Hip pain that begins or increases when standing or after prolonged time on your feet is a common complaint. This symptom suggests that weight-bearing stresses an underlying anatomical structure in or around the hip joint. The hip is a complex intersection of bones, muscles, and nerves, making the source of discomfort challenging to pinpoint without medical evaluation. Pain felt when standing often involves soft tissues, the joint itself, or structures in the lower back that refer sensation to the hip region. Understanding the distinct characteristics of the pain can help identify its origin.
Soft Tissue Inflammation and Lateral Hip Pain
Pain located on the outer side of the hip is frequently caused by Greater Trochanteric Pain Syndrome (GTPS). This syndrome often involves Gluteal Tendinopathy, which is an irritation or microscopic tearing of the tendons for the gluteus medius and gluteus minimus muscles. These tendons attach to the greater trochanter and are responsible for stabilizing the pelvis when you stand, walk, or run.
Prolonged standing or standing with weight shifted onto one leg increases the compressive load on these tendons as the gluteal muscles work to maintain balance. This sustained pressure can aggravate the irritated tendons, leading to a dull ache or sharp pain on the lateral hip. For many people, pain from tendinopathy is also noticeable when lying on the affected side at night or when performing activities that require single-leg stability, such as climbing stairs or standing up from a chair.
While historically the condition was often called trochanteric bursitis, inflammation of the bursa is less often the primary issue than tendinopathy. However, the symptoms are similar, involving pain and tenderness on the outer hip that worsens with direct pressure or weight-bearing activities. The mechanical stress of holding the body upright directly challenges the strength and health of these soft tissues.
Joint Deterioration and Weight-Bearing Stress
When pain is felt deeper in the body, typically in the groin or the front of the hip, it usually indicates a problem within the hip joint itself, which is classically aggravated by standing and walking. The most common cause of this intra-articular pain is osteoarthritis (OA), a condition where the smooth cartilage covering the ends of the bones wears away. The hip joint is a ball-and-socket mechanism, and its cartilage acts as a low-friction surface for movement.
When this cartilage deteriorates, the protective space between the bones narrows, and the bone underneath can become rough. Standing places the full weight of the upper body directly onto the compromised joint surfaces, increasing friction and pain. People with hip OA often describe a distinct “start-up” pain, which is intense discomfort when first standing up after a period of rest, such as getting out of a chair.
The pain from hip OA can also radiate to the thigh, knee, or the buttock area. This discomfort is amplified by sustained weight-bearing because the joint is compressed, forcing the damaged surfaces together. Other structural issues, such as Femoroacetabular Impingement (FAI), can also cause anterior hip pain with standing, as the abnormal bone shape creates mechanical conflict within the joint capsule.
Pain Originating from the Spine and Pelvis
Sometimes, the pain felt in the hip area does not originate from the hip joint or its surrounding muscles but is referred from the lower back or pelvis. This is often described as “hip-spine syndrome,” where problems in the lumbar spine mimic hip pain because of the shared network of nerves. The lower back bears the weight of the upper body and transfers that load to the legs, and any irritation in the lumbar spine can be exacerbated by standing.
A herniated disc or spinal stenosis in the lower back can compress a nerve root, leading to referred pain (sciatica) that travels into the hip, buttock, or down the leg. When standing, the spinal column is loaded, which increases pressure on the irritated nerve and worsens the hip symptoms. This type of pain is often described as shooting, burning, or tingling.
Another source of referred pain involves the joints and muscles of the pelvis itself. Dysfunction in the sacroiliac (SI) joint, which connects the spine to the pelvis, can cause radiating pain in the hip and buttock area, particularly when standing or walking.
Muscular imbalances, such as weak gluteal muscles or tight hip flexors, alter the natural alignment of the pelvis. This instability forces the body to use compensatory movements to maintain an upright stance, leading to muscle fatigue and pain around the hip when standing for long periods.
Knowing When to Consult a Professional
While minor hip discomfort when standing may resolve with rest and home care, certain signs indicate the need for professional medical evaluation. You should seek an assessment if the hip pain is severe, if it interferes with your sleep, or if it prevents you from performing your normal daily activities. Pain that lasts for more than two to four weeks without showing improvement also warrants a doctor’s visit to determine the underlying cause.
Several red flag symptoms require immediate medical attention. These include the sudden onset of severe hip pain, an inability to bear any weight on the leg, or a visible deformity of the joint.
If hip pain is accompanied by a fever, chills, or significant swelling and redness, it could indicate an infection and requires urgent care. An accurate diagnosis, often involving a physical exam and imaging studies, is necessary before a treatment plan can be established.