Why Is My Right Hip Hurting? Causes and Relief

Right hip pain usually traces to one of a handful of common musculoskeletal problems, with the specific cause depending heavily on where around the hip you feel it, your age, and your activity level. The hip joint itself sits deep in the body, surrounded by layers of muscle, tendon, and bursa, and pain in that region can originate from the joint, the soft tissues around it, or even from the lower back. Sorting out what is actually hurting, and whether it needs professional attention, starts with paying close attention to the location and character of the pain.

Where You Feel It Changes What It Means

Hip pain falls into three broad zones: front (anterior), side (lateral), and back (posterior). Each zone points toward different structures and different diagnoses. Anterior hip pain in younger adults often comes from a labral tear or femoroacetabular impingement, while in older adults osteoarthritis is the more likely culprit. Lateral hip pain is most commonly caused by greater trochanteric pain syndrome, a group of conditions involving the tendons and bursae on the bony prominence you can feel on the outside of your hip. Posterior hip pain frequently involves referred pain from the lumbar spine, deep gluteal syndrome with sciatic nerve irritation, or hamstring tendon problems.¹

This means a dull ache on the outer side of your right hip while lying on it at night is a very different problem from a sharp catch in the front of the hip when you bring your knee to your chest. The distinction matters for treatment, so when you describe the pain to a clinician, pointing to the exact spot helps more than saying “my hip hurts.”

Osteoarthritis

Osteoarthritis is the most common reason for persistent hip pain in people over about 50. The cartilage lining the ball-and-socket joint gradually wears down, leading to stiffness, deep groin or thigh pain, and reduced range of motion. Pain tends to build slowly over months or years and often worsens with activity, though some people notice stiffness after sitting for long periods too.² Risk factors include previous hip injuries, excess body weight, family history, and certain structural abnormalities of the joint. Osteoarthritis can affect one hip more than the other, or be limited to just one side entirely, so having pain in only the right hip is common.

Greater Trochanteric Pain Syndrome

If the pain is concentrated on the outside of your right hip, particularly when you press on the bony point, lie on that side, or climb stairs, greater trochanteric pain syndrome (GTPS) is a leading suspect. For years this was called trochanteric bursitis, and some clinicians still use that term, but the thinking has shifted. Research now shows that the problem is more often in the gluteal tendons, specifically the gluteus medius and minimus, rather than in the bursa alone. GTPS is considered a multifactorial condition influenced by biomechanical loading, age-related tendon degeneration, and functional factors like hip muscle weakness.³

GTPS is more common in women, in runners, and in people who have recently increased their walking or stair-climbing volume. It can also develop after a period of inactivity if the gluteal tendons have weakened. The condition is rarely dangerous but can be stubbornly persistent, sometimes lasting months before responding to targeted rehabilitation.

Labral Tears and Femoroacetabular Impingement

The labrum is a ring of cartilage that lines the rim of the hip socket, helping to seal and stabilize the joint. Tears in this structure cause a catching, clicking, or sharp pain in the front of the hip, often provoked by deep squatting, pivoting, or prolonged sitting. Labral tears frequently occur alongside femoroacetabular impingement (FAI), a condition in which extra bone along the ball or socket creates abnormal contact during movement.⁴

One important nuance: labral tears sometimes show up on imaging in people who have no symptoms at all. Research examining the hips of patients who had a symptomatic labral tear on one side found that labral tears were also present in the opposite, pain-free hip in many cases.⁵ This does not mean a tear is never the problem, but it does mean that finding one on an MRI does not automatically explain the pain. The clinical picture, including physical exam findings and response to a diagnostic injection into the joint, matters as much as the image.⁶

Structural variation in the thighbone also influences where labral damage occurs. Patients whose femur is rotated more inward tend to develop tears in the front of the labrum, while those with the opposite rotation pattern tend to damage the top of it.⁷ These differences help surgeons plan treatment but are not something you would notice on your own.

