Hip pain can originate from the joint, surrounding tissues (muscles, tendons, bursae), or be referred from the lower back or pelvis. Since the hip is a major weight-bearing joint, an accurate diagnosis is the primary step in determining the correct specialist. Finding the right doctor depends on whether the problem is mechanical, inflammatory, neurological, or requires specialized rehabilitation. Recovery is guided by identifying the precise anatomical source and the nature of the condition, whether sudden or chronic.
The Initial Assessment: Primary Care Providers
A Primary Care Provider (PCP), such as a family physician or internal medicine doctor, is the standard starting point for new hip pain complaints. Their role is to perform initial triage to assess the severity and potential origin of the pain. This evaluation includes a detailed history, a physical examination focusing on hip range of motion, and specific maneuvers like the FABER test.
The PCP acts as a gatekeeper, determining if the issue can be managed conservatively or requires specialist referral. They typically order initial diagnostic imaging, such as a plain X-ray, to check for bone abnormalities, fractures, or signs of osteoarthritis. They also rule out non-hip related causes, such as referred pain from the lumbar spine (sciatica). If the pain is minor, they may initiate first-line treatments like rest, anti-inflammatory medications, and physical therapy before escalating care.
Specialists for Structural and Surgical Conditions
When hip pain is caused by mechanical failure, trauma, or structural breakdown, referral to an orthopedic surgeon is often necessary. These specialists focus on the musculoskeletal system, managing conditions like severe osteoarthritis, hip fractures, labral tears, and femoroacetabular impingement (FAI). Orthopedic surgeons manage these structural issues using both non-surgical and surgical methods.
Non-surgical options include joint injections or physical therapy. Surgical treatments range from minimally invasive hip arthroscopy to repair torn cartilage or labrums. For severe degenerative joint disease, they perform total hip replacement (hip arthroplasty), replacing damaged joint surfaces with prosthetic components. Their expertise centers on restoring the mechanical integrity and function of the hip joint.
Specialists for Inflammatory and Systemic Causes
If the hip pain is not primarily due to mechanical wear-and-tear but instead stems from a body-wide condition, a rheumatologist is the appropriate specialist. These physicians specialize in inflammatory and autoimmune diseases that affect joints and connective tissues. Conditions such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis can cause severe hip inflammation and joint destruction.
A rheumatologist’s diagnostic approach relies heavily on laboratory studies, including blood tests for inflammatory markers like C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR), or specific antibodies. Their treatment strategy focuses on managing the systemic disease progression through disease-modifying anti-rheumatic drugs (DMARDs) and biologics to control the immune response. This medical management aims to reduce inflammation and prevent further joint damage.
Experts in Rehabilitation and Pain Management
For non-surgical recovery and long-term function, rehabilitation and pain specialists are essential.
Physical Therapists (PTs)
Physical therapists (PTs) are movement experts who analyze gait and muscle function to create individualized exercise programs. They focus on strengthening hip muscles, improving mobility, and providing manual therapy to restore functional movement and prevent injury recurrence.
Physiatrists (PM&R)
Physiatrists (PM&R physicians) are medical doctors specializing in restoring function and non-surgical treatment of nerve, muscle, and bone conditions. They often act as non-surgical orthopedic specialists, diagnosing complex problems and coordinating comprehensive rehabilitation plans. Physiatrists frequently utilize targeted interventional procedures, such as ultrasound-guided steroid or orthobiologic injections.
Pain Management Specialists
A dedicated pain management specialist, often an anesthesiologist, focuses on advanced interventional techniques to alleviate chronic pain. These procedures include nerve blocks, radiofrequency ablation, and regenerative medicine options like Platelet-Rich Plasma (PRP) therapy. These specialists manage pain that has not responded to conservative measures, providing relief to facilitate physical rehabilitation.