My Hip Hurts. Now What?

Hip pain has a way of sneaking up on you. One day you notice a little stiffness getting out of a chair. Then it's a twinge walking to the car. Then it's keeping you up at night. Then it's changing everything.

If you're reading this, you're probably somewhere in that progression — and you're wondering what's actually going on and what to do next.

Let's start with the basics.

Where Hip Pain Actually Shows Up

Here's something that surprises a lot of people: hip pain doesn't always feel like it's in your hip.

The hip joint sits deep in the pelvis, and pain from it can radiate in unexpected directions. Common locations include:

• Groin — this is the most classic location for true hip joint pain
• Front of the thigh, sometimes all the way to the knee
• Buttock — though buttock pain can also come from the lower back or piriformis muscle
• The outer hip or side of the thigh (often bursitis, not the joint itself)
• The knee — yes, really. Hip problems can refer pain to the knee

This is why "hip pain" is such a broad term — and why self-diagnosis is genuinely unreliable. Pain in your groin might be your hip. Pain in your buttock might be your hip, your lower back, or something else entirely.

Common Symptoms Worth Paying Attention To

Beyond pain location, certain patterns tend to point toward the hip joint:

• Stiffness in the morning or after sitting for a while
• Pain that improves with movement but worsens with prolonged activity
• Difficulty putting on shoes or socks (bending the hip)
• A grinding, clicking, or catching sensation in the joint
• Reduced range of motion — trouble rotating the leg inward or outward
• Pain walking, especially on uneven surfaces or stairs
• Pain at night that disrupts sleep
• A limp that develops gradually

None of these symptoms automatically mean you need surgery. But they do mean your hip deserves a proper evaluation.

What Causes Hip Pain?

Hip-area pain can come from many sources. Some of the most common include:

• Osteoarthritis — the most common cause of hip joint pain in adults over 50, caused by cartilage breakdown
• Hip bursitis — inflammation of the fluid-filled sacs (bursae) around the joint
• Hip labral tears — damage to the cartilage ring around the socket
• Femoroacetabular impingement (FAI) — abnormal contact between the ball and socket
• Hip dysplasia — a shallow socket that causes abnormal wear
• Avascular necrosis (AVN) — loss of blood supply to the femoral head
• Tendinitis — inflammation of the tendons around the hip
• Referred pain from the lower back or sacroiliac joint
• Stress fractures (less common, but worth knowing about)

This is exactly why hip pain should not be self-diagnosed. The treatment for bursitis is very different from the treatment for osteoarthritis, which is very different from the treatment for a labral tear.

When Should You See an Orthopedic Specialist?

There's no single rule, but most people benefit from an orthopedic evaluation when:

• Pain has persisted for more than a few weeks without improvement
• Pain is affecting your sleep, work, or daily activities
• You've noticed a significant change in how you walk
• Over-the-counter pain relief is no longer helping
• You're avoiding activities you used to enjoy because of hip pain
• You've had a fall or injury involving the hip area

Your primary care doctor is often a good first stop — they can order initial imaging and refer you to an orthopedic specialist if needed. Some people go directly to an orthopedic surgeon; others see a physiatrist (a physical medicine and rehabilitation specialist) first.

What an Orthopedic Evaluation Typically Involves

An orthopedic evaluation for hip pain usually includes:

• A detailed history of your symptoms — when they started, what makes them better or worse, how they affect your daily life
• A physical examination — the doctor will assess your range of motion, strength, gait, and where exactly you feel pain
• Imaging — X-rays are almost always the first step. They show bone structure, joint space, and signs of arthritis. MRI may be ordered to evaluate soft tissue (cartilage, labrum, tendons)
• Sometimes blood tests, if inflammatory arthritis is suspected

The goal of the evaluation is to identify the source of your pain and rule out other causes — not to immediately recommend surgery.

Questions Worth Asking at Your First Appointment

Going into an orthopedic appointment prepared makes a real difference. Consider asking:

• What do you think is causing my pain?
• What does the imaging show?
• What are my treatment options at this stage?
• Are there conservative treatments I should try first?
• What would you expect to happen if I don't treat this?
• When would you recommend considering surgery?
• Are there lifestyle changes that might help?

One More Thing

Hip pain is common. It's also highly treatable — often without surgery, at least initially. Physical therapy, anti-inflammatory medications, activity modification, and injections can all provide meaningful relief for many people.

But the first step is understanding what you're actually dealing with. And that starts with a proper evaluation.

You deserve to know what's going on in your own body. Don't wait until the pain is unbearable to find out.