When the Pain Is Coming from Somewhere Else

Not all right hip pain starts in the hip. The lower back and sacroiliac (SI) joint are frequent culprits. A herniated disc in the lumbar spine can irritate nerves that supply the buttock and hip region, producing pain that feels like it is coming from the hip itself. One proposed mechanism involves compression of nerve branches that supply the gluteal area, effectively mimicking hip pain even though the disc problem is in the spine.⁸

The SI joint, where the base of the spine meets the pelvis, is another under-recognized source of pain that can radiate into the hip and buttock. SI joint dysfunction can result from abnormal joint motion, inflammation, leg length differences, pregnancy, or prior spinal surgery.⁹ Because the SI joint sits so close to the hip, distinguishing between the two can be tricky without specific provocative tests or diagnostic injections.¹⁰

Deep Gluteal Syndrome and Muscular Causes

Deep gluteal syndrome is a catch-all term for conditions in which the sciatic nerve gets pinched or irritated in the space behind the hip joint. This includes what used to be called piriformis syndrome, but the concept has expanded to include compression by fibrous bands, the obturator internus muscle, the quadratus femoris, and various other structures in the deep buttock.¹¹ Symptoms typically include deep buttock pain, sometimes with tingling or numbness running down the back of the thigh. Sitting for long periods often makes it worse. The condition is frequently underdiagnosed because the symptoms overlap with lumbar disc problems and true hip joint pathology.

Why Just the Right Side

People often wonder why only one hip hurts. A few factors can make the right side more vulnerable. Most people are right-leg dominant, meaning they push off that leg more forcefully and bear more load on it during single-leg tasks. Over years, this asymmetry can translate into more wear on the dominant side. Habitual postures contribute too: if you always cross the same leg, lean on one side while driving, or carry heavy bags on one hip, the tissues on that side accumulate more stress.

Leg length differences are another reason one hip may hurt and the other does not. Even a small discrepancy can alter the mechanics of gait and shift extra load onto one side. Research on leg length inequality has found that the shorter leg is at higher risk for developing hip osteoarthritis, with the risk climbing steeply once the difference reaches about two centimeters. Workplace posture also plays a role: people who spend long hours either standing or sitting in fixed positions develop lower-limb kinematic changes that can concentrate strain on one joint more than the other.¹²

Less Common but Serious Causes

A few conditions are rarer but worth knowing about because they require prompt treatment. Avascular necrosis (also called osteonecrosis) of the femoral head occurs when blood supply to the ball of the hip joint is disrupted, causing bone tissue to die. Risk factors include long-term corticosteroid use, heavy alcohol consumption, and certain autoimmune conditions. The incidence of avascular necrosis has been rising, partly due to broader use of corticosteroid medications.¹³ Early-stage disease may respond to conservative measures or core decompression surgery, but advanced cases often require hip replacement.

Stress fractures of the femoral neck can cause sudden groin or hip pain, particularly in runners, military recruits, and people with low bone density. Recovery time depends on the severity of the fracture: milder grades can heal in roughly seven to eight weeks, while more severe ones take around four months or longer before a return to running is realistic.¹⁴

Systemic inflammatory conditions like rheumatoid arthritis, lupus, and ankylosing spondylitis can also target the hip joint and sometimes cause enough destruction to require hip replacement.¹⁵ In adolescents, a condition called slipped capital femoral epiphysis, in which the growth plate at the top of the thighbone shifts, can present as vague hip or knee pain and needs surgical stabilization.¹⁶

Getting the Diagnosis Right

Because so many conditions can produce hip-region pain, the physical exam carries more weight than people expect. For femoroacetabular impingement, one commonly used screening maneuver involves bending the hip, bringing the knee across the body, and rotating the leg inward. A systematic review found this FADIR test is consistently supported as a screening tool, with strong sensitivity, meaning it is good at catching cases, though less reliable at ruling them out.¹⁷ X-rays and MRI help confirm the diagnosis and identify the specific structural problem, but the clinical exam and how your pain responds to a numbing injection into the joint remain central to the workup.⁶

