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Last reviewed: June 2025
This article is for informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment of hip pain.
Hip pain that persists for more than two to four weeks and interferes with daily activities is generally a strong signal to see a physiotherapist. Research from the Hospital for Special Surgery suggests that hip pain lasting more than a few weeks without improvement warrants considering physiotherapy. In this piece, you’ll learn which types of hip discomfort tend to resolve on their own, which red flags demand urgent medical attention, and the specific signs that mean booking a physiotherapy appointment is a smart next step. You’ll also find out what to expect from your first session and how quickly most people start noticing a difference.
Key Takeaways
- Minor hip soreness after unusual activity often resolves within one to two weeks with rest, gentle movement, and basic self-care.
- Hip pain lasting beyond two to four weeks, or pain that limits walking, sitting, or sleeping, is a clear reason to consult a physiotherapist.
- Certain red flag symptoms (sudden severe pain, inability to bear weight, fever, unexplained weight loss) require immediate medical evaluation, not just physiotherapy.
- A first physiotherapy session typically involves a thorough assessment of movement, strength, and daily habits before any hands-on treatment begins.
- Most people notice meaningful improvement within three to six sessions, though complex or chronic cases may take longer.
- Early intervention tends to produce better outcomes and can help prevent a short-term niggle from becoming a chronic problem.
Signs Hip Pain Might Settle On Its Own
Not every twinge in your hip needs professional intervention. The body is remarkably good at self-repair when the irritation is minor and the underlying structures are healthy. Knowing which situations tend to resolve naturally can save you time and money, and spare you unnecessary worry.
Muscle soreness after a new workout, a long run, or an unusually active weekend is the most common example. This kind of delayed-onset muscle soreness (DOMS) typically peaks 24 to 48 hours after the activity and fades within five to seven days. If you’ve recently increased your training volume or tried a new sport, a dull ache around the hip or glute region is fairly normal.
Mild stiffness first thing in the morning that loosens within 15 to 20 minutes of moving around is another pattern that usually isn’t cause for alarm. This is especially common in desk-based workers who spend eight-plus hours seated. The hip flexors shorten in a prolonged sitting position, and that tightness can create a stiff, achy sensation when you first stand up. Taking movement breaks every 30 to 45 minutes during your working day, and doing a few gentle hip stretches before bed, often makes a noticeable difference within a week or two.
A single episode of hip discomfort following an awkward movement, like catching yourself mid-stumble, may also settle without treatment. If the pain is mild, you can bear weight comfortably, and the discomfort improves day on day, your body is likely healing on its own.
The general rule of thumb: if the pain is mild, improving steadily, and not stopping you from doing your normal activities, it’s reasonable to monitor it for one to two weeks. Keep moving gently, apply ice or heat as feels comfortable, and avoid the specific activity that triggered it. If things are clearly trending in the right direction, you’re probably fine. If they plateau or worsen, that’s when the calculus changes.
Red Flags – Get Help Immediately
Some hip symptoms have nothing to do with tight muscles or training errors. They can indicate serious pathology that requires urgent medical assessment, not a physiotherapy appointment.
If you experience any of the following, contact your GP, visit A&E, or call 111 without delay:
- Sudden, severe hip pain after a fall or impact, especially if you cannot bear weight on the affected leg. This pattern raises concern for a hip fracture, particularly in older adults or anyone with reduced bone density.
- Hip pain accompanied by fever, chills, or redness and warmth over the joint. These can be signs of septic arthritis, a joint infection that requires emergency treatment.
- Unexplained weight loss alongside persistent hip or groin pain. While rare, this combination can occasionally point to underlying malignancy or systemic inflammatory conditions.
- Sudden onset of pain with swelling in the leg, particularly in the calf or thigh. This could indicate a deep vein thrombosis, especially if you’ve recently been immobile after surgery or a long-haul flight.
- Loss of bladder or bowel control alongside hip, groin, or lower back pain. This is a potential sign of cauda equina syndrome, a neurological emergency.
- Pain that wakes you consistently at night and is not relieved by changing position. Night pain that doesn’t respond to repositioning can be a marker of inflammatory arthritis or, less commonly, bone pathology. The NHS recommends that persistent night pain warrants investigation.
These red flags are uncommon, but they’re worth knowing about. The key distinction is between pain that behaves “mechanically” (gets better or worse with specific movements and positions) and pain that seems disproportionate, constant, or accompanied by systemic symptoms like fever or weight loss. Mechanical pain is usually safe to manage conservatively. Non-mechanical or systemic pain needs a medical opinion first.
If you’re unsure, err on the side of caution. A quick GP visit or urgent care assessment can rule out anything serious and give you the green light to pursue physiotherapy if appropriate.
7 Signs You Should Book Physiotherapy Now
Between “it’ll probably settle” and “go to A&E” sits a wide middle ground. This is where physiotherapy is most valuable: catching problems early, before they become entrenched. Here are seven clear indicators that booking a session is the right call.
- Your hip pain has persisted for more than two to four weeks without meaningful improvement. As physiotherapist Meghan Homoky (PT, DPT) from the Hospital for Special Surgery has noted, any hip pain warrants a check-up, regardless of severity. If you’ve given it a reasonable window and things aren’t shifting, waiting longer rarely helps.
