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Hip Pain: Symptoms, Causes, Treatment and When to See a Physio

Hip pain reaches every kind of person: runners and lifters, desk workers, and older adults who notice walks getting shorter. The pain itself takes different forms, a deep ache in the groin, a sharp catch when walking or twisting, an outer-hip soreness that ruins side-sleeping, and each form points somewhere different. Where your hip hurts, and when, does most of the diagnostic work, and this guide walks through both.

Key Takeaways

  • Location is the hip's most reliable clue: joint problems speak deep in the groin, tendon problems on the outer hip, and referred pain travels in from the lower back or pelvis.
  • Outer hip pain that is worse lying on that side at night points to the trochanteric bursitis pattern rather than the joint itself.
  • Morning stiffness that eases with movement is the classic signature of joint-related hip pain, including early arthritis.
  • Hip pain lasting beyond twelve weeks rarely resolves on its own; by then capacity, not healing, is the limit, and strengthening is the treatment.
  • Numbness around the groin or changes in bladder or bowel control alongside hip pain need urgent medical review, not physiotherapy.\

What is Hip Pain?

Hip pain is discomfort, stiffness, or aching around the hip joint, groin, buttock, or outer thigh. The hip is a deep ball-and-socket joint surrounded by some of the strongest muscles and tendons in the body, so pain here can come from the joint itself, the tendons beside it, or arrive as referred pain from the lower back or pelvis.

Location is the most reliable first clue: joint problems tend to be felt deep in the groin, tendon problems on the outer hip, and referred pain travels in from elsewhere. Assessment works out which of those stories yours is telling, then treatment follows the actual source rather than the sore spot.

Main Types of Hip Pain

Groin-Pain-or-Hip-Joint-Arthritis with red spot indicate pain

Groin Pain or Hip Joint Arthritis

Deep, aching pain felt in the front of the hip or groin, common in active adults and older individuals. Morning stiffness that eases with movement is the classic joint signature, and the quiet early signals are mapped in our guide to early hip osteoarthritis warning signs. Where groin pain has several possible sources, our guide to groin pain that comes from the hip sorts the hip-driven kind from the rest.

How Hip Joint Pain Shows Up In The Buttocks

Gluteal or Outer Hip Pain (Trochanteric Bursitis)

Pain and tenderness over the bony point on the outside of the hip, often worse lying on that side at night and after longer walks. Our guide to hip bursitis symptoms and self-testing covers the recognition pattern, and the broader clinical picture behind it is explained in our guide to greater trochanteric pain syndrome.

Labral-Tear-or-Hip-Impingement with red spot indicate pain

Labral Tear or Hip Impingement

Sharp, pinching pain or catching deep in the groin, typically with twisting, deep squats, or long sitting, and more common in younger active hips. Home tests for the impingement pattern sit in our guide to hip impingement (FAI) symptoms, and the catching pattern is mapped in our guide to hip labral tear signs.

The Early Warning Signs

Referred Hip Pain from the Lower Back or SIJ

Pain travelling from the spine or pelvis that mimics hip symptoms, often buttock-centred. Deep buttock pain has its own differential, covered in our guide to piriformis syndrome or hip pain.

The Signs Of A Hip Labral Tear

Postural or Muscle-Related Pain

 Tightness and aching from imbalance between the hip flexors, glutes, and core, common in people who sit most of the day and in athletes after load jumps.

Where Is Your Groin Pain Coming From

Post-Injury or Post-Surgery Pain

 Stiffness, weakness, and lost confidence following trauma, fracture, or hip replacement surgery, where structured rehabilitation restores what immobilisation took.

Each type needs its own approach, which is why accurate diagnosis comes before any treatment plan.

Common Causes and Contributing Factors

  • Overuse or repetitive strain from sport, running, or a jump in training load
  • Prolonged sitting compressing and deconditioning the hip's support muscles
  • Weak glutes and core muscles leaving the joint under-supported
  • Muscular imbalance or genuinely shortened hip flexors
  • A previous injury, or impingement-shaped anatomy, loading the joint unevenly
  • Age-related joint change, the most common driver of hip pain over 60

Often no single cause explains it. Hip pain usually reports the combined load of lifestyle, strength, and movement habits, and assessment weighs all three rather than hunting one villain.

