A sharp pinch getting out of the car, an ache after a long run, or pain that wakes you when you roll onto one side can all feel like the same problem: hip pain. But hip pain causes are not always located exactly where you feel them. The hip is a complex joint surrounded by strong muscles, tendons, nerves, and structures that can refer pain from the low back, pelvis, or even the knee.
That is why the right question is not simply, “How do I get rid of this pain?” It is, “What is driving it, and what does my body need to move well again?” A clear assessment can help you avoid treating a temporary symptom while the underlying movement issue continues.
Hip Pain Causes Often Depend on Where It Hurts
The location and behavior of pain offer useful clues, although they do not confirm a diagnosis on their own. Pain in the front of the hip or groin may involve the joint itself, the hip flexor muscles, or the labrum, which is a ring of cartilage that helps stabilize the joint. People often notice this discomfort with deep squats, stairs, running, or bringing the knee toward the chest.
Pain on the outside of the hip is commonly linked to irritation of the gluteal tendons or the bursa, a small fluid-filled sac that reduces friction around the joint. It may be especially bothersome when lying on that side, walking for longer distances, climbing stairs, or standing with most of your weight on one leg.
Pain in the buttock or back of the hip can come from deep gluteal muscles, the sacroiliac region, the hamstring attachment, or the lumbar spine. If pain travels below the knee, includes tingling or numbness, or changes significantly with back movements, a nerve or low-back contribution becomes more likely.
Patterns matter. So do the details: how the pain started, whether it is worsening, which movements provoke it, and what your strength and mobility look like under load.
Common Causes of Hip Pain
Muscle strain or tendon overload
A muscle strain can happen suddenly during a sprint, awkward lift, change of direction, or slip. It can also develop gradually when training volume, hills, speed work, or gym intensity increases faster than your body can adapt. Hip flexors, adductors in the inner thigh, hamstrings, and gluteal muscles are frequent sources of pain in active adults.
Tendon-related pain is often more persistent. You may feel relatively comfortable at the start of a workout, then ache afterward or the next morning. Rest can calm symptoms temporarily, but complete rest rarely rebuilds a tendon’s capacity. Progressive, well-dosed strengthening is usually part of a successful plan.
Greater trochanteric pain syndrome
This term describes pain around the bony outer part of the hip. It is often called hip bursitis, but the gluteal tendons are frequently involved as well. Compression and repeated overload can aggravate the area, which is why side-lying, crossing the legs, and standing with one hip dropped may trigger symptoms.
Treatment is not just about reducing irritation. It often includes improving glute strength, pelvic control, walking or running mechanics, and the way training load is progressed. The best approach depends on the person. A runner, a new parent carrying a child, and someone who sits for long workdays may all need different strategies.
Hip osteoarthritis
Osteoarthritis involves changes to the joint over time and becomes more common with age, previous injury, joint shape differences, and family history. Stiffness after sitting, reduced ability to rotate the hip, groin pain, and discomfort with longer walks are common experiences.
An arthritis diagnosis does not mean you should stop moving. In many cases, specific strengthening, mobility work, and activity modification can reduce symptoms and improve function. The goal is not to force painful movement or avoid movement entirely. It is to find the right dose that keeps you active while respecting the joint’s current tolerance.
Femoroacetabular impingement and labral injury
Femoroacetabular impingement, often called FAI, occurs when the shape of the ball-and-socket hip joint causes contact during certain positions. Deep hip flexion and rotation can produce a pinch in the front of the hip or groin. Some people with FAI have no symptoms at all, so imaging findings must always be considered alongside your actual movement, pain, and goals.
A labral injury can create catching, clicking, locking, or a sense that the hip is not moving smoothly. Not every click is a problem, and not every labral finding requires surgery. A thorough clinical assessment helps determine whether focused rehabilitation is appropriate and when a sports medicine or orthopedic opinion may be useful.
Referred pain from the back or pelvis
The hip and lower back work together during walking, lifting, running, and nearly every daily task. A lumbar spine issue can feel like hip pain, particularly when symptoms include burning, tingling, numbness, or pain that travels into the thigh or lower leg. Conversely, a hip mobility or strength deficit can increase stress on the back.
This is one reason a movement-based assessment should look beyond the painful spot. Treating only the area that hurts may miss the limitation that is keeping the problem alive.
Stress injuries and fractures
Bone stress injuries can develop when repetitive impact exceeds the bone’s ability to recover. They are more likely after a rapid increase in running or jumping, inadequate recovery, low energy availability, or certain bone-health concerns. Deep groin pain that worsens with impact and progresses from activity pain to pain with walking deserves prompt evaluation.
A fall, collision, or sudden inability to bear weight can indicate a fracture or other significant injury. Do not try to push through it.
When Hip Pain Needs Urgent Attention
Most hip pain is not an emergency, but certain symptoms should be assessed urgently. Seek immediate medical care if you have:
- Severe pain after a fall, collision, or other trauma, especially if you cannot put weight through the leg
- A hot, swollen, red hip or fever with significant joint pain
- New loss of bladder or bowel control, numbness in the groin area, or rapidly worsening leg weakness
- Sudden calf swelling, chest pain, or shortness of breath
- Unexplained weight loss, unrelenting night pain, or pain that is steadily worsening without a clear reason
These signs do not automatically mean something serious is happening, but they should not be managed with home exercises alone.
How Physiotherapy Identifies the Root Cause
A useful hip assessment is more than a quick flexibility test. It should consider how your symptoms began, your work and sport demands, previous injuries, training changes, sleep, and the movements that matter most to you. Your clinician may assess hip range of motion, strength, balance, gait, squat mechanics, spinal movement, and how the hip responds to loading.
From there, treatment can be built around your actual goal, whether that is walking without pain, returning to pickleball, lifting confidently, or training for a race. Hands-on treatment may help reduce pain and improve short-term mobility for some people. Exercise is what builds the capacity to keep moving well. Depending on the presentation, a plan may also include activity modifications, progressive loading, sports-specific drills, medical acupuncture, or dry needling as part of broader rehabilitation.
At The Physio Approach, care is centered on one-on-one assessment and a plan that progresses with you. The aim is not to make you dependent on treatment. It is to help you understand your body, restore confidence in movement, and build the strength to stay active.
What to Do While You Wait for an Assessment
If your pain is mild and there are no warning signs, avoid the all-or-nothing approach. Temporarily reduce the movements that produce sharp or escalating pain, but keep moving within a comfortable range. Short walks, gentle cycling, or modified strength work may be better tolerated than complete inactivity.
Pay attention to your 24-hour response. Mild discomfort during activity that settles quickly may be acceptable in some rehabilitation plans. Pain that is substantially worse later that day or the following morning is often a sign that the load was too high. This simple feedback can help guide better decisions until you have a personalized plan.
Hip pain can be frustrating because it affects so much of daily life, from sleeping and commuting to training and playing with your family. The encouraging news is that many hip problems respond well when the cause is properly assessed and rehabilitation is matched to your body and goals. Move with intention, get help when symptoms persist or limit your life, and give your recovery the structure it deserves.