Hip pain has dozens of possible causes, and the single best clue to narrowing yours down is where exactly you feel it. Pain in the front of the hip points to a different set of problems than pain on the outer side or deep in the buttock. Your age, activity level, and whether the pain came on suddenly or crept up over weeks also matter. Here’s how to make sense of what your hip is telling you.
Where You Feel It Matters Most
The hip is a deep ball-and-socket joint surrounded by layers of muscle, tendons, and fluid-filled cushions called bursae. Pain that seems to come from “the hip” can originate inside the joint itself, in the soft tissues around it, or from somewhere else entirely, like the lower back or abdomen. Pinpointing the location is the fastest way to sort through the possibilities.
Pain in the Front of the Hip or Groin
Anterior hip pain, the kind you feel in the crease of your groin or deep in the front of the joint, usually signals something happening inside the joint or in the muscles that flex your hip. In younger adults, the two most common culprits are labral tears and femoroacetabular impingement (FAI), a condition where the bones of the hip don’t fit together smoothly and pinch the soft tissue between them. FAI is one of the most frequent causes of hip pain in people under 40.
A labral tear involves damage to the ring of cartilage that lines the rim of the hip socket. The hallmark sign is a clicking or popping sensation when you move your hip, sometimes with a feeling of catching or locking. The pain is often hard to pinpoint. Many people instinctively cup the front of their hip with their hand in a C-shape when trying to show a doctor where it hurts.
In people over 50, osteoarthritis becomes the most likely explanation for front-of-hip pain. The cartilage inside the joint wears down over time, causing stiffness and an aching soreness that tends to be worst in the morning or after sitting for a while. You may notice it getting harder to bend down to tie your shoes or to walk without a slight limp. Osteoarthritis develops gradually. If your pain appeared over months rather than days, and you’re in your 50s or older, this is a strong possibility.
Less commonly, anterior hip pain can be referred from somewhere else entirely. Hernias, appendicitis, ovarian cysts, and bladder problems can all send pain signals to the front of the hip. If your pain doesn’t change with hip movement, or if it came with digestive or urinary symptoms, the source may not be the hip at all.
Pain on the Outer Side of the Hip
Lateral hip pain, the kind that runs along the outside of your hip and upper thigh, is most often caused by a group of problems collectively called greater trochanteric pain syndrome. This includes irritation of the bursa (a small fluid-filled cushion) that sits over the bony point on the outside of your hip, tendon problems in the muscles that stabilize your pelvis, and friction from the thick band of tissue that runs down the outside of your thigh.
The signature complaint is pain when lying on the affected side at night. Many people first notice it because it wakes them up or makes it impossible to sleep in their usual position. The outer hip is tender to the touch, and climbing stairs or walking for long stretches makes it worse. This type of pain is especially common in women over 40 and in runners.
Pain in the Buttock or Back of the Hip
Posterior hip pain has a wide range of causes, and many of them don’t actually start in the hip. Lower back problems are one of the most common sources. Irritation or compression of the sciatic nerve, which threads from the lower spine through the hip and down each leg, can produce sharp, shooting pain that feels like it’s coming from the hip itself. Sciatica pain typically worsens when sitting, radiates from the lower back into the hip and down the leg, and may come with tingling, numbness, or a burning sensation. It often feels better when lying down.
The key distinction: pain from the hip joint itself tends to stay localized near the joint and gets worse with hip-specific movements like rotating the leg. Nerve pain travels. If your “hip pain” shoots down your thigh or into your calf, or if you feel weakness or numbness in the leg, the problem is more likely in your spine than your hip.
Other causes of posterior hip pain include piriformis syndrome, where a muscle deep in the buttock compresses the sciatic nerve, sacroiliac joint dysfunction (pain from the joint where the spine meets the pelvis), and hamstring injuries, which tend to cause pain right at the base of the buttock where you sit.
Hip Flexor Strains From Activity
If your hip started hurting during or shortly after exercise, a hip flexor strain is a common explanation. These muscles run across the front of the hip and are responsible for lifting your knee. When overstretched or suddenly overloaded, the muscle fibers can partially tear. Runners and hockey players are especially prone, but you don’t need to be an athlete. Suddenly exerting yourself much harder than usual, like sprinting for a bus or jumping into a pickup game, is enough.
A mild strain causes soreness and tightness in the front of the hip. A more severe one can make it painful to lift your leg at all. Most hip flexor strains heal with rest and gradual return to activity, though recovery time varies widely depending on severity.
When Hip Pain Affects Both Sides
If both hips hurt, especially if the pain came with fatigue, prolonged morning stiffness lasting more than 30 minutes, or swelling in other joints like your hands or wrists, inflammatory arthritis is worth considering. Rheumatoid arthritis and similar conditions tend to affect the same joints on both sides of the body, which distinguishes them from osteoarthritis or injury. These conditions involve the immune system attacking joint tissue rather than simple wear and tear, and they require different treatment. Blood tests for inflammation markers can help confirm or rule this out.
Signs That Need Urgent Attention
Most hip pain is not an emergency, but a few situations call for same-day medical evaluation. If you cannot put weight on the leg at all, especially after a fall, a fracture is possible even if the pain doesn’t seem severe. A fractured hip can cause the leg to look shorter than the other and rotate outward. Some people with hip fractures can still walk on them, so being able to stand doesn’t rule out a break.
Fever combined with hip pain, especially a hot, swollen joint, can indicate infection inside the joint. Any visible deformity of the hip or leg after an injury also warrants immediate evaluation.
How Hip Pain Is Typically Treated
Treatment depends entirely on the cause, but for the most common culprit in older adults, osteoarthritis, physical therapy is a recommended first-line approach. About half of clinical studies show significant improvement in pain and function with structured exercise and physical therapy. It doesn’t make arthritis worse, and it often delays or prevents the need for surgery.
Corticosteroid injections into the hip joint can improve pain and function for up to four months for osteoarthritis. They carry a small risk: about 6% of patients experience accelerated joint damage within six months of receiving an injection. This is worth discussing before opting for repeated injections.
For soft tissue problems like bursitis, tendon issues, and mild strains, the initial approach is usually rest, ice, and targeted strengthening exercises. Lateral hip pain from bursitis often responds well to stretching the outer hip and strengthening the muscles that stabilize the pelvis. Sleeping with a pillow between the knees can reduce nighttime pain.
For labral tears and FAI that don’t respond to conservative treatment, arthroscopic surgery to repair the cartilage or reshape the bone is an option, particularly in active younger adults. For nerve-related pain originating in the spine, treatment focuses on the back rather than the hip, typically through physical therapy, activity modification, and sometimes spinal injections or surgery for severe cases.
A Simple Way to Start Sorting It Out
Before your appointment, pay attention to a few things that will help your provider narrow the diagnosis quickly. Note exactly where the pain is: front, side, or back. Notice what makes it worse: walking, sitting, lying on it, climbing stairs, or bending. Track whether it’s constant or comes and goes, and whether it started suddenly or built up over time. If you feel any clicking, catching, tingling, or numbness, note that too. These details matter more than imaging in the early stages of figuring out what’s going on.