- You’ve started changing how you walk, sit, or stand to avoid the pain. Compensatory movement patterns are a big deal. Limping or shifting weight to one side might protect the hip short-term, but it loads other structures (your lower back, opposite knee, ankle) in ways they aren’t designed for. This is often the trigger for secondary injuries.
- The pain is affecting your sleep. If you can’t lie on the affected side, or you’re waking up multiple times because of hip discomfort, your recovery is being compromised. Poor sleep increases pain sensitivity and slows tissue healing. A physiotherapist can advise on sleeping positions: many people find relief sleeping on their back with a pillow under the knees, or on the unaffected side with a firm pillow between the knees.
- You’ve had to reduce or stop your regular exercise. For those who train consistently, this is often the most frustrating sign. Whether it’s running, cycling, gym work, or a sport, hip pain that forces you to scale back is telling you something. A physiotherapist can identify whether the issue is muscular, joint-related, or tendon-driven, and build a rehabilitation programme that keeps you active while addressing the root cause.
- The pain started gradually without an obvious injury. This pattern often points to overuse, deconditioning, or biomechanical issues rather than acute tissue damage. It’s the classic scenario where the “trigger” (a particular run or gym session) is different from the “root cause” (months of accumulated hip stiffness, weak glutes, or excessive sitting). Physiotherapy is particularly effective here because it addresses both.
Rebecca Bossick (BSc (Hons) Physiotherapy) at One Body LDN puts it well: “The clients I see most often aren’t people who’ve had a dramatic injury. They’re busy professionals who’ve been sitting for years, training hard on weekends, and ignoring a gradually worsening hip niggle. By the time they come in, the hip itself is only part of the picture: their glutes have switched off, their hip flexors are chronically tight, and their lower back is picking up the slack.”
- You’ve noticed stiffness that lasts longer than 30 minutes each morning. Brief morning stiffness is normal. Prolonged stiffness, particularly if it’s getting worse over weeks, can suggest an inflammatory component. Conditions like hip osteoarthritis or inflammatory arthritis often present this way. Early physiotherapy intervention for hip osteoarthritis is supported by NICE guidelines (CG177), which recommend exercise and manual therapy as first-line treatment.
- You’ve tried rest, ice, and over-the-counter painkillers, and they’re not making a lasting difference. These measures can mask symptoms temporarily, but they don’t address the underlying mechanical or structural issue. If paracetamol or ibuprofen takes the edge off but the pain returns as soon as you stop, that’s a clear signal you need a proper assessment.
The common thread across all seven signs is that something isn’t resolving on its own. The longer you wait beyond that two-to-four-week mark, the more likely compensatory patterns will develop, and the longer rehabilitation tends to take.
What Happens in Your First Session at One Body LDN
If you’ve never seen a physiotherapist before, or it’s been a while, knowing what to expect removes a lot of the uncertainty. A first session at One Body LDN typically lasts around 60 minutes and follows a structured but conversational format.
The session begins with a detailed subjective assessment. Your physiotherapist will ask about the history of your hip pain: when it started, what makes it better or worse, how it affects your daily routine, and what your goals are. They’ll also ask about your work setup (how many hours you sit, your desk arrangement), your training habits, sleep quality, and stress levels. This isn’t small talk. Research consistently shows that pain is influenced by biological, psychological, and social factors. A physiotherapist who understands your full picture can design a far more effective plan than one who only looks at the hip in isolation.
Next comes the objective assessment: the hands-on portion. Your physiotherapist will observe how you move, testing your hip’s range of motion, strength, and stability. They may also assess your lower back, pelvis, and knee, since these areas are closely linked to hip function. Specific clinical tests help differentiate between common diagnoses like hip impingement, gluteal tendinopathy, labral irritation, and referred pain from the lumbar spine.
One thing that often surprises people: imaging like MRI or X-ray is rarely needed at this stage. NICE guidelines and the Chartered Society of Physiotherapy both emphasise that clinical assessment is usually sufficient to guide initial treatment. Routine imaging for non-specific hip pain can sometimes do more harm than good by revealing incidental findings that cause unnecessary anxiety.
After the assessment, your physiotherapist will explain their clinical reasoning: what they think is driving your pain, why, and what the plan looks like going forward. At One Body LDN, this typically includes a combination of hands-on manual therapy (soft tissue work, joint mobilisation) and a tailored exercise rehabilitation programme. You’ll leave with a clear understanding of what’s going on and a set of specific exercises to begin between sessions.
For those with private health insurance, the process is straightforward. One Body LDN accepts all major insurers, and no GP referral is needed. You can book your first appointment online in under 60 seconds.
How Soon Can You Expect to Feel a Difference?
This is the question everyone asks, and the honest answer is: it depends. But that doesn’t mean the timeline is completely unpredictable.
