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:

Watch these three short videos of an internationally-respected physiotherapist explaining hip osteoarthritis, also known as OA, and why it hurts.

Watch these three short videos addressing some of the questions you might have about physical activity, weight loss and other strategies to help your knee pain due to osteoarthritis (OA).

For a summary of this information, the Provide Physiotherapy Outpatients Service have created a short educational video on hip osteoarthritis including links to additional support services that you can refer yourself to.

To create your own exercise programme at a level you can tolerate based on what you like and what you need, Click Here. Alternatively, go straight to the exercise inventory for beginner and more advanced knee and hip exercises and get started today!

If you want to learn more about your hip osteoarthritis, watch these short educational videos to get some simple advice and information to help you better manage your hip pain.

Although if you are looking for a more structured education and exercise programme to improve the management of your hip osteoarthritis, Click Here to access a free NHS online programme called ESCAPE-pain, which consists of 12 sessions over a 6 week period you can complete from home.

For help with weight loss, visit Essex Wellbeing Service or Click Here for more information on how losing weight can help to reduce pain and disability related to osteoarthritis.

Click Here for exercises that our physiotherapists would recommend for helping with the movement of your hip. Or Click Here for exercises that may assist with strengthening of the hip. Often a combination of both movement and strength can assist with the management of hip osteoarthritis.

Click Here for further information on Osteoarthritis and ways to manage it effectively.

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. You can also click Here for early stage exercises to help with managing symptoms of Greater Trochanteric Pain Syndrome.

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.

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!

This information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment if required. All content is for general information purposes only.

Click Here to access our getUBetter app, which is an easy, safe and effective way to support your recovery.

Leaflets

Low Risk Musculoskeletal Pain
Hip Osteoarthritis
Greater Trochanteric Pain Syndrome (GTPS)

Videos

Hip osteoarthritis – Part 1 of Why does it hurt – is it “Bone on Bone”?
PlayPlay

Watch this useful short video for advice on how to manage back pain
Source: Chartered Society of Physiotherapy

Hip Osteoarthritis – Part 1 of Why does it hurt – is it “Bone on Bone”? A deep dive into the common misconception that you have pain because you have ‘bone on bone’ changes on X-ray.
Source: OA optimism

Hip osteoarthritis – Part 2 of Why does it hurt – is it wear and tear?
PlayPlay

Hip osteoarthritis – Part 2 of Why does it hurt – is it wear and tear?
Source: OA optimism

Hip Osteoarthritis – Part 2 of Why does it hurt – is it wear and tear?
Source: OA optimism

Hip osteoarthritis – Part 3 of Why does it hurt – pain is more about sensitivity than damage
PlayPlay

Hip Osteoarthritis Part 3 of Why does it hurt – pain is more about sensitivity than damage.
Source: OA optimism

Hip osteoarthritis – Part 4. Overview on some of the things that you can do to help yourself.
PlayPlay

Hip Osteoarthritis – Part 4. Overview on some of the things that you can do to help yourself.
Source: OA optimism

Hip osteoarthritis – Part 5
PlayPlay

Hip Osteoarthritis – Part 5. Looking into the idea of whether weight is essential to help yourself and how exercise and activity can still help even if you don’t lose weight
Source: OA optimism

Hip osteoarthritis – Part 6. Talking about the benefits of exercise and activity even when painful and how you can do it safely.
PlayPlay

Hip Osteoarthritis – Part 6. Talking about the benefits of exercise and activity even when painful and how you can do it safely.
Source: OA optimism

A short 90 second video on how pain is influenced by a number of factors using the cup analogy for pain
PlayPlay

A short 90 second video on how pain is influenced by a number of factors using the cup analogy for pain
Source: Greg Lehman – Movement Optimism

Provide Back to Activity Programme – Circuit exercises
PlayPlay

Provide Back to Activity Programme – Circuit exercises

Provide Back to Activity Programme – Pilates exercises
PlayPlay

Provide Back to Activity Programme – Pilates exercises

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Exercises

Adductor Tendinopathy Stage 1
Adductor Tendinopathy Stage 2
Adductor Tendinopathy Stage 3
Adductor Tendinopathy Stage 4
GTPS Stage 1
GTPS Stage 2
GTPS Stage 3
GTPS Stage 4
Hip Strengthening Exercises
Stiff & Painful Hip

Useful Links

Further Support

If your hip pain is still not improving despite following the advice and guidance provided on the website 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 Service. Please click on the ‘Physiotherapy Self-Referral’ box to refer yourself to the service for further management of your back problem.

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 hip 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.