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Hip Pain: Why You May Have Hip Pain & How to Reduce It

Hips with green underwear and high green socks. Red splotches spread over the right hip.
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Written by Jack Wilkinson, MD.
Fellow, Cornell/Columbia New York Presbyterian Child Psychiatry Program
Medically reviewed by
Certified Nurse Midwife, Takoma Park Gynecology
Last updated April 16, 2024

Hip pain quiz

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Understand your hip pain symptoms with Buoy, including 10 causes and common questions concerning your hip pain.

Hip pain symptoms

Whether it's sharp, aching, or throbbing, hip pain can be a fact of life for many of us, especially as we get older. The hip joint is at work whenever we're on the go, so it's vulnerable to injury or wear-and-tear. Since the area around the hip also contains many muscles, ligaments, cartilage, and nerves, pain may also come from outside the joint.

Many people think that hip pain is only a problem for older adults. That's often true, and in some studies, more than 10 percent of people above age 60 complain of hip pain on a regular basis. Still, younger people are not immune to the problem, especially those who are active or participate in sports.

Common accompanying symptoms of hip pain

If you're experiencing hip pain, it's also likely to experience:

Hip pain causes and conditions

The hip is a ball-and-socket joint where the head of the leg bone (the ball) fits snugly into the pelvis (the socket). In most people, this setup is very secure and the hip functions well to support our weight and keep us moving. Sometimes, though, trauma like a fall or sports injury can knock the joint out of place leading to pain and other symptoms. Irritation from overuse and breakdown of the body's natural padding is also common. Aging weakens both bones and padding, making injury more likely. Certain medical conditions can also impact the hip joint even when direct injury has not occurred.

Trauma

Trauma to the hip can quickly result in hip pain.

  • Fracture: The upper leg bone (called the femur) can break in older people even after a minor injury. Younger people are usually impacted after more serious trauma.
  • Dislocation: In some cases, the femur can pop out of its socket, causing intense hip pain until it is put back into place.
  • Sprain: Other injuries can tear or strain the ligaments of the hip joints, which work to connect bones together, even if the bones themselves are uninjured.

Musculoskeletal causes

Musculoskeletal causes of hip pain may include the following.

  • Arthritis: This is irritation that occurs in the joint, usually after years of use that causes breaks in natural padding.
  • Bursitis: The lubricating fluid that sits between muscles, tendons, and bones near the hip joint can become painfully inflamed.
  • Nerve entrapment: Direct compression of a nerve in or around the joint can produce intense discomfort that is often described as shooting or radiating.

Other causes of hip pain

Other causes of hip pain may include the following.

  • Infection: Bacteria can enter the hip joint directly through a break in the skin or through the bloodstream, leading to a joint that is painful and often red, hot, or swollen.
  • Blocked blood flow: The hip joint requires regular blood flow to stay healthy, but the blood vessels that lead there can sometimes become blocked. If without blood for long enough, some of the bone can die.
  • Medications: Certain medications such as steroids and fluoroquinolone antibiotics (Cipro, Levaquin) increase the risk of problems with the hip joint.
  • Cancer: Pain in the hip and back more rarely may result from cancer that has usually spread from other organs.

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

Hip pain quiz

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Snapping hip syndrome

Snapping hip syndrome is an audible snap in a hip during movement, which may be accompanied by pain, locking, or a sharp stabbing sensation. This often happens in athletes, especially soccer players, weight-lifters, runners, and ballet dancers.

You can treat this at home by avoiding aggravating exercises, stretching, and NSAIDs. If things keep bothering you, a doctor can offer an anesthetic or corticosteroid injection to calm things down.

Rarity: Common

Top Symptoms: hip pain, snapping or clicking sensation of the hip, hip pain from overuse, popping hip, clicking sensation in the hip

Symptoms that always occur with snapping hip syndrome: snapping or clicking sensation of the hip

Urgency: Self-treatment

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.

Piriformis syndrome

Piriformis syndrome

The two piriformis muscles, left and right, each run from the base of the pelvis to the top of the thighbone. The two sciatic nerves, left and right, are each attached to the spine and run down between the pelvic bone and the piriformis muscle to the back of each leg.

