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Last reviewed: June 2025
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Hip pain is one of the most common musculoskeletal complaints among adults, and it can range from a mild ache after a long day at your desk to a sharp, debilitating sensation that stops you mid-stride. Roughly 14.3% of adults aged 60 and older report significant hip pain on most days, and the problem is far from limited to older populations: chronic hip pain affects 30%-40% of adults who play sports. Whether your discomfort started after a weekend run, a heavy deadlift session, or simply after hours of sitting in a boardroom, understanding the causes, symptoms, and warning signs can help you make smarter decisions about your body. This guide breaks down what hip pain actually is, what drives it, and the specific red flags that mean you need professional attention fast.
Key Takeaways
- Hip pain has many sources: It can originate from the joint itself, surrounding muscles, tendons, or even be referred from the lower back.
- Desk-bound professionals are at particular risk: Prolonged sitting tightens hip flexors and weakens glutes, creating conditions for pain over time.
- Morning and night pain have different causes: Stiffness on waking often relates to inactivity, while night pain can signal inflammatory or more serious conditions.
- Not all hip pain means damage: A biopsychosocial approach recognises that stress, sleep, and lifestyle all influence pain perception.
- Red flag symptoms exist: Sudden inability to bear weight, fever with joint pain, or visible deformity warrant urgent medical evaluation.
- Active rehabilitation outperforms passive rest: Physiotherapy and graded exercise are first-line treatments for most hip conditions.
What Is Hip Pain?
Hip pain refers to any discomfort felt in or around the hip joint, the largest ball-and-socket joint in the human body. The hip connects your femur (thighbone) to your pelvis, and it bears your full body weight during standing, walking, running, and sitting. Because the joint is so central to movement, problems here tend to ripple outward, affecting your gait, your lower back, and even your knees.
The pain itself can show up in several locations. Some people feel it deep in the groin, which often points to an issue within the joint itself. Others notice it on the outer hip, the buttock, or even radiating down the thigh. This variation matters because where you feel the pain often gives clinicians their first clue about the underlying cause.
One thing worth understanding early: pain does not always equal structural damage. Your nervous system plays an active role in how pain is produced and perceived. Stress, poor sleep, and prolonged inactivity can all amplify pain signals, even when no significant tissue injury exists. This biopsychosocial model of pain is now widely accepted in clinical practice, and it is especially relevant for high-pressure professionals whose work-related stress and sedentary habits may be sensitising their pain response without them realising it.
Rebecca Bossick (BSc (Hons) Physiotherapy), a physiotherapist at One Body LDN, puts it plainly: “I see a lot of clients who assume their hip pain must mean something is torn or worn out. Often, the real issue is a combination of prolonged sitting, deconditioning, and accumulated stress. Once we address those factors alongside the physical symptoms, the improvement can be remarkable.”
It is also important to distinguish between an immediate trigger and a root cause. You might feel a sudden twinge during a squat or a sprint, but the underlying issue is frequently weeks or months of accumulated stiffness, muscle weakness, or movement imbalance. The acute episode is the straw that broke the camel’s back, not the whole story.
Common Causes of Hip Pain
The causes of hip pain span a wide spectrum, from overuse injuries to degenerative conditions to systemic diseases. Here are the most frequent culprits.
Osteoarthritis is the leading cause of hip pain in adults over 50. It involves the gradual breakdown of cartilage that cushions the joint, leading to bone-on-bone friction, stiffness, and aching. The global hip osteoarthritis pain drug market is projected to reach $8.06 billion by 2025, which gives you a sense of how widespread this condition is. Osteoarthritis tends to develop slowly and worsen over years, though the rate of progression varies enormously between individuals.
Femoroacetabular impingement (FAI) is a structural issue where extra bone grows along one or both of the bones forming the hip joint, causing them to fit together improperly. FAI affects approximately 54.4 per 100,000 person-years, and it is particularly common in younger, active adults. Many people with FAI on imaging are completely pain-free, which is another reminder that structural findings do not always correlate with symptoms.