Symptoms and What They Mean

Hip pain symptoms vary with the structure involved:
  • Dull, aching pain deep in the hip or groin, the joint's usual voice
  • Sharp pain when walking, climbing stairs, or standing from sitting, patterns our guide to hip pain when climbing stairs breaks down
  • Stiffness after rest or first thing in the morning
  • Clicking, catching, or locking sensations in the joint
  • Pain lying on the affected side, and night pain generally, which has its own escalation rules covered in our guide to hip pain at night
  • Weakness or difficulty squatting, running, or lifting

The pattern matters as much as the pain: where it sits, what fires it, and whether it is trending better or worse across weeks. Assessment reads that pattern, rules out the serious causes, and names the structure behind it.

Clinical insight from One Body LDN
"The giveaway we listen for with outer hip pain is the sleeping position. When someone tells us they have swapped sides in bed, or put a pillow between their knees just to get through the night, that points at the tendons and bursa on the outer hip long before any test confirms it, and it changes the plan from stretching, which usually aggravates it, to graded strengthening."

Rebecca Bossick — Chartered Physiotherapist & Clinical Director

How Long Does Hip Pain Last?

Acute hip pain, under six weeks, often settles with treatment, sensible activity changes, and targeted exercise. Sub-acute pain, six to twelve weeks, usually needs a structured strengthening programme, because by then the limiting factor is capacity rather than tissue healing.

Persistent pain beyond twelve weeks rarely resolves on its own and responds best to an integrated plan of manual therapy, progressive loading, and movement retraining. Early help prevents the compensations, the limp, the lean, the shrinking walks, that make later recovery slower.

When Hip Pain Needs Urgent Attention (Red Flags)

Most hip pain is mechanical and responds well to physiotherapy, but urgent medical review is needed if you experience:
  • Sudden inability to walk or bear weight, especially after a fall or trauma
  • Severe pain with swelling or deformity in the hip or thigh
  • A hot, swollen hip with fever or feeling unwell
  • Numbness around the groin or changes in bladder or bowel control
  • Unexplained weight loss, night sweats, or constant pain unrelated to movement
If in doubt, a physiotherapist can triage your symptoms and refer you to the right medical specialist promptly, the same day where needed.

How Physiotherapists Diagnose Hip Pain

During your assessment, your physiotherapist will:
  • Take a detailed history of your symptoms, lifestyle, and activity levels
  • Watch how you stand, walk, and move, since the hip shows its problems in motion
  • Test muscle strength, flexibility, and joint mobility against the other side
  • Work out whether symptoms come from the hip joint, the tendons, the spine, or the pelvis
  • Use specific clinical tests to rule out serious pathology
Where imaging such as X-ray, ultrasound, or MRI would genuinely change the plan, your physiotherapist coordinates with your GP or an orthopaedic specialist to arrange it. Most hip diagnoses, though, are made through examination, not scans.

Physiotherapy Treatment for Hip Pain

Treatment follows the diagnosis, and for most hip problems it blends four elements:

Hands‑On Therapy

Joint mobilisation, trigger-point release, and soft-tissue work to ease pain and restore movement.

Exercise Therapy

Focused strengthening for the glutes, hip stabilisers, and core, the engine of every lasting hip recovery.

Movement Retraining

Correcting gait, posture, and exercise technique so the joint stops being overloaded the same way twice.

Rehabilitation Programmes

Staged progression from early mobility work through to sport-specific or life-specific conditioning.
For stubborn cases, shockwave therapy, dry needling, or Pilates-based rehabilitation can support the loading work where the evidence backs them.

How Physiotherapy Helps Long Term

The aim goes past short-term relief to lasting movement confidence. Physiotherapy helps to:
  • Restore joint range of motion and muscle balance
  • Reduce inflammation and stiffness
  • Improve walking mechanics and posture
  • Support a safe return to exercise, sport, or daily activity
  • Prevent recurrence through strength, education, and load management
You also learn to self-manage: what to do when the hip niggles, how to keep the key muscles strong, and how to spot the difference between a flare and a new problem.

