Hip Pain: Causes, Prevention, Treatment, and Best Exercises
Hip pain affects your activity and mobility, but there's a lot you can do about it. Get tips to treat hip pain, especially with exercises from our physical therapists.
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Your hips play a very important role in how you move your body. They are uniquely strong and flexible, supporting the weight of your upper body and allowing you to squat, sit, walk, jump, and more. You rely on your hips for many everyday activities, which is why hip pain is common for many Americans. But just because hip pain is common doesn’t mean it’s inevitable or untreatable.
Here, learn more about what can cause hip pain, and how to prevent and manage it — especially with exercises from our Hinge Health physical therapists.
Our Hinge Health Experts
Cody Anderson, PT, DPT
Jonathan Lee, MD, MBA
Dylan Peterson, PT, DPT
What Is Hip Pain?
Hip pain is a general term for pain that occurs in or around the hip. The hip is a ball-and-socket joint that attaches the femur (thighbone) to the pelvis (a basin-shaped structure that supports the spinal column and abdominal organs). Surrounding muscles, ligaments, and cartilage make the hips very strong and resilient, but there are still many factors that can contribute to hip pain or injury.
Hip Pain Symptoms
The hip is one of the largest joints in the body, which means it can be hard to pinpoint exactly where the pain stems from. Symptoms can include:
Pain in the inside or outside of your hip
Decreased range of motion in your hip
Pain near your hip that gets worse with physical activity
You might experience thigh, buttock, or groin discomfort. Or you may feel pain in your back, down the front of your leg, or in your knee. In fact, knee pain (called referred or radiating pain) is sometimes the only indication that there’s a problem in the hip.
Hip Pain: A Hinge Health Perspective
While you may not be able to control every factor that contributes to your pain, you can always take control of some things. And that often starts with moving more. It can be scary to move through pain, especially when it impacts your quality of life. But gentle movement is actually one of the most important tools you have to manage and treat your hip pain. Whether it’s doing therapeutic exercises or walking an extra 100 steps in a day, it all counts, and it all helps.
Causes of Hip Pain
Here are some of the most common reasons you may experience hip pain.
Arthritis. There are several different types of arthritis that can contribute to hip pain, including osteoarthritis and rheumatoid arthritis. Arthritis can cause changes to the shock-absorbing cartilage between bones. While these changes are a normal part of aging and don’t necessarily cause symptoms, they can contribute to hip pain, inflammation, and swelling for some people.
Bursitis. Bursae are fluid-filled sacs that sit between bones, muscles, and tendons. They act like cushions and aid in smooth joint motion. There are two major bursae in the hip. When one or both become inflamed (usually from repetitive motion that your body isn’t prepared for or increased pressure), it can cause pain in the hip, outer thigh, or groin.
Tendinitis. Hip tendinitis is characterized by inflammation or changes to the hip tendons (thick cords that attach muscle to bone). It usually results from repetitive stress that your hip isn’t ready for, such as sudden increases in physical activity like running or cycling.
Hip fracture, or a break in the upper part of the femur (thighbone). Hip fractures are more common among older adults due to the increased risk of falling and loss of bone mass (osteoporosis).
Hip labral tear. The labrum is a ring of cartilage that helps hold the top of the femur (the “ball” of the hip) within the hip socket. Labral tears are typically caused by traumatic injuries, misalignment in the hip bones, or overuse. They’re especially common among people who participate in sports like hockey, soccer, football, golf, and ballet.
Femoroacetabular impingement (FAI). Also called hip impingement syndrome, this condition is characterized by abnormal bone growth in the hip that causes friction between bones during activity.
Sprains and strains. These are soft tissue injuries that occur when a muscle, tendon, or ligament around the hip is torn or stretched beyond its normal limit, often due to muscle tightness, injury, or overuse.
Sprains and strains differ in the structure that’s injured. A sprain is an injury to a ligament, whereas a strain (common cause of hip flexor pain) is an injury to a muscle or tendon.
IT band syndrome. The iliotibial (IT) band is a long band of connective tissue that runs from the hip to the knee. It works with the gluteal (butt) muscles to stabilize the leg. If the IT band repeatedly rubs against the bones of the knee or hip, it can become swollen and irritated, causing pain on the outside of the knee or hip.
Avascular necrosis. Also known as osteonecrosis, this is when bone tissue dies from lack of adequate blood supply. It’s sometimes due to a broken bone, dislocated joint, long-term steroid use, or excessive alcohol consumption.
Osteomyelitis, or a bone infection. Infection can begin in the bone (often caused by an injury that exposes the bone to bacteria), or it can start somewhere else in the body and travel to the bone.
When to See a Doctor
Given the complex nature of hip pain, many people wonder, “How do I know if my hip pain is serious?”
“While hip pain can definitely be uncomfortable and even scary, almost all types of hip pain can initially be managed with non-invasive treatments,” says Jonathan Lee, MD, orthopedic surgeon and senior expert physician at Hinge Health. “Treatments like injections and surgery are typically reserved for people who have persistent symptoms after first trying non-invasive choices, such as exercise therapy.”
In rare cases, hip pain may indicate a more serious problem. See a doctor if:
You’re unable to move or bear weight on your leg or hip
Your pain was triggered by a fall or injury
Your hip is visibly deformed
Your pain does not go away or interferes with your daily activities
Your pain is accompanied by fever or chills
Prevention Tips
If you’re prone to hip pain, there are many things you can do to manage and prevent it.
