Hip soreness is one of the most common musculoskeletal complaints, and the cause usually depends on where exactly you feel it. About 14% of adults over 60 report significant hip pain on most days, with women affected more often than men. But hip soreness isn’t limited to older adults. Muscle overuse, tendon irritation, and even lower back problems can all show up as hip pain at any age.
Where You Feel It Matters
The hip is a deep ball-and-socket joint surrounded by layers of muscle, tendons, and fluid-filled cushions called bursae. Pain can come from any of these structures, and the location of your soreness is the single best clue to what’s going on.
Front of the hip or groin: Pain here usually involves the hip joint itself. Osteoarthritis, labral tears (damage to the cartilage ring lining the socket), and pinching where the ball meets the socket are the most common culprits. If you feel a clicking or catching sensation along with groin pain, a labral tear is worth considering.
Outside of the hip: This is the most common spot for soreness, and it’s almost always related to the soft tissues rather than the joint. Bursitis (inflammation of the cushioning sac over the bony point of your hip) and gluteal tendon problems top the list. You might also notice a snapping sensation when walking or standing up.
Back of the hip or buttock: Pain here often originates from the lower back or the sacroiliac joint at the base of your spine, not the hip joint at all. Nerve irritation from the lumbar spine, piriformis syndrome (where a deep buttock muscle compresses the sciatic nerve), and sacroiliac joint dysfunction are the usual suspects.
Bursitis: The Most Common Outer Hip Pain
If your hip is sore on the outside, especially when you lie on that side at night or stand up after sitting, trochanteric bursitis is a likely explanation. The pain typically sits right over the bony prominence on the side of your hip and can radiate down your outer thigh or into your buttock. Walking upstairs, getting out of a car, or any movement that loads that area tends to make it worse.
Bursitis develops when the fluid-filled sac that cushions the tendons sliding over the bone becomes irritated, usually from repetitive friction. Runners, people who suddenly increase their walking distance, and anyone who sleeps consistently on one side are particularly prone to it. Most cases respond well to rest, ice, and targeted stretching over a few weeks.
Tendon Problems vs. Muscle Strains
The gluteal tendons that attach your buttock muscles to the hip bone are a frequent source of soreness, particularly in women over 40. There’s an important distinction between two stages of tendon trouble. Tendinitis is the earlier, inflammatory phase: you feel a deep ache in the hip area that improves with rest, ice, and time off. Tendinopathy is more advanced, involving actual breakdown of the tendon tissue. Unlike tendinitis, tendinopathy rarely gets better with rest alone and typically requires a structured exercise program to recover.
If your hip has been sore for a week or two and improves when you take it easy, you’re likely dealing with tendinitis or a mild muscle strain. If the soreness has lingered for months and rest hasn’t helped, tendinopathy is more likely, and progressive strengthening exercises become the primary treatment.
When the Problem Isn’t Your Hip at All
One of the trickiest things about hip soreness is that it frequently comes from somewhere else entirely. The lower back and the hip joint share overlapping nerve pathways, which means a problem in your lumbar spine can produce pain you’d swear is in your hip. This overlap is common enough that doctors have a name for it: hip-spine syndrome.
A few patterns can help you sort this out. True hip joint problems tend to cause pain in the groin or front of the thigh, along with stiffness when rotating the leg. Spinal problems are more likely to send pain down the back or side of the leg and may come with numbness, tingling, or weakness below the knee. But the overlap between these presentations is significant, and many people have both issues simultaneously, which is one reason hip pain can be so frustrating to pin down on your own.
Age, Activity Level, and Risk
Hip soreness doesn’t follow a single pattern across life stages. In younger, active people, muscle strains, tendinitis, and labral tears from repetitive impact are the most common causes. In adults over 60, osteoarthritis and bursitis dominate.
Interestingly, being sedentary doesn’t protect you. Among older adults who hadn’t exercised in the previous month, 18.4% reported significant hip pain, compared to 12.6% of those who were physically active. Regular movement helps maintain the muscle strength and flexibility that keep the hip joint stable and well-supported. The hips are designed to move, and they tend to get sorer when they don’t.
What You Can Do at Home
For most cases of hip soreness that aren’t caused by a sudden injury, a consistent routine of stretching and strengthening is the most effective thing you can do. The American Academy of Orthopaedic Surgeons recommends a 4 to 6 week hip conditioning program performed 2 to 3 days a week, with a 5 to 10 minute warm-up (walking or stationary cycling) before each session.
Two stretches are particularly useful for lateral and posterior hip soreness:
- IT band stretch: Stand next to a wall for support. Cross the leg closest to the wall behind your other leg, then lean your hip toward the wall until you feel a stretch on the outside of the hip. Hold for 30 seconds and repeat four times on each side.
- Seated piriformis stretch: Sit on the floor with both legs straight, then cross one leg over the other and gently rotate your trunk toward the crossed knee. This targets the deep rotator muscles in the buttock. Repeat four times per side.
For strengthening, side-lying hip abduction is one of the most effective exercises for building stability in the outer hip muscles. Lie on your side with the sore hip on top, bottom leg bent for support, and slowly raise the top leg. Start with 8 repetitions and work up to 12. Once that feels easy, add a 1-pound ankle weight and build back up from 8 reps again.
Ice can help during the first few days of a flare-up, especially with bursitis. Apply it for 15 to 20 minutes at a time. If your soreness is more chronic and doesn’t involve swelling, gentle heat before stretching may feel better and help loosen tight muscles.
Signs That Need Prompt Attention
Most hip soreness is not an emergency, but certain symptoms signal something more serious. Get medical care right away if your hip looks misshapen or your leg appears shorter than the other, you can’t move the hip or put weight on the leg, you develop sudden intense pain or swelling, or you notice fever, chills, or skin color changes on the affected leg. These can indicate a fracture, dislocation, or infection, all of which require urgent evaluation.
Outside of those red flags, hip soreness that hasn’t improved after 4 to 6 weeks of consistent home management, or pain that wakes you from sleep regularly, is worth having evaluated. Imaging and a physical exam can distinguish between joint, tendon, and spinal causes, which makes a real difference in choosing the right treatment.