My Hip Hurts.
You're not imagining it. And you're not alone. Let's figure out what might be going on — and what to do next.
When Hip Pain Stops Being Something You Can Ignore
Hip pain has a way of sneaking up on you. At first it's a twinge after a long walk. Then it's stiffness in the morning that takes a while to shake off. Then it's the thing that wakes you up at 3 a.m. and makes you wonder if something is actually wrong.
If you're here, you've probably been living with hip pain for a while. Maybe you've been told it's just arthritis, or just getting older, or just something you need to manage. Maybe you've been told you're too young to have a real hip problem. Maybe you've been told all three.
This page won't diagnose you — only your doctor can do that. But it will help you understand what might be happening, what questions to ask, and when it's time to get a proper evaluation.
Where Hip Pain Actually Shows Up
Hip pain doesn't always feel like it's in your hip. That surprises a lot of people.
Groin
Pain deep in the groin — especially when walking, climbing stairs, or getting up from a chair — is one of the most common signs of true hip joint problems.
Outer hip and thigh
Pain on the outside of the hip or down the outer thigh may involve the hip joint, the bursa, or surrounding muscles and tendons.
Buttock
Buttock pain can come from the hip joint, the sacroiliac joint, or the lower back. It can be tricky to sort out without imaging.
Knee
Yes, really. Hip problems sometimes refer pain to the knee. If your knee hurts but your knee checks out fine, your hip may be the culprit.
Lower back
Hip and lower back problems often coexist and can mimic each other. A thorough evaluation helps sort out which is which.
Common Causes of Hip Pain
Several conditions can cause the kind of hip pain that eventually leads people to consider hip replacement. Here are the most common ones.
Osteoarthritis
The most common reason people eventually need hip replacement. Osteoarthritis is the gradual breakdown of cartilage — the cushioning tissue inside the hip joint. As cartilage wears away, bone begins to rub against bone, causing pain, stiffness, and loss of mobility. It tends to develop over years and is not simply a consequence of age — it can affect people in their 40s, 50s, and 60s.
Hip Dysplasia
A condition in which the hip socket doesn't fully cover the ball of the femur, leading to abnormal wear and instability. Many people with hip dysplasia are diagnosed in childhood, but some don't discover it until adulthood — sometimes when significant arthritis has already developed. Hip dysplasia is a leading cause of hip replacement in younger patients.
Avascular Necrosis (Osteonecrosis)
When blood supply to the femoral head (the ball of the hip joint) is disrupted, the bone tissue can begin to die. This is called avascular necrosis or osteonecrosis. It can be caused by long-term steroid use, excessive alcohol use, certain medical conditions, or trauma. It can progress to collapse of the femoral head and severe arthritis.
Femoroacetabular Impingement (FAI)
FAI occurs when the bones of the hip joint don't fit together perfectly, causing them to rub abnormally during movement. Over time, this can damage the cartilage and labrum (the ring of cartilage around the hip socket). FAI is increasingly recognized as a cause of hip pain in younger, active adults.
Rheumatoid and Inflammatory Arthritis
Unlike osteoarthritis, rheumatoid arthritis is an autoimmune condition in which the body's immune system attacks the joint lining. Other forms of inflammatory arthritis can also affect the hip. These conditions can cause significant joint damage and may eventually lead to hip replacement.
Post-Traumatic Arthritis
A previous hip fracture, dislocation, or other injury can damage the joint and lead to arthritis years later. Post-traumatic arthritis can develop even when the original injury seemed to heal well.
When to Get a Proper Evaluation
Not every hip ache needs an orthopedic surgeon. But some signs suggest it's time to stop waiting.
These are general guidelines, not medical advice. If you're concerned about your hip, trust your instincts and see a doctor.