For acute, straightforward presentations (a muscle strain, mild hip flexor irritation, early-stage tendinopathy), many people notice a meaningful reduction in pain within two to three sessions. That might mean less morning stiffness, improved comfort while sitting, or the ability to return to light training. A systematic review published in the Journal of Orthopaedic & Sports Physical Therapy found that exercise-based physiotherapy produced significant improvements in pain and function for hip osteoarthritis within six to eight weeks.
Sub-acute issues (pain that’s been present for six to twelve weeks) often take a bit longer. Expect four to six sessions over a similar timeframe, with progressive loading and movement retraining forming the core of your programme. The key here is consistency with your home exercises. Your physiotherapist might see you once a week, but the real progress happens in the other six days.
Chronic hip pain (lasting more than three months) requires more patience. Tissue changes, movement pattern adaptations, and central sensitisation (where the nervous system becomes more sensitive to pain signals) all take time to unwind. A realistic timeframe is eight to twelve sessions over two to three months, though some people need longer. The biopsychosocial model of pain tells us that factors like stress, sleep quality, and beliefs about pain all influence recovery speed. Your physiotherapist should be addressing these alongside the physical components.
A point worth emphasising: physiotherapy isn’t just about eliminating current pain. As Meghan Homoky notes, a common misconception is that physiotherapy is only about getting rid of pain, when phase two should focus on preventing the problem from recurring and slowing the progression of any underlying issues so you can stay active long-term. This prevention phase is where the real value lies, especially for people who train regularly and want to stay injury-free.
Cost can be a consideration, though for those with private health insurance, out-of-pocket expenses are typically minimal. Specialist physiotherapy sessions can cost between £75 and £150 per hour in London, but insurance co-pays are usually far lower. If you’re paying privately, think of it as an investment in avoiding months of reduced activity, potential medication costs, and the knock-on effects of compensatory injuries.
Frequently Asked Questions
Can I see a physiotherapist without a GP referral?
Yes. In the UK, you can self-refer to a physiotherapist without seeing your GP first. Most private clinics, including One Body LDN, accept direct bookings. If you’re using private health insurance, check your policy: some insurers require a GP or consultant referral for reimbursement, though many now allow direct access to physiotherapy.
Is hip pain from sitting all day serious?
Prolonged sitting increases load on the hip flexors and can contribute to gluteal deconditioning, but it’s rarely dangerous. The concern is cumulative: years of excessive sitting without adequate movement can create the conditions for tendinopathy, bursitis, or early osteoarthritis. Regular movement breaks, a proper desk setup, and targeted strengthening exercises significantly reduce this risk.
Should I stop exercising if my hip hurts?
Not necessarily. Complete rest is rarely the best approach for musculoskeletal hip pain. The key is modifying your activity rather than stopping entirely. A physiotherapist can help you identify which movements to avoid temporarily and which are safe or even beneficial. Staying active within comfortable limits generally produces better outcomes than prolonged rest.
Do I need an MRI for hip pain?
Most hip pain does not require imaging. Clinical assessment by a skilled physiotherapist or doctor is usually sufficient to guide treatment. MRI may be recommended if your symptoms don’t respond to initial treatment, if there’s suspicion of a labral tear or stress fracture, or if surgery is being considered. Routine MRI for non-specific hip pain is not recommended by NICE.
How many physiotherapy sessions will I need?
This varies widely depending on the nature and duration of your problem. Acute issues may resolve in two to four sessions. Chronic or complex presentations might require eight to twelve sessions or more. Your physiotherapist should give you an estimated timeline after your initial assessment and adjust it as you progress.
Is physiotherapy or osteopathy better for hip pain?
Both disciplines can be effective for hip pain, and there’s significant overlap in the techniques used. Physiotherapy tends to place greater emphasis on exercise rehabilitation and progressive loading, while osteopathy often focuses more on manual therapy and joint manipulation. The best choice often depends on the individual practitioner’s skill and experience rather than the discipline itself.
Hip pain is one of those problems that’s easy to dismiss early on and frustrating to deal with once it’s become chronic. The single most useful thing you can do is pay attention to the timeline. If your hip pain isn’t clearly improving within two to four weeks, or if it’s already affecting your sleep, movement, or training, booking a physiotherapy assessment is a practical and evidence-based next step.
At One Body LDN, rated 4.9 on Google from over 6,500 reviews and named London Physiotherapy Clinic of the Year 2025, the team combines hands-on treatment with structured exercise rehabilitation tailored to your specific needs and goals. All major private health insurers are accepted, and no GP referral is required. You can book your first session online in under 60 seconds.
References
- Hospital for Special Surgery: Physical Therapy for Hip Pain – https://www.hss.edu/health-library/move-better/physical-therapy-for-hip-pain
- NICE Clinical Guideline CG177: Osteoarthritis: care and management – https://www.nice.org.uk/guidance/cg177
- Chartered Society of Physiotherapy: What to expect from physiotherapy – https://www.csp.org.uk/public-patient/what-expect
- Fransen M, et al. Exercise for osteoarthritis of the hip. Cochrane Database of Systematic Reviews, 2014 – https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007912.pub2/full
- PPT and Fitness: Average Cost of Physical Therapy – https://pptandfitness.com/blog/average-cost-of-physical-therapy-in-the-us/