Check your chair. A major contributor to joint pain among adults is sitting for long periods of time. If you’re not able to change how long you spend sitting, a few small adjustments to your seat can make a big difference.
Height: Adjust the height of your chair so that your feet rest flat on the floor. This reduces pressure on your hips. If you can’t adjust your chair height, you can put your feet on a stool or footrest. You want your hips to sit slightly higher than your knees.
Seat firmness: Sitting on soft surfaces like couches and beds can put extra pressure on your hips or cause you to tilt to one side.
Back support: An ergonomic chair or seat with lumbar support helps keep your back and pelvis in good alignment to prevent slouching and tilting at your hips.
Be mindful of your body mechanics. Everyone is different and there’s no one way of sitting, standing or walking that works for all people. But there are a few techniques that help many people reduce the stress put on their hips.
Avoid crossing your legs for long periods when sitting as this can put extra pressure on one or both of your hips. If you like to cross your legs, just make sure to sneak some movement every 30 minutes by switching positions.
Sit with your buttocks and shoulders against the back of the seat to maintain a neutral upright posture.
Stand with feet shoulder-width apart to avoid leaning and putting more weight on one side of your body.
Wear flat shoes with good support to help with shock absorption. Even if you sit for much of the day, high heels can cause hips to tilt unevenly. If you have flat feet, you could try shoe inserts and arch supports (orthotics).
Move often. As Hinge Health physical therapists say, movement is medicine. It’s important to move your hip joints through a wide range of motion. This stabilizes and strengthens the muscles in and around your hips, which helps prevent pain and stiffness.
If you’re a runner, you may have experienced your fair share of hip aches. Try the following to prevent and manage pain after running:
Avoid running straight down hills, especially steep ones. Walk down instead.
Avoid hard surfaces like cement. Try to run on a smooth, soft surface, such as a track.
Check your shoes. Your running shoes should fit you well and have adequate cushioning. Hinge Health clinicians also suggest changing shoes every 350 to 500 miles as this is when running shoes tend to lose their cushioning and put extra stress on joints.
Mix it up. Incorporate strength training and non-weight-bearing activity such as swimming or cycling into your exercise routine. This challenges different muscles and cardiovascular endurance while giving your joints a break.
Maintain a healthy body weight for you. The ideal weight is different for everyone but maintaining a body weight that works for you can help reduce extra pressure on the joints of your lower body.
Do exercise therapy. Targeted movements, exercises, and stretches increase the strength and flexibility of the structures in and around your hips. (More information on this below).
Treatment for Hip Pain
The right course of treatment depends a lot on the nature and cause of your pain. The following tips from our Hinge Health physical therapists and medical doctors can provide relief for mild to moderate hip pain.
Over-the-counter (OTC) medication. Pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol), can be helpful for hip pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.
Ice and heat. Alternate using an ice pack and heating pad for 20 minutes at a time as needed to reduce swelling and inflammation (ice) and increase blood flow to reduce stiffness (heat).
Compression and elevation. To manage swelling, you can gently wrap a soft bandage around your hip and elevate your leg so your foot is above your heart.
Steroid injections. If over-the-counter medication does not offer sufficient pain relief, your doctor may suggest steroid injections to help counter pain and inflammation.
Change your sleep position. If you like to sleep on your side, lie on the side of your body that does not have hip pain to reduce pressure on your painful hip. You can also put a pillow between your knees to support your top hip and keep your hips in their natural alignment while you sleep. If you prefer to sleep on your back, placing a pillow under your knees may reduce hip pain caused by extra pressure on your low back.
Complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for hip pain relief, such as massage, acupuncture, or chiropractic care.
While all of the above steps can help with hip pain, one of the most effective is exercise therapy.
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
Exercises for Hip Pain
- Hip Flexor Stretch
- Bridge
- Squat
Low-impact exercises stretch, strengthen, and stabilize the structures that support your hip, which increases joint mobility while decreasing pain. The given exercises are recommended by Hinge Health physical therapists as a starting point.
Start by working these into your routine once or twice a week and build up to doing them daily if they’re helpful. If you have any concerns or questions about whether this routine is right for you, check with your healthcare provider first.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Surgery for Hip Pain
Most people can get hip pain relief from targeted exercise and stretching and other conservative treatments. There are, however, some instances when surgery is advised. If hip pain causes you to change your daily activities or it takes a toll on your quality of life, your surgeon may suggest hip replacement surgery (hip arthroplasty) and physical therapy.
Talk to your doctor about whether you’re a good candidate for surgery.
How Hinge Health Can Help You
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
Looking for pain relief? Check if your employer or health plan covers our program
References
Dick, A. G., Houghton, J. M., & Bankes, M. J. K. (2018). An approach to hip pain in a young adult. British Medical Journal, 361, k1086. doi: 10.1136/bmj.k1086
Flynn, D. M. (2020). Chronic Musculoskeletal Pain: Nonpharmacologic, Noninvasive Treatments. British Medical Journal, 102(8), 465-477. doi: 10.1136/bmj.k1086
Ahuja, V., Thapa, D., Patial, S., Chander, A., & Ahuja, A. (2020). Chronic hip pain in adults: Current knowledge and future prospective. Journal of Anaesthesiology Clinical Pharmacology, 36(4), 450. doi: 10.4103/joacp.joacp_170_19
Schwarze, M., Häuser, W., Schmutzer, G., Brähler, E., Beckmann, N. A., & Schiltenwolf, M. (2019). Obesity, depression and hip pain. Musculoskeletal Care, 17(1), 126–132. doi: org/10.1002/msc.1380