Bursitis occurs when the fluid-filled sacs (bursae) that cushion the hip become inflamed. Greater trochanteric bursitis, felt on the outer hip, is one of the most common forms and is frequently seen in runners and people who sleep on one side.
Tendinopathy of the gluteal tendons or hip flexors is extremely common among both athletes and desk workers. Prolonged sitting shortens the hip flexors and weakens the gluteal muscles, creating an imbalance that places excessive load on tendons. The hip tendinitis market is projected to grow at a 5.44% CAGR from 2024 to 2035, reflecting rising prevalence globally.
Referred pain from the lumbar spine is an often-overlooked cause. A disc bulge or facet joint irritation in the lower back can send pain signals into the hip, groin, or buttock. If your hip pain is accompanied by lower back stiffness or tingling in the leg, the spine may be the true origin.
Other causes include labral tears, stress fractures (particularly in endurance athletes), hip flexor strains, and less commonly, inflammatory conditions such as rheumatoid arthritis or infection.
Typical Symptoms of Hip Pain
Hip pain presents differently depending on its source, and recognising the pattern of your symptoms can help guide appropriate care.
Joint-related pain, such as that from osteoarthritis or a labral tear, is typically felt deep in the groin or front of the hip. You might notice it during weight-bearing activities like walking or climbing stairs, and it often comes with a sensation of stiffness or catching. Range of motion may feel restricted, particularly when rotating the leg inward or bringing the knee toward the chest.
Tendon and muscle-related pain tends to localise on the outer hip or buttock. It can be sharp with specific movements, such as crossing one leg over the other, or it may present as a dull, persistent ache that worsens with prolonged activity. Gluteal tendinopathy, for instance, often flares when lying on the affected side at night.
Referred pain from the lumbar spine can mimic hip joint problems closely. It may present as a deep ache in the buttock or groin, sometimes travelling down the back of the thigh. Numbness, tingling, or a burning sensation alongside the pain often suggests nerve involvement from the lower back.
General symptoms to track include the location of pain, what makes it better or worse, whether it is constant or intermittent, and how it affects your daily activities. Keeping a brief symptom diary for a week before seeing a clinician can be genuinely helpful.
Is Hip Pain Normal?
Occasional hip discomfort after a long run, an intense gym session, or a full day of travel is not unusual. Muscles and joints respond to unaccustomed loads with temporary soreness, and this typically resolves within 24 to 48 hours with rest and gentle movement.
What is not normal is pain that persists beyond a couple of weeks, progressively worsens, or begins to limit your ability to perform everyday tasks. In the 45-54 age group, 9.7% of women and 4.6% of men report hip pain, so it is certainly common, but common does not mean it should be ignored or accepted as inevitable.
If you find yourself modifying how you walk, avoiding exercise, or relying on painkillers more than twice a week, that is your body telling you something needs attention. Pain that has been present for more than 12 weeks is classified as chronic and typically requires a structured rehabilitation programme rather than a wait-and-see approach.
Hip Pain in the Morning / at Night
Morning hip stiffness is one of the most frequently reported symptoms, and it has a straightforward physiological explanation. During sleep, you are relatively immobile for hours. Synovial fluid, which lubricates the joint, distributes less effectively when you are still. Discs in the spine also rehydrate overnight, which can increase pressure on surrounding structures. The result is that first-step-out-of-bed stiffness that eases after 15 to 30 minutes of movement.
For desk-based professionals, morning stiffness can be compounded by the previous day’s prolonged sitting. If you spent eight hours in a chair followed by an evening on the sofa, your hip flexors have been in a shortened position for most of the day. A medium-firm mattress and sleeping on your side with a pillow between the knees can reduce mechanical stress on the hips overnight.
Night pain is a different matter and deserves closer attention. Pain that wakes you from sleep or prevents you from falling asleep may indicate an inflammatory condition such as rheumatoid arthritis, an infection, or in rarer cases, a bone-related pathology. Inflammatory conditions tend to produce pain that is worst in the early hours and improves with movement, whereas mechanical pain typically worsens with activity and eases with rest.
