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Musculoskeletal Symptom

Hip pain

Hip pain is a common musculoskeletal complaint affecting people of all ages, from young athletes to older adults. The hip is a complex joint and pain can arise from many structures — the joint itself, surrounding muscles, tendons, bursae or referred from the lumbar spine. A thorough assessment to identify the source of pain directs the most effective treatment, with physiotherapy central to most presentations.

What is Hip pain?

Pain in and around the hip can originate from the hip joint itself (osteoarthritis, labral tears, femoroacetabular impingement); surrounding soft tissues (hip flexor or gluteal tendinopathy, greater trochanteric pain syndrome); the lumbar spine and sacroiliac joint referring pain to the hip region; or systemic conditions such as rheumatoid arthritis.

Hip pain in younger, active people often involves soft tissue or structural issues amenable to conservative management. Hip pain in older adults more commonly involves osteoarthritis, though conservative management remains effective in many cases.

Signs and symptoms

Hip pain presentations vary by cause:

  • Pain in the groin, outer hip, buttock or thigh — location helps identify the source
  • Stiffness — particularly in the morning or after sitting for extended periods
  • Reduced range of movement — difficulty with rotation, squatting or crossing legs
  • Pain with specific activities — walking, climbing stairs, lying on the affected side
  • Clicking, catching or locking sensations within the joint

Hip pain following trauma, present in a child with a limp, or accompanied by fever requires prompt medical assessment.

How therapy can help

Management of hip pain depends on the cause:

  • Physiotherapy — the cornerstone of conservative hip pain management; specific exercise programmes targeting hip strength, flexibility and movement patterns
  • Osteopathy and sports therapy — manual therapy for joint and soft tissue components
  • Acupuncture — evidence for pain relief in hip osteoarthritis and soft tissue hip pain
  • Massage therapy — for muscle tension, trigger points and soft tissue components
  • Hydrotherapy — for hip OA where weight-bearing exercise is poorly tolerated

Seeking help

A physiotherapist or GP is the appropriate first contact for most hip pain. Imaging may be needed to clarify diagnosis in complex cases. For hip OA that does not respond to conservative management, orthopaedic referral for consideration of steroid injection or joint replacement is appropriate.

Therapies that may help with Hip pain

We don't currently have any therapies mapped to this condition.

Frequently asked questions

What causes hip pain in young adults?

Common causes include femoroacetabular impingement (FAI), labral tears, hip flexor or gluteal tendinopathy, greater trochanteric pain syndrome, and referred pain from the lumbar spine or SIJ. A physiotherapist or sports medicine physician can differentiate between these through clinical assessment.

Is hip pain always arthritis?

No — hip pain has many causes across all ages. Arthritis is more common in older adults but soft tissue conditions, referred pain and structural issues are common across all age groups. A thorough assessment identifying the specific source of pain is important.

Can physiotherapy help hip pain without surgery?

Yes — physiotherapy is effective for many hip conditions including mild to moderate osteoarthritis, tendinopathies and soft tissue conditions. Exercise therapy addressing hip strength and movement patterns has evidence comparable to steroid injection for several hip conditions.

When should hip pain be investigated urgently?

Hip pain following significant trauma, associated with fever, in a child with a limp, with severe sudden onset, or with systemic symptoms requires prompt medical assessment. In older adults, hip pain following a fall raises the possibility of fracture and requires urgent assessment.

Does hip pain always need surgery?

No — the majority of hip pain, including mild to moderate osteoarthritis, responds well to conservative management including physiotherapy and exercise. Surgery is considered when conservative measures have been adequately tried without sufficient relief and quality of life is significantly affected.