Condition guide
Hip Pain: What Causes It and What Actually Helps
Hip pain covers several very different problems that people describe with the same word. Pain in the groin behaves differently from pain on the outer hip, which behaves differently again from buttock pain that is actually coming from the back. Working out which one you have is most of the job. This page is general information, not a diagnosis. If anything here matches your symptoms, an assessment is the sensible next step.
What is Hip Pain?
Groin sided hip pain usually involves the hip joint itself, including osteoarthritis or the labrum. Pain on the outer hip is most often gluteal tendon related, sometimes described as bursitis, and is classically painful when lying on that side. Buttock pain that travels down the leg is frequently referred from the lumbar spine rather than the hip at all.
Typical Symptoms
- Deep groin ache, worse with prolonged walking, stairs or getting out of the car
- Pain on the outer hip when lying on that side at night
- Stiffness putting on socks and shoes or cutting toenails
- Buttock pain that can spread down the leg
- A limp or reduced walking distance without an obvious injury
Common Causes & Triggers
- Hip joint osteoarthritis, which responds better to strengthening than most people are told
- Gluteal tendon overload, common in women over forty and after a change in activity
- Referred pain from the lower back or sacroiliac region
- A sudden increase in walking, running or hill work
- Previous injury or surgery altering how the hip loads
How We Treat Hip Pain at Bluebell
- 1
Assessment that separates hip joint, tendon and spinal sources, because treatment differs completely.
- 2
Progressive strengthening for the glutes and surrounding muscles, the mainstay for both arthritic and tendon related hips.
- 3
Position and load advice, including sleeping positions for painful outer hips.
- 4
Hands-on treatment and adjuncts to help you tolerate the rehab.
- 5
Onward referral where a surgical opinion is appropriate, without pushing you towards it prematurely.
Honest Recovery Timeline
Gluteal tendon problems commonly need eight to twelve weeks of consistent loading, and often improve at night earlier than that. Hip osteoarthritis is managed rather than cured, and a well delivered strength and activity programme can meaningfully reduce pain and improve function, sometimes for years.
When Hip Pain Needs Urgent Medical Attention (Not Physio)
- •Hip pain after a fall in an older adult with inability to weight bear, go to A and E as this can be a fracture.
- •Hip or groin pain after significant trauma such as a fall from height or a road traffic collision, urgent medical review before any treatment.
- •Hot, swollen joint with fever or feeling unwell, urgent medical review.
- •Unexplained weight loss, night pain that wakes you consistently, or a history of cancer, see your GP.
- •Numbness in the saddle area or loss of bladder or bowel control with back and leg symptoms, A and E immediately.
Hip Pain — Common Questions
Is my hip pain arthritis?
Not necessarily, and even where arthritis is present it is often not the whole story. Assessment tells us how much of your pain is modifiable, which is usually more than people expect.
Why does it hurt most in bed?
Lying on the side compresses the gluteal tendons against the bone. A pillow between the knees and avoiding lying on the painful side often helps while treatment works.
Should I stretch it?
Aggressive stretching often aggravates outer hip tendon pain. We choose stretches carefully based on what your assessment shows.
Can physio delay a hip replacement?
For some people strengthening and activity changes reduce symptoms enough to postpone surgery. We will be honest if we think the pattern points towards a surgical opinion.
Is it coming from my back?
Sometimes. Buttock pain that travels down the leg is often spinal, which is why we assess both.