Help for Hip Pain

Diagnosing the cause of hip pain can be complicated. Here's what you need to know.

Daniel B. Marcus, M.D.

Sutter Maternity & Surgery Center of Santa Cruz

Palo Alto Medical Foundation

One day, you feel a twinge in your hip. That twinge gets worse, and you start to notice just how many movements your hips make in a day — sitting, rising, walking, climbing stairs. What can you do about it?

It’s complicated, says Daniel Marcus, M.D., a specialist in physical medicine and rehabilitation with the Palo Alto Medical Foundation. “When I ask a patient to point to the pain, you’d be surprised how many areas are identified as the ‘hip,’ ” he says. Patients may point to the side of the body, the groin area, the buttocks or the low back.

What people describe as hip pain may not be pain in the hip joint itself, Dr. Marcus says. “Hip pain is a symptom, not a diagnosis.”

Woman having hip adjusted

Common Causes of Hip Pain

The hip joint sits deep within the body, where the top of the thigh bone rotates inside the hip socket. The joint is supported by tendons, ligaments and muscles that hold it all together and initiate movement.

Strong, flexible muscles help the hip joint function smoothly. But it’s common for one part of the hip to be overused and tight while the opposite side doesn’t get enough use and is weak, causing pain.

Poor biomechanics of the feet, knees or spine can also cause discomfort in the hip joint. Runners can strain the hip due to bad running form or improper shoes, which can cause unusual force on the joint and surrounding muscles.

Back problems can cause pain that radiates down the leg or hip, when the culprit is a nerve exiting the vertebrae of the spine. Some hip pain might not be musculoskeletal at all, but arising from a hernia or a urinary tract infection.

Osteoarthritis is another common cause of hip pain, characterized by the breakdown of the cartilage that cushions the ends of the bones where they meet to form joints.

Preventing and Treating Hip Pain

Good conditioning is key to keeping your hip joint pain free. “Stretching and strengthening are so important, especially as we age,” Dr. Marcus says. “You may have been able to push your body in your chosen sport in your 20s and 30s without much stretching, but in later life, you need to be more careful to avoid injuries.”

He recommends swimming, running in the shallow end of the pool, yoga and regular long walks to keep the hip joint limber and flexible.

If you have hip pain, treatment depends on your age, fitness level and needs. For younger athletes with hip pain, physical therapy and other non-invasive treatments can help. For older people with severe pain, treatment depends on your goals.

“If your goal is to walk with your grandchildren, then good shoes, a stretching routine, or even use of cane might be all you need to achieve them,” Dr. Marcus says. “If your pain is more severe or limiting daily activities, then a new hip joint might be the best answer."