If the piriformis muscle is damaged through sudden trauma, or through overuse as in sports, the resulting inflammation or spasm of the muscle can trap the sciatic nerve between the pelvic bone and the muscle.

Piriformis syndrome is most often found in women over 30.

Symptoms include pain over one or both sides of the low back, and shooting pain (sciatica) down one or both legs.

Diagnosis is made through physical examination and sometimes imaging such as CT scan or MRI.

Treatment involves rest; over-the-counter, nonsteroidal anti-inflammatory drugs; physical therapy; therapeutic injections; and, rarely, surgery.

The best prevention is a good regimen of stretching before exercise, to help prevent damage to the piriformis.

Rarity: Common

Top Symptoms: pelvis pain, butt pain, pain when passing stools, leg numbness, hip pain

Symptoms that never occur with piriformis syndrome: involuntary defecation, leaking urine

Urgency: Primary care doctor

Mild/moderate 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

Iliotibial (IT) band syndrome ('runner's knee')

Iliotibial band syndrome is also called ITBS or IT syndrome. The iliotibial band is a long, thick piece of connective tissue that begins at the top of the hip bone, runs down the outside of the leg, and attaches at the side of the knee.

ITBS is an overuse syndrome. Athletes in heavy training are susceptible to it, for example, runners and cyclists. Pain and inflammation result if the far end of the iliotibial band constantly rubs against the outside of the knee joint.

Symptoms include pain on the outside of the knee, especially while running or while sitting with the knee flexed.

Diagnosis is made through patient history and physical examination, with simple stretching tests to identify the exact location of the pain. An MRI is sometimes ordered.

Treatment involves rest; ice; over-the-counter nonsteroidal anti-inflammatory drugs; stretching exercises for the iliotibial band; strengthening of the upper leg muscles; and, if needed, changes in the way the person strides or trains. Corticosteroid injections can be helpful and surgery may be tried in some cases.

Rarity: Common

Top Symptoms: knee pain, pain in one knee, dull, achy knee pain, knee pain that gets worse when going down stairs, sharp knee pain

Symptoms that always occur with iliotibial (it) band syndrome ('runner's knee'): knee pain

Urgency: Primary care doctor

Iliopsoas bursitis

Bursae are small fluid-filled sacks located around the body in strategic locations to provide a cushion and help reduce friction. Iliopsoas bursitis, or hip bursitis, is an inflammation of the hip bursa, causing pain at the point of the hip. The pain may extend to the outside of the thigh area.

You should visit your primary care physician. Treatment for this condition usually involves avoiding activities that worsen the symptoms, over-the-counter pain medication, physical therapy, and steroid injections. Surgery is rarely needed.

Rarity: Uncommon

Top Symptoms: thigh pain, groin pain, limping, snapping or clicking sensation of the hip, pain in the front of the hip

Symptoms that never occur with iliopsoas bursitis: fever, back pain, butt pain from an injury, pain in both hips, unmovable hip lump, hard hip lump, back pain that shoots down the leg

Urgency: Primary care doctor

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.

Rarity: Common

Top Symptoms: pain in one hip, moderate hip pain, mild hip pain, difficulty moving the hip, swelling of one hip

Symptoms that always occur with hip strain: pain in one hip

Urgency: Self-treatment

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.

Rarity: Common

Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache

Symptoms that always occur with fibromyalgia: arthralgias or myalgias

Urgency: Primary care doctor

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 pain treatments and relief

The vast majority of hip pain symptoms can be taken care of at home with over-the-counter remedies, especially if there is no injury and the pain is mild. A doctor can provide additional hip pain treatment for pain that is more severe or gets in the way of everyday activity. A more comprehensive evaluation is often undertaken after injury, in older people, or if there are other concerning hip pain symptoms that may indicate a more serious problem.

At-home hip pain treatments

You can begin addressing your hip pain at home with the following remedies.

