Overview

Hip pain can affect people at all stages of life for different reason.
Causes of hip pain can be due to the joint or surrounding soft tissue structures and usually get better with simple measures.
Most cases of hip pain do not require X-rays or scans although there are occasions where these investigations may be needed.
Find out more about your hip pain in the other sections for further help.

Type of Hip Pain

Osteoarthritis is a normal, age related process affecting the hip joint. It is most common in adults over 55. The joint space will narrow and the hip become stiff. This can affect movement and mobility.
Commonly pain and stiffness is worse after prolonged rest or prolonged activity. Often this stiffness can be worst in the morning and may last up to half an hour.
Although many people associate osteoarthritis with a joint replacement, this is only needed in the most severe cases.
Most often hip osteoarthritis can be self-managed well with physical activity, weight loss and specific exercises.
This leaflet provides information, answers and self-help strategies regarding the condition:

Greater Trochanteric Pain Syndrome (also known as lateral hip pain or gluteal tendinopathy) affects the outside of the hip and the thigh and can radiate down the outside of the thigh.

Commonly pain is worse with prolonged walking, cross-legged sitting or lying down on the effected hip at night.

The tendons attaching muscles to the bony prominence on the outside of your hip and the bursa (fluid filled sacs) become irritated when the muscles are weak.

Strengthening the muscles around the hip has been shown to be significantly more effective for long term relief compared to steroid injections. Shockwave therapy is a possible treatment alongside physiotherapy for some patients. This leaflet provides information, answers and self-help strategies regarding the condition:

Greater Trochanteric Pain Syndrome

gtps

FAI is common in sports such as football, hockey and squatting. These sports involve twisting.

It can be due to the ball and socket not moving completely freely throughout its range of movement. This can be due to abnormalities of the femur (ball) and if isn’t completely spherical or the acetabulum (socket) because the socket is too deep, or both.

It is most often very well managed with physiotherapy. Less commonly in more severe cases, hip arthroscopy is an effective key-hole surgery to relieve symptoms, combined with post-operative rehabilitation.

Dysplasia is an abnormal formation of the ball and socket joint of the hip. It can affect both children and adults.

When detected early, dysplasia can be easily managed with physiotherapy and without the need for surgery.

A common sign is one leg dragging behind the other when crawling or limping when walking.

For more severe cases, a number of surgical options are available depending on the type of dysplasia.

Tendons attach muscles to bone. The tendons of the hamstring, hip flexor and adductor are affected less commonly than the gluteal tendon, but can be a cause of local pain around the buttock, groin or front of the hip.
Tendinopathies may be triggered by trauma (e.g. strain), by compression (e.g. prolonged kneeling), or by an increase in load (e.g. more walking). Inflammation will occur when the muscles and tendons are not strong enough to meet the demands on the body.
Pain is often intermittent, but can be felt as a constant, dull ache. It will ease with rest but static positions may allow inflammation and therefore pain may worsen at night.
Pain most often relates to activity levels and can be successfully treated with activity modification and a strengthening programme.

Is my hip pain likely to persist?

Take our one minute test

This quick questionnaire can help you identify how likely your pain is to persist over the next 6 months and whether you may need some extra support. It has been developed by a team of experts from Keele University – Click here for more information about the tool.

The tool has been shown to be very useful for people with common Musculoskeletal pain to profile individual risk of having a poor recovery and to use as a guide in conjunction with support from a healthcare professional if necessary.

Try out the questionnaire for yourself to see how you score and to get further help and advice. It will also be useful to retake the questionnaire after you have learned more key facts about your pain, either from this website or from a healthcare professional, to re-assess in time whether your hip pain problem is improving.

For question 1 – 9, think about just the last two weeks:
Pain intensity
1. On average, how intense was your pain? [where 0 is “no pain”, 10 is “pain as bad as it could be”]











Select one of the options for each question below Yes No
2. Do you often feel unsure about how to manage your pain condition?
3. Over the last 2 weeks, have you been bothered a lot by your pain?
4. Have you only been able to walk short distances because of your pain?
5. Have you had troublesome joint or muscle pain in more than one part of your body?
6. Do you think your condition will last a long time?
7. Do you have other important health problems?
8. Has a pain made you feel down or depressed in the last two weeks?
9. Do you feel it is unsafe for a person with a condition like yours to be physically active?
10. Have you had your current pain problem for 6 months or more?

 

High Risk

This test suggests you have some serious concerns about how well your hip pain will recover.

This may be related to feeling low and anxious generally or by being afraid that you might have done something serious to your hip.

It might help to discuss your concerns with a doctor or physiotherapist if things are still not improving over the next few weeks after following the advice and exercise in the Self Help section.

