Pain associated with hip osteoarthritis is often felt in the groin or front of the hip, although it can also occur in the buttock or thigh. Some people experience discomfort that seems to extend toward the knee.
Symptoms often develop gradually. At first, pain may occur only during longer walks, climbing stairs, or other demanding activities. As the condition progresses, everyday movements may become more uncomfortable.
Common symptoms include:
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Pain during walking or standing.
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Stiffness after sitting or resting.
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Difficulty putting on shoes or socks.
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Reduced ability to rotate or bend the hip.
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Discomfort when getting into or out of a car.
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A gradual reduction in walking distance.
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Pain that interferes with sleep in more advanced cases.
Some people experience stiffness after waking up or after sitting for a prolonged period. The stiffness associated with osteoarthritis often improves after gentle movement, although symptoms can return after sustained activity.
These patterns may suggest a joint problem, but they do not confirm the diagnosis. Other conditions can cause similar symptoms.
Hip stiffness after rest and discomfort during everyday movement can occur with osteoarthritis, although other conditions may cause similar symptoms.
How Is Hip Osteoarthritis Diagnosed?
A healthcare professional will generally ask about the symptoms, when they started, and which activities make them worse. They may examine the hip's range of motion, muscle strength, walking pattern, and areas of tenderness.
Depending on the findings, imaging may be recommended. X-rays can show changes such as narrowing of the joint space, bone spurs, and other features associated with osteoarthritis.
However, imaging findings do not always correspond directly to the level of pain a person experiences. Some people have visible joint changes but relatively few symptoms, while others experience substantial discomfort.
The diagnosis therefore depends on the combination of the clinical history, physical examination, and appropriate investigations.
What Can Help Manage Osteoarthritis?
There is no single treatment that works for everyone, but several approaches can help reduce symptoms and maintain mobility.
Appropriate physical activity is an important part of management. Gentle walking, swimming, water-based exercise, and other low-impact activities may help maintain strength and endurance without placing excessive demands on the joint.
Strengthening exercises can improve the function of muscles that support the pelvis and hip. A physical therapist can help select exercises according to pain levels, mobility, and individual goals.
Weight management, when relevant, may reduce the mechanical load on weight-bearing joints and improve overall health. The aim should be a sustainable approach rather than rapid or extreme weight loss.
Pain-relief medication may be appropriate for some people. The choice depends on other medical conditions, medication interactions, and individual risks. Oral anti-inflammatory medicines, for example, may be unsuitable for certain people with kidney disease, stomach ulcers, cardiovascular conditions, or specific medication regimens.
For people whose symptoms remain severe despite appropriate nonsurgical treatment, joint replacement may be considered. The decision depends on pain, mobility limitations, overall health, and the person's preferences.
Hip osteoarthritis is not something that should automatically be accepted as an unavoidable consequence of aging. An appropriate treatment plan can help many people remain active and independent.
3. Bursitis: Inflammation Around the Hip
Bursitis is another possible cause of hip discomfort. It occurs when a bursa, a small fluid-filled sac that helps reduce friction between tissues, becomes irritated.
Bursae are located near joints, including around the outer part of the hip. Their function is to allow muscles, tendons, and bones to move smoothly against one another.
When a bursa becomes irritated, movements that compress or stretch the surrounding tissues can cause pain.
One common form of lateral hip pain is greater trochanteric pain syndrome. It may involve irritation of the bursa over the outer hip, but it can also involve the nearby gluteal tendons. This is an important distinction because not every case of pain over the outer hip is caused by bursitis alone.
What Can Trigger Hip Bursitis?
Several factors can contribute to irritation around the hip.
Repetitive walking, running, climbing stairs, and other activities that repeatedly load the muscles and tendons around the hip may aggravate the area. A direct impact, such as falling onto the side of the hip, can also cause symptoms.
People who stand for long periods, rapidly increase their activity, or repeatedly perform movements that load the outer hip may notice discomfort.
In some cases, the pain develops alongside changes in the way someone walks or moves. Weakness in the muscles that stabilize the pelvis can increase stress on surrounding structures.
However, the presence of these risk factors does not prove that bursitis is the cause. Pain around the outer hip can also arise from tendon problems, joint conditions, lower-back disorders, or other issues.
Recognizing the Symptoms
Bursitis or related lateral hip pain often causes discomfort on the outside of the hip, near the bony prominence at the upper thigh.
Symptoms may include:
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Pain when lying on the affected side.
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Tenderness when pressing the outer hip.
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Discomfort while walking or climbing stairs.
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Pain when standing after sitting for a long time.
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Discomfort during activities that require the hip to support body weight.
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Pain that extends down the outer thigh.
Some people notice that the pain is particularly troublesome at night because pressure from lying on the affected side aggravates the area.
Others experience discomfort during longer walks or when moving from sitting to standing.
Pain may develop gradually rather than after a single obvious injury. This can make it difficult to identify the original cause.
What Can Help?
Reducing activities that aggravate the pain can be useful while the affected tissues recover. However, avoiding all movement for prolonged periods is not usually necessary.
If lying on the painful side causes discomfort, sleeping on the opposite side with a pillow between the knees may reduce pressure. Some people find that lying on their back with suitable support is more comfortable.
A physical therapist may recommend exercises to strengthen the hip and pelvic muscles and improve movement control. The choice of exercise matters because some movements can increase compression around the outer hip and aggravate symptoms if introduced too aggressively.
Applying a cold pack wrapped in a towel may provide temporary relief after activity.
A clinician may also discuss medication or other treatment options when symptoms persist. In selected cases, an injection may be considered, although the benefits and risks depend on the diagnosis and individual circumstances.
If the hip becomes hot, red, markedly swollen, or severely painful, particularly when accompanied by fever, prompt medical evaluation is important. Infection involving a joint or nearby tissue requires a different approach from ordinary overuse-related pain.
The key point is that pain on the outside of the hip does not automatically mean the bursa is the only structure involved. Accurate assessment can help identify the most appropriate treatment.
4. Tendon Problems: When Repetitive Movement Causes Pain
Tendons connect muscles to bones and transmit the forces needed to move the body. Around the hip, tendons help lift the leg, stabilize the pelvis, rotate the thigh, and control movement during walking and running.
Repeated loading can sometimes cause a tendon to become painful and less tolerant of activity. Tendon problems may involve changes in the tendon structure, irritation of surrounding tissues, or a combination of factors.
The term tendinopathy is often used to describe tendon pain and dysfunction associated with these changes. It is more accurate in many cases than assuming every painful tendon is experiencing active inflammation.
Which Tendons Can Cause Hip Pain?
Several tendon groups may be involved, depending on where the pain occurs.