If night pain is persistent and not relieved by changing position, it warrants prompt medical review.
When Should You Worry About Hip Pain?
Most hip pain is benign and responds well to conservative management. But certain symptoms are red flags that require urgent evaluation.
- Sudden inability to bear weight on the affected leg, especially after a fall or impact
- Visible deformity of the hip or leg
- Fever accompanied by hip or groin pain, which may suggest infection
- Severe pain that came on suddenly without an obvious cause
- Pain that is constant, worsening, and unrelieved by rest or position changes
- Unexplained weight loss alongside hip pain
- Night pain that consistently wakes you from sleep
- Numbness, weakness, or loss of bladder or bowel control (which may indicate cauda equina syndrome and is a medical emergency)
A useful clinical rule of thumb from the American Hip Institute: you should see a specialist when pain expands beyond the event where it occurs and becomes a constant presence, especially when you have to plan your day around it. If you are rearranging meetings, skipping workouts, or avoiding stairs because of your hip, that is a clear signal to seek professional assessment.
For active individuals and athletes, pain that does not settle within two weeks despite relative rest, or that returns every time you resume training, also warrants investigation. Pushing through persistent pain without a diagnosis risks turning an acute, treatable issue into a chronic one.
How Is Hip Pain Diagnosed?
Diagnosis typically begins with a thorough clinical history and physical examination. A skilled physiotherapist or doctor will ask about the onset, location, and behaviour of your pain, your activity levels, and any relevant medical history. They will then perform a series of physical tests to assess range of motion, strength, and specific provocative manoeuvres that help identify the affected structure.
Common clinical tests include the FADIR test (flexion, adduction, internal rotation) for labral tears and impingement, the FABER test for sacroiliac or hip joint pathology, and resisted muscle tests for tendinopathy. A thorough examination of the lumbar spine is also essential to rule out referred pain.
Imaging is not always necessary and is often overused. Routine MRI scans for hip pain frequently reveal incidental findings, such as labral tears or mild cartilage changes, that are present in people with no symptoms at all. NICE guidelines recommend that imaging should be guided by clinical findings, not used as a first-line screening tool. An X-ray may be appropriate if osteoarthritis is suspected, and MRI is reserved for cases where the clinical picture is unclear or a specific structural injury needs confirmation.
At One Body LDN, rated 4.9 on Google based on 6,500+ reviews, the approach prioritises a detailed physical assessment before considering imaging. This avoids unnecessary scans that can sometimes cause more anxiety than clarity.
Blood tests may be ordered if an inflammatory or systemic condition is suspected, such as rheumatoid arthritis, gout, or infection.
How Is Hip Pain Usually Treated?
The treatment pathway depends entirely on the diagnosis, but for the vast majority of hip conditions, active rehabilitation is the gold standard. Prolonged bed rest is no longer recommended for most musculoskeletal hip problems: it tends to worsen stiffness and deconditioning.
Physiotherapy is the first-line treatment for most hip pain. A structured programme typically includes targeted strengthening of the gluteal muscles, hip flexor stretching, and graded loading of affected tendons or joints. Research published in the British Journal of Sports Medicine consistently supports exercise-based rehabilitation as the most effective conservative intervention for conditions including osteoarthritis, tendinopathy, and post-surgical recovery.
For desk-bound professionals, treatment should also address the habits that contributed to the problem. That means taking movement breaks every 30 to 45 minutes, setting up an ergonomic workstation, and incorporating regular hip mobility work into your routine. A standing desk used for part of the day can also reduce cumulative hip flexor shortening.
Manual therapy, including deep tissue massage and joint mobilisation, can complement exercise by reducing muscle tension and improving joint mobility in the short term. It works best when combined with an active exercise programme rather than used in isolation.
Medication such as non-steroidal anti-inflammatory drugs (NSAIDs) may help manage acute flare-ups, but they are not a long-term solution. Corticosteroid injections can provide temporary relief for bursitis or severe tendinopathy, though repeated injections carry risks including tendon weakening.