Also, visit the section on Persistent Pain for more information and support.

Most hip problems are not related to a serious condition.  Allowing yourself to move normally, without too much worry, will help your hip to return to normal. Painkillers often help you to move normally, while your hip recovers.

If you are feeling low or anxious, whether this I related to your hip pain or not, and you would like further help and support, visit NHS website – Health in Mind.

Medium Risk

This test suggests you may have some doubts about how well your hip will recover.

This may be related to feeling low and anxious generally or by being afraid that you might have done something serious to your hip.

It might help to discuss your concerns with a doctor or physiotherapist if things are still not improving over the next few weeks after following the advice and exercise in the Self Help

Most hip problems are not related to a serious condition.  Allowing yourself to move normally, without too much worry, will help your hip to return to normal. Painkillers can help you to move normally, while your hip recovers.

You might also want to access the Essex Lifestyle Service for further support and help on making healthy lifestyle choices and live healthier lives as this could be contributing to your hip pain.

Low Risk

Congratulations!  You most likely have the right ideas about your hip pain, and feel in control of how you manage your recovery.

We all know an episode of hip pain is very annoying, and at times extremely painful.   Carrying on as normal and continuing to move your hip allows the quickest recovery, and stops your hip stiffening up and losing strength.

Keep going as you are, although check out this link for more information and advice to get better even quicker.

You might also want to access the Essex Lifestyle Service for further support and help on making healthy lifestyle choices and live healthier lives as this could be contributing to your hip pain.

Please select all options.

Self help

Evidence has shown that people who understand their Musculoskeletal health problem and take an active involvement to help themselves have a much better outcome.

Here are some really helpful leaflets and useful links to other websites that have been approved by our physiotherapists so that you can start getting better with your hip pain today!

Leaflets

Hip Osteoarthritis
Source: Versus Arthritis

Further Support

If your hip pain is still not improving despite following the advice and guidance provided on the website for up to 6 weeks and you score a ‘Medium’ or ‘High Risk’ when completing the Is my hip pain likely to persist?, you may require further help and support from the Physiotherapy Outpatients Service. Please see your GP if you wish to be referred or discuss the management of your hip problem further.

With all hip pain it is best to try to keep the hip moving as able and to continue your normal activities but in smaller amounts until you can resume them normally again. If you are finding it difficult to walk then using crutches or a walking aid may help.

Remember that most causes of hip pain are not due to anything serious, although there are rare cases where you would need to seek urgent medical help. Contact NHS 111  for immediate medical advice if you have any of the symptoms below:

  • your hip pain was caused by a serious fall or accident
  • your leg is deformed, badly bruised or bleeding
  • you’re unable to move your hip or bear any weight on your leg
  • you have hip pain with a temperature and feel unwell

Seek an urgent GP appointment or attend A&E if your child has the following hip related symptoms:

  • Sudden pain in their hip, thigh or knee (hip problems can sometimes be felt in the thigh or knee)
  • Limping or can’t put any weight on one leg

Click here for further support and guidance.

 

FAQs

There is a poor link between changes visible on x-ray and symptoms of osteoarthritis. You can be in lots of pain but have minimal changes on x-ray and vice versa. Changes seen on X-ray does not mean you have to stop being active – Keeping active can help knee pain.
An x-ray is not necessary to diagnose arthritis. It is only needed if you are going to have joint replacement surgery. An x-ray can be useful if it is not obvious if the hip joint is contributing to your symptoms and your symptoms are lasting longer than 3 months.
Most people will never need a joint replacement and can manage their symptoms conservatively.
Physiotherapists are able to perform steroid injections for greater trochanteric pain syndrome, but not for hip osteoarthritis pain. Whilst injections can be very effective in the short term, research shows medium to long term relief is not often achieved, and physiotherapy is the best long-term option for pain relief. Your physiotherapist will be able to discuss if an injection is appropriate if you are being seen within the Physiotherapy Outpatient Service.
If it is too painful to walk and you are limping then a walking aid will probably help. You could try a walking stick or a pair of crutches.
You should go to A&E if you have had a serious fall or accident, if you are unable to bear any weight or unable to move your leg, or if you have hip pain alongside a fever/ generally unwell.
It is important not to overdo exercise if you feel you may have a tendinopathy. Equally it is important not to completely rest. Find a suitable amount of daily activity that you can manage and try to gradually increase this as the pain subsides.
A clicking noise or ‘popping out’ sensation is common at the hip. This is often where the tendon flicks over the pelvis – it does not mean something is breaking and is nothing to be concerned by. Often strengthening the hip muscles can help.