vulnerable to a stress fracture, even with ordinary activities of daily living.

Symptoms include pain deep in the thigh or groin, especially during exercise. The pain may have started gradually instead of being sudden, as with a traumatic injury. The condition might be thought to be a simple strain.

Diagnosis is made through physical examination, with simple tests such as hopping on the painful leg, and imaging.

Treatment involves rest; improved nutrition; study of proper training and striding techniques; and sometimes surgery.

Ankylosing spondylitis

"Ankylosing" means a joint has become stiffened and fixed in one position due to injury or disease. "Spondylitis" means inflammation in the joints of the spine.

In ankylosing spondylitis, inflammation has damaged the vertebrae of the low back and caused a form of arthritis, leaving the lower spine inflexible.

The exact cause is unknown. It is thought to be an inherited, abnormal immune response that is triggered following damage to the lining of the intestines.

Most susceptible are those with a family history of ankylosing spondylitis and a history of intestinal damage from illness. However, anyone can be affected at any age.

Symptoms include pain and stiffness in the back and hips, and sometimes in the neck and shoulders. The pain will be worse during sleep and rest.

Early treatment can help to manage the symptoms, prevent complications, and improve quality of life.

Diagnosis is made through physical examination and x-rays.

Treatment involves nonsteroidal anti-inflammatory drugs; new forms of biologic medications; physical therapy; and, in some cases, surgery to repair damaged joints.

Hip joint stiffness treatments and relief

As long as your hip joint stiffness or associated pain is not severe or debilitating, treatment can begin at home. However, if stiffness persists, you should consult your physician.

At-home treatments

Various treatments can be tried at home to try to alleviate your hip stiffness.

  • Walking aids: You may choose to use a cane or walker to help with getting around for activities of daily living.
  • Mild regular exercise: You can try low-impact exercises such as walking, yoga, or swimming.
  • Stretching exercises: This may be especially helpful for a tight iliotibial band.
  • Lifestyle changes: You can make adjustments in your diet, sleep habits, and work on stress management to improve overall health.

Medical treatments

You should consult your physician in order to discuss the following:

  • If your stiffness persists despite rest
  • Possible physical therapy

Seek immediate treatment in the emergency room or call 911 for the following

If you cannot move or bear weight on the hip at all, this may be a hip fracture, which can actually be life-threatening in the elderly.

FAQs about hip joint stiffness

Does osteoporosis (bone thinning) cause stiffness of the hip?

No. At first, osteoporosis causes no outward symptoms at all. Once the disease has progressed, later symptoms may include pain once the bones have become weakened enough to sustain stress fractures. Osteoporosis can be especially serious in the hip because of the hip's weight-bearing function. The bone can actually give way under the body's own weight.

Does hip joint pain and stiffness always lead to hip replacement surgery?

No, not always. Hip replacement surgery is most often done to replace a joint severely damaged by arthritis, and people nearly always see great improvement in their quality of life. Hip replacement is also done in cases of ankylosis (spontaneous fusing of bone after injury or disease) and in cases where trauma has directly damaged the joint.

Does sciatica cause hip joint stiffness?

Sciatica is a general term for shooting pain caused by pressure on the sciatic nerve, in the low back. Sciatica does not usually affect the hip; however, a condition called piriformis syndrome occurs when the piriformis muscle in the low back becomes inflamed and presses on the sciatic nerve. This causes pain, numbness, and tingling, but not stiffness.

Does hip joint stiffness always mean arthritis?

No. A number of other conditions can cause stiffness without involving loss of cartilage in the joint (arthritis). A previous traumatic injury with resulting damage and scar tissue; one of many autoimmune diseases, which cause inflammation; and short, tight hip muscles and tendons due to loss of fitness can all cause hip joint stiffness.

Does fibromyalgia cause hip joint stiffness?

Fibromyalgia is a type of autoimmune disease. It causes chronic musculoskeletal pain throughout the body, exhaustion and sleep disturbance, headaches, anxiety and depression, and stiffness in the joints and muscles. The pain is believed to be caused by inflammation and may come and go in intensity. Stiffness may appear in any joint in the body.

Questions your doctor may ask about hip joint stiffness

  • Any fever today or during the last week?
  • Do you have multiple joints that are stiff?
  • Have you had any changes in your weight?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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