Surgery is typically reserved for cases that have not responded to a thorough course of conservative treatment, usually a minimum of three to six months. Hip replacement surgery has excellent outcomes for end-stage osteoarthritis, and arthroscopic surgery may be considered for certain labral tears or FAI. The knee and hip disorders market is projected to reach $30 billion by 2027, reflecting both the prevalence of these conditions and the growing range of treatment options.
Kurt Johnson (M.Ost, Master of Osteopathy) at One Body LDN notes: “The clients who get the best outcomes are the ones who commit to their rehab programme and understand that recovery is an active process. A good treatment plan should give you the tools to manage your condition independently, not make you dependent on appointments.”
Frequently Asked Questions
Can sitting too long cause hip pain? Yes. Prolonged sitting shortens the hip flexors and weakens the gluteal muscles, creating muscular imbalances that can lead to pain over time. If you work at a desk, aim to stand or walk for a few minutes every 30 to 45 minutes. Even brief movement breaks can make a meaningful difference to hip health.
Should I stop exercising if my hip hurts? Not necessarily. Complete rest is rarely the best approach. Modifying your activity to avoid movements that aggravate the pain is usually more effective. Low-impact exercise such as swimming, cycling, or walking often remains comfortable and helps maintain joint health. A physiotherapist can help you find the right balance.
Is hip pain more common in women? Research suggests it is. In the 45-54 age group, 9.7% of women report hip pain compared to 4.6% of men. Hormonal factors, wider pelvic anatomy, and differences in muscle strength may all contribute to this disparity.
Do I need an MRI for hip pain? Not usually as a first step. Clinical examination by a qualified professional can identify the likely cause in most cases. MRI is typically reserved for situations where the diagnosis is unclear or surgery is being considered. Incidental findings on scans can sometimes cause unnecessary worry.
Can stress make hip pain worse? It can. Stress increases muscle tension and affects how the nervous system processes pain signals. High-pressure work environments and poor sleep are both associated with increased pain sensitivity. Addressing these factors alongside physical treatment often produces better results.
How long does hip pain take to resolve? This varies widely. Acute muscle strains may settle within two to four weeks. Tendinopathy and osteoarthritis often require several months of consistent rehabilitation. Chronic hip pain lasting more than 12 weeks typically needs a structured, progressive treatment programme.
When should I see a physiotherapist for hip pain? If your pain has lasted more than two weeks, is affecting your daily activities, or keeps returning with exercise, professional assessment is a good idea. Early intervention tends to produce faster and more complete recovery than waiting months and hoping it resolves on its own.
Your Next Steps
Hip pain is extremely common, but it is rarely something you simply have to live with. The majority of hip conditions respond well to a combination of targeted exercise, lifestyle modification, and hands-on treatment. The key is getting an accurate diagnosis early and committing to an active rehabilitation approach rather than relying on painkillers or hoping the problem disappears.
If your hip pain has been lingering or is starting to affect your training, your sleep, or your ability to focus at work, professional guidance can make all the difference. At One Body LDN, named London Physiotherapy Clinic of the Year 2025, the team combines exercise rehabilitation with hands-on treatment to address both the symptoms and the root cause. All major private health insurers are accepted, and no GP referral is needed. You can book your first session online in under 60 seconds.
References
- Chronic hip pain affects 30%-40% of adults who play sports
- 12%-15% of adults over 60 experience hip pain
- Approximately 14.3% of adults aged 60 and older report significant hip pain on most days
- In the 45-54 age group, 9.7% of women and 4.6% of men report hip pain
- Femoroacetabular impingement (FAI) affects 54.4 per 100,000 person-years
- Global hip osteoarthritis pain drug market projected to reach $8.06 billion by 2025
- Hip tendinitis market projected to grow at 5.44% CAGR from 2024 to 2035
- Knee and hip disorders market projected to reach $30 billion by 2027
- When hip pain becomes a constant presence, see a specialist