  • Rest: Since many cases of hip pain are caused by injury, it's best to take it easy for a few days, trying to avoid twisting, bending and excessive weight-bearing as much as possible.
  • Pain medication: Over-the-counter options like Tylenol and NSAIDs such as ibuprofen (Advil, Motrin) are good options for the management of mild to moderate hip pain.
  • Ice: Whether you use a proper icepack, or a wet cloth placed in the freezer, cold works to dull many causes of hip pain symptoms.
  • Heat: Some people may find that heating pads or hot water bottles ease discomfort, while others like to alternate heat and ice.
  • Stretching: Gentle, passive stretching should become part of a daily routine for anyone with hip pain symptoms.
  • Sleep with a pillow between the legs: A firm pillow helps keep your hips in line and reduces stress on the joints overnight, especially if you sleep on your side.

Hip pain treatment quiz

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Professional hip pain treatments

If your hip pain persists and at-home treatments are not enough, you should consult your physician. He or she may recommend the following.

  • Physical therapy: A professional can teach more advanced techniques and target therapy to the specific area of injury.
  • Imaging: A doctor may order X-rays or some other form of imaging like a CT or MRI to better evaluate the cause of your hip pain.
  • Steroid injections: If your hip pain stems from inflammation in a joint or the surrounding area, steroids can treat this problem directly and alleviate your discomfort.
  • Nerve blocks: An anesthetic can be injected directly into a nerve near the hip joint if a doctor determines that you are suffering from nerve pain.
  • Antibiotics: Suspected infections of the hip joint can be very damaging and should be treated without delay.
  • Surgery: Hip replacements can reduce pain dramatically in joints chronically damaged by wear-and-tear or other causes.

When hip pain is an emergency

You should seek help without delay if you have:

  • Serious injury to the hip: Especially if you have changes in sensation or your leg appears pale or cold
  • Fever and hip pain: Especially if the joint is red, hot, or swollen
  • A history of joint or bloodstream infections
  • Sickle cell disease
  • Been prescribed corticosteroids

FAQs about hip pain

Here are some frequently asked questions about hip pain.

Why is hip pain worse at night?

Hip pain at night that is constant may be a sign of a systemic illness including an infectious process, inflammatory process, or neoplastic (cancer). Most frequently, hip pain that is worse at night is a sign of an inflammation of the joint, but if you are experiencing constant hip pain that is worse at night, you should seek medical care.

Why do I have hip pain before my period?

Dysmenorrhea is pain that occurs during and just before a menstrual period. It can affect and usually does affect the lower abdomen but may also affect the hip. It may also be associated with premenstrual syndrome though usually this syndrome is signaled by pain in the breasts.

Can hip pain be related to back pain?

Yes, hip pain can be and is commonly related to back pain. A single process like osteoarthritis can cause both back and hip pain, and in some cases, back pain caused by a pinched nerve can lead to referred hip pain. Sometimes severe back pain leads to abnormal gait that may, over time, cause hip pain.

Why does my hip pain come and go?

Your hip pain may be due to a variety of reasons. If it is because of a particular activity (horseback riding, yoga, dancing), the pain should subside as the involved muscles and ligaments rest. Hip pain may also be due to a pinched nerve, in which case movements that further pinch the involved nerve may worsen pain, and movements that alleviate the pinched nerve will lessen the pressure.

Is hip pain a symptom of pregnancy?

Hip pain and joint pain generally can be symptoms of pregnancy. The weight of a gravid (pregnant) uterus (womb) can be enough to stretch and stress the joints of a woman's body. This includes her spine, pelvis, and knees as well as her hips. The additional body weight that most women put on can also stress the hips. The best remedies for hip pain in pregnancy are to make sure you have proper back support, to gain only as much weight as your physician recommends, and to rest when tired.

Questions your doctor may ask about hip pain

  • Do you feel a snapping or clicking sensation in your hip?
  • Do you run for exercise or sport?
  • Do your symptoms get worse when you exercise?
  • How would you explain why your hip hurts?

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

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Certified Nurse Midwife, Takoma Park Gynecology
Carina is a Nurse-Midwife with 20 years of clinical experience in both high- and low-risk obstetrical settings. She received her MS and BSN from Columbia University of Nursing. Most recently she has extended her scope of practice to include care for the peri/menopausal woman, and has NCMP (North American Menopause Society Certified Menopause Provider) certification in this area. Carina also has ex...
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References

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