1. Osteoarthritis of the hip
Osteoarthritis is one of the most common causes of persistent hip pain, particularly among older adults.
The condition involves changes in the cartilage and other tissues within the joint. Cartilage normally helps the joint surfaces move smoothly against one another. As osteoarthritis develops, the joint may become painful and stiff, and the surrounding bone and tissues can also change.
Symptoms often develop gradually.
At first, you may notice discomfort only after a long walk or a particularly active day. Over time, pain may begin to appear during ordinary activities, such as getting out of a chair, walking around a supermarket, or climbing stairs.
Morning stiffness or stiffness after sitting is also common.
Some people experience reduced range of motion, making it harder to bend the hip or rotate the leg. The pain may be felt in the groin, thigh, or buttock rather than directly over the outside of the hip.
Age is an important risk factor, but osteoarthritis is not an inevitable consequence of getting older. Previous injuries, certain structural differences in the joint, family history, and other factors may influence a person's risk.
Treatment depends on the severity of symptoms and their effect on daily life. Options may include therapeutic exercise, physical therapy, appropriate pain management, assistive devices, and changes to activities that aggravate symptoms.
For severe osteoarthritis that substantially limits daily activities despite other treatment, hip replacement surgery may be considered.
The important point is that a diagnosis of osteoarthritis does not automatically mean that you must stop exercising or accept constant pain. Many people improve their function with an individualized treatment plan.
2. Tendon problems around the hip
Tendons connect muscles to bones. Around the hip, they help stabilize the pelvis and control movement during walking, standing, and climbing stairs.
When a tendon is repeatedly overloaded or becomes less able to tolerate the demands placed on it, it can become painful.
Gluteal tendinopathy is one example. It affects tendons attached to the gluteal muscles, which help stabilize the pelvis during walking and other activities.
Typical symptoms include pain on the outer hip, tenderness when lying on that side, and discomfort when climbing stairs or standing on one leg.
The condition may develop gradually, particularly when physical activity increases faster than the tissues can adapt. It can also occur in people who are not especially athletic.
Complete rest for long periods is not always helpful. Tendons often respond better to carefully adjusted activity and a progressive strengthening program guided by a physiotherapist or other qualified professional.
However, the appropriate exercises depend on the diagnosis. Some movements and stretches may aggravate a painful tendon if introduced too early or performed too aggressively.
If outer hip pain persists, a clinician can help determine whether tendon rehabilitation, another treatment, or further testing is appropriate.
3. Bursitis
Bursae are small, fluid-filled sacs that help reduce friction between moving tissues.
Around the hip, irritation of a bursa may contribute to pain and tenderness. When people refer to hip bursitis, they often mean inflammation or irritation around the outer hip.
Symptoms may include tenderness when pressing the affected area, pain when lying on that side, and discomfort during walking or climbing stairs.
The term bursitis is sometimes used broadly, but outer hip pain often involves tendon problems as well. This is why an accurate assessment is useful when symptoms persist.
Management may include temporarily modifying aggravating activities, avoiding direct pressure on the painful side, and following an appropriate exercise program.
A healthcare professional may also discuss medication or other treatment options depending on the cause and severity of the symptoms.
Do not repeatedly press, massage, or aggressively stretch a painful outer hip in the hope of making the inflammation disappear. These actions may worsen symptoms in some conditions.
4. Muscle strain
A muscle strain occurs when muscle fibers are overstretched or damaged.
Around the hip, strains may affect the hip flexors, adductor muscles on the inner thigh, hamstrings, or gluteal muscles.
A strain may occur after sprinting, lifting something heavy, slipping, kicking, or performing a movement your body is not accustomed to.
Symptoms may include localized pain, tenderness, swelling, and discomfort when contracting or stretching the affected muscle.
A mild strain may improve with relative rest and gradual return to activity. More severe injuries may require professional assessment and rehabilitation.
If you experienced a sudden pop, extensive bruising, severe pain, or significant difficulty walking, seek medical evaluation rather than assuming the injury is minor.
5. Hip fractures and stress fractures
A hip fracture is a break in one of the bones that form the hip joint or the upper part of the thighbone.
Fractures can occur after a major accident, but in older adults—especially those with osteoporosis—a relatively minor fall can sometimes cause a serious injury.
Symptoms may include sudden hip or groin pain, difficulty standing, swelling or bruising, and inability to bear weight normally.
Some fractures are less obvious than others. Being able to move the leg does not reliably rule out a fracture.
Stress fractures are different. They involve small cracks in bone that develop when repeated loading exceeds the bone's ability to repair itself. They may occur in people who rapidly increase running or other weight-bearing activity, and risk can be influenced by bone health and nutritional factors.
Stress fractures may initially cause pain only during activity. As the injury progresses, pain can become more frequent or occur during ordinary walking.
If a stress fracture is suspected, stop the activity that causes pain and seek prompt medical assessment. Continuing to train through a possible fracture can worsen the injury.
Sudden severe pain after a fall or injury, or an inability to bear weight, requires urgent evaluation.
6. Rheumatoid arthritis and other inflammatory conditions
Not all arthritis is caused by gradual wear and tear.
Rheumatoid arthritis is an autoimmune condition in which the immune system mistakenly attacks the lining of joints. It can cause pain, swelling, and stiffness and may affect multiple joints.
Although the hands and feet are frequently involved, other joints, including the hips, can also be affected.
Inflammatory joint conditions may cause prolonged morning stiffness or symptoms that improve somewhat with movement. However, these patterns are not unique to inflammatory arthritis.
If hip pain occurs alongside swelling in several joints, persistent fatigue, or prolonged morning stiffness, discuss the symptoms with a healthcare professional.
Early diagnosis can be important because treatment may help control inflammation and reduce the risk of joint damage.
7. Pain referred from the lower back
Sometimes the hip itself is not the main source of the pain.
The lower back contains nerves that travel toward the buttocks and legs. Irritation of these nerves can cause discomfort that feels as though it originates in the hip.
Depending on the cause, symptoms may include burning pain, tingling, numbness, or weakness. The discomfort may travel down the thigh and sometimes below the knee.
Pain referred from the spine may change with certain back movements or prolonged sitting, although symptoms vary.
If you experience new or worsening leg weakness, seek prompt medical advice. Sudden severe weakness, numbness around the groin or saddle region, or new loss of bladder or bowel control requires emergency assessment.