Overview

Hip pain is the general term for pain felt in or around the hip joint. It isn’t always felt in the hip itself but may instead be felt in the groin or thigh.

What causes hip pain?

Certain injuries or conditions can cause hip pain.

Inflamed tendons

The most common cause of acute hip pain is inflamed tendons, or tendonitis. This is often due to too much exercise. This condition can be very painful, but it usually heals within a few days.

Arthritis

The most common cause of long-term hip pain is arthritis. Arthritis can cause pain, stiff and tender joints, and difficulty walking. There are various types of arthritis: 

Osteoarthritis (OA) can be the result of age-related wearing down of the cartilage that surrounds the joints.

Trauma to a joint, like a fracture, may cause traumatic arthritis like osteoarthritis.
Infectious arthritis is due to an infection in the joint causing the destruction of cartilage.
Rheumatoid arthritis (RA) is due to the body’s immune system launching an attack on the joints. This type of arthritis may eventually destroy joint cartilage and bones.
Osteoarthritis is much more common than rheumatoid arthritis.

Trochanteric bursitis

Another possible cause of hip pain is trochanteric bursitis. This condition occurs when the bursa, which is a liquid-filled sac near the hip joint, becomes inflamed.

A number of factors can cause trochanteric bursitis, including hip injury, overuse of the joints or posture problems.

Other conditions such as RA can also cause hip pain. This condition is much more common in women than in men.

Hip fractures

Hip fractures are common in older adults and in those who have osteoporosis, which is a weakening of the bones due to age or other factors.

Hip fractures cause very sudden, severe hip pain, and they require immediate medical attention. There are complications that can arise from a fractured hip, such as a blood clot in the leg.

A hip fracture usually requires surgery to be corrected. You’ll most likely need to have physical therapy to recover.

Less common causes

There are other, less common conditions that can cause hip pain. These include snapping hip syndrome and osteonecrosis, or avascular necrosis.

Snapping hip syndrome

Snapping hip syndrome, which most commonly occurs in dancers or athletes, is characterized by a snapping sound or feeling in the hip.

This snapping may occur when you’re walking or getting up out of a chair, for example. The condition is usually painless, but can cause pain in some cases.

Snapping hip with pain is usually a sign of cartilage tear or fragments of material in the hip.

Osteonecrosis

Osteonecrosis, or avascular necrosis, occurs when blood doesn’t reach the bones, either temporarily or permanently. This can lead to the loss of the supporting bone.

In this condition, the cartilage is normal initially but will eventually collapse as it progresses. Eventually, bones may break or crumple. It’s not always clear what causes osteonecrosis.

Joint injury, heavy use of steroid medications or alcohol, and cancer treatments may put you at greater risk for this condition. But in many cases, the cause is never determined.

When should I seek emergency care?

Contact your doctor if you have hip pain that lasts longer than a few days. They can come up with a plan to manage pain and treat your condition.

However, you should contact your doctor immediately if the hip is bleeding or you can see exposed bone or muscle, a popping noise occurs, or you can’t bear weight.

Also, seek immediate help if your hip joint appears deformed or is swollen, or if you have severe pain.

Prompt medical attention is necessary for hip pain accompanied by any of the following:

• swelling
• tenderness
• soreness
• warmth
• redness

These may be signs of serious conditions, including septic arthritis, which is a joint infection. If it’s left untreated, septic arthritis can lead to deformed joints and osteoarthritis.

How is hip pain diagnosed?

For pain that could be related to a condition such as arthritis, your doctor will ask you a range of questions, including:

Is the pain worse at a time of day?
Does it affect your ability to walk?
When did your symptoms first appear?
You may need to walk around to let your doctor observe the joint in motion. They’ll measure the motion in the normal and abnormal hip and compare the two.

To diagnose arthritis, your doctor will perform fluid and imaging tests. Fluid tests involve taking samples of blood, urine, and joint fluid for testing in a laboratory. Imaging tests may include:

• X-rays
• CT scans
• MRI scans
• ultrasounds

Imaging tests will provide your doctor with detailed views of your bones, cartilage, and other tissues.

What are the treatment options for hip pain?

The treatment of hip pain depends on the cause. For exercise-related pain, rest is usually enough to allow the hip to heal. This type of pain is typically gone within a few days.

If you have arthritis, your doctor will prescribe medications to relieve pain and stiffness.

Your doctor may refer you to a specialist who can offer further advice and a physical therapist who can show you how to do exercises to help keep the joint mobile.

For injuries, treatment typically involves bed rest and medications, such as naproxen (Aleve), to relieve swelling and pain.

Hip fractures, malformation of the hip, and some injuries may require surgical intervention to repair or replace the hip. In hip replacement surgery, a surgeon replaces the damaged hip joint with an artificial one.

Although hip replacement surgery will take some physical therapy to get used to the new joint, this is a common surgery that’s most often successful.

Alternative therapies

Some holistic therapies can provide relief from hip pain. Make sure you discuss treatment options with your doctor before undergoing any alternative treatment.

Possible holistic therapies include seeing a chiropractor for an adjustment or having acupuncture. This involves the temporary placement of very small needles into key body areas to promote healing.

What is the long-term outlook?

After you know the cause of your hip pain and treat the pain correctly, you can successfully manage it.

For very minor injuries and exercise-related accidents, no treatment may be necessary and your hip may soon return to normal.

However, for more serious conditions, such as arthritis, fractures, and necrosis, the symptoms are likely to worsen until you receive treatment. Talk to your doctor so they can help you with a treatment plan.