Exercises That Target the Right Muscles

For many of the most common causes of right hip pain, particularly GTPS, gluteal tendinopathy, and general hip instability, strengthening the gluteal muscles is the backbone of treatment. The gluteus medius, a muscle on the side of the hip that stabilizes the pelvis during walking and single-leg stance, is almost always weak or inhibited in people with lateral hip pain. Research into which exercises activate this muscle most effectively found that side-lying hip abduction, the hip hitch (standing on one leg and dropping and lifting the opposite pelvis), and single-leg bridging all generate high levels of gluteal activation.¹⁸

For the gluteus maximus, the larger muscle that powers hip extension, single-limb squats and single-limb deadlifts produce the greatest activation.¹⁹ Practically speaking, a sensible starting program for someone with right hip pain would begin with low-load exercises like side-lying leg lifts and progress to standing exercises like single-leg bridges and resisted side-stepping as strength improves. The key is progressive loading rather than stretching alone: tendons respond to gradually increasing force, not passive lengthening.

Injections and Shockwave Therapy

When pain is severe enough to interfere with sleep or rehabilitation, corticosteroid injections can buy time. For hip osteoarthritis, randomized trials show that an image-guided corticosteroid injection into the joint produces meaningful pain relief lasting about two to three months. In one well-designed trial, pain scores dropped roughly 50 percent in the corticosteroid group at two months, compared with almost no change in the placebo group, and the benefit persisted at three months.²⁰ A systematic review confirmed that hip corticosteroid injections outperform hyaluronic acid, anti-inflammatory drugs, and saline for both short- and longer-term pain reduction.²¹ The trade-off is that repeated injections may have diminishing returns and possible effects on cartilage, so most clinicians limit how often they are given.²²

For tendon-related problems around the hip, including GTPS and hamstring tendinopathy, extracorporeal shockwave therapy has emerged as an alternative. A systematic review found that shockwave therapy significantly improved pain and function in patients with GTPS and other peritrochanteric tendinopathies, and outperformed conservative treatment, sham treatment, ultrasound therapy, and corticosteroid injections in several direct comparisons.²³ It is not widely available everywhere and is often not covered by insurance, but the evidence for tendon conditions specifically is growing.

When Surgery Becomes the Conversation

Most right hip pain does not end up needing surgery, but for conditions that do not respond to months of conservative care, there are well-established options. Hip arthroscopy, a minimally invasive procedure using small cameras and instruments, is commonly used to repair labral tears and correct FAI. It produces meaningful symptom improvement in most patients. However, for people over 40, the conversion rate to total hip replacement is substantially higher than in younger populations, particularly if there is already some osteoarthritis present.²⁴ In one study, about 16 percent of all patients who underwent hip arthroscopy eventually required a total hip replacement, with younger patients and those with milder arthritis having a longer interval before needing one.²⁵

Total hip replacement itself is one of the most successful operations in modern medicine, with high satisfaction rates and durable results. It becomes the right choice when joint destruction is advanced enough that conservative treatments no longer control pain or maintain function. For inflammatory conditions like rheumatoid arthritis, lupus, or ankylosing spondylitis that have damaged the joint, hip replacement remains the standard solution when the joint fails.¹⁵

How Sex and Pelvic Shape Affect Hip Problems

The human pelvis evolved under competing demands: walking upright efficiently and, in women, accommodating childbirth. These pressures have produced meaningful differences in hip and pelvis shape between men and women, and those differences influence the pattern of hip problems each sex tends to develop.²⁶ Women have wider pelvises and different angles of femoral neck orientation, which may contribute to higher rates of GTPS and certain patterns of hip impingement. Men are more likely to develop the cam-type impingement, where extra bone on the ball of the femur creates friction. These anatomical realities mean that two people with “right hip pain” can have structurally different problems driven by their skeletal geometry, even if their symptoms sound similar on the surface.