When to See a Physio

See a physiotherapist if:
  • Pain persists beyond two to three weeks or keeps returning
  • Sleep is disrupted by hip discomfort
  • Pain limits walking, training, or daily activities
  • A limp or lean has appeared in your walk
  • You are unsure whether exercise is helping or harming

The full decision rules, by time, cause, and recurrence, are set out in our guide to when to see a physio for hip pain, and our guide to finding a private physio for hip pain covers how to choose well. For older adults weighing up what hip pain means and what physiotherapy can realistically do, our guide to hip pain in older adults answers the questions we hear most.

Take the Next Step Toward Recovery

At One Body LDN, our physiotherapists treat the full range of hip problems, from muscle tightness and bursitis to impingement, arthritis, and post-surgical rehabilitation. We combine thorough assessment, hands-on treatment, and staged rehabilitation so you can move confidently again. Direct access applies: no GP referral needed.

Book an appointment with a Hip Pain Physiotherapist

Learn more about Hip pain

Frequently Asked Questions

Why does my hip hurt when sitting but not walking?

Sitting folds the hip deep and holds it there, which compresses the front of the joint and shortens the hip flexors; walking moves the joint through range and often feels easier. This pattern leans toward impingement, flexor tightness, or an irritated joint front, and it responds to sitting habits plus targeted strengthening.
Both directions are real. The hip commonly refers pain down the thigh toward the knee, particularly in children and older adults, and a weak hip changes leg mechanics enough to overload the knee. A knee that hurts without local tenderness earns a hip check in assessment.
It depends on the diagnosis, which is why this question matters. Joint stiffness and tight flexors often respond well to mobility work; outer-hip tendon and bursa pain is usually aggravated by stretching and needs strengthening instead. If stretching keeps making it worse, that is diagnostic information, not a reason to stretch harder.
Usually yes, in doses the hip settles from within a day. Walking keeps the joint moving and the muscles working. Distances that flare the pain for days, or a walk that produces a limp, mean the current dose is too high while treatment rebuilds capacity.
Both hips together usually reflects a shared driver: sitting hours, a training jump, or general deconditioning affecting each side equally. Both hips with long morning stiffness and other joints involved can suggest an inflammatory condition and deserves a GP review.
Yes, through two routes: sustained compression at the front of the folded hip, and gradual deconditioning of the glutes that support it. The fix is dosage and strength, movement breaks, varied sitting positions, and glute work, rather than a special chair alone.
Painless clicking is common and usually tendons flicking over bony points as the hip moves; on its own it needs no treatment. Clicking with pain, catching, or locking deep in the groin points toward the joint or labrum and is worth assessing.
Usually not, or not yet. Most hip arthritis is managed well for years with strengthening, load management, and activity adjustments, and the evidence for exercise in hip osteoarthritis is strong. Replacement enters the conversation when pain and function stay poor despite a proper course of conservative care.
Night removes distraction and adds sustained positions: lying on the sore side compresses the outer-hip tissue, and lying still stiffens an irritated joint. An evening ache after busier days is common; night pain that wakes you regularly regardless of the day’s activity deserves assessment.
Often, yes. Many labral tears, especially degenerative ones, settle to full comfortable function with strengthening and movement modification, and labral changes appear on scans of pain-free hips too. Surgery is a considered option for the minority that stay symptomatic despite proper rehabilitation.
Temporarily, the ones that sharply reproduce your specific pain, deep loaded squats and pigeon-style stretches for impingement-type pain, side-lying pressure and long stretching for outer-hip pain. Avoidance is short-term load management, not a permanent list; the goal of treatment is to earn those movements back.
Both usually load a sore hip more gently than running, which makes them useful bridges that keep fitness while capacity rebuilds. Saddle height matters in cycling for impingement-type pain, and breaststroke kick can aggravate some groins. The right bridge depends on your diagnosis.

References

Medically Reviewed

This page has been reviewed for clinical accuracy, clarity and patient safety in line with One Body LDN's Editorial and Clinical Standards.