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5 Common Causes of Hip Pain

October 15, 2023

Hip pain can be the source of a lot of stress – especially if you’re worried that hip replacement surgery is in your future.

But Daniel Witmer, MD, an orthopedic surgeon at the Bone & Joint Institute at Hartford Hospital has good news for you.

“Not only is hip pain very common, but it’s also usually benign and treatable without surgery,” he says. “Many people are nervous to see an orthopedic surgeon because they think we will do surgery. But, getting your issues evaluated properly leads to fewer problems down the road.”

Here’s the downlow on hip pain and five common causes, according to Dr. Witmer.

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Hip pain can start in several ways

Hip pain is uncomfortable, especially since we spend a lot of our lives upright.

“Just like our knees, hips can get pretty beat up over time. This usually presents as arthritis and bursitis, but there are other reasons why your hip can hurt,” says Dr. Witmer.

Here are five of the most common causes:

1. Arthritis

Hip arthritis is common for people over 45 years old. Osteoarthritis occurs when the cartilage that protects and cushions joints breaks down over time.

Symptoms of hip arthritis include groin pain and pain that radiates down your thigh that gets worse with activity and better with rest.

> Related: Is Arthritis Causing Your Hip or Knee Pain? If You’re 1 in 4 Americans, the Answer’s Likely Yes

2. Bursitis

Bursitis is inflammation of the bursa, a small sac of fluid that provides cushion and lubricates areas where tissues (i.e., ligaments, tendons, muscles, skin) rub against each other. It can happen when you put continued pressure on a joint or repeat the same movement repeatedly.

If you have bursitis, the outer side of your hip may really hurt, especially when you lay on it at night. You may also feel pain when you try to put on your socks and shoes.

3. Overuse

It’s easy to strain your muscles to cause hip pain, especially if you jumped into a new physical activity without much preparation. After rest and medication, chat with your doctor before you resume activity.

Whether you want to tackle a half marathon or 18 holes of golf, your orthopedist can help create a realistic plan to get you there.

4. Avascular necrosis (AVN)

Avascular necrosis (AVN) is when the femoral head of the hip joint (aka the “ball”) dies and becomes misshapen because it doesn’t have enough blood flow. As the hip rapidly becomes bone on bone, it’s incredibly painful.

AVN is more common in people who took a lot of steroids like prednisone, had chemotherapy, or experienced previous hip trauma. The solution for AVN is hip replacement, a procedure that has people walking hours after surgery.

5. Injury

Hip injuries can happen to anyone. Muscle tears can happen to young people during physical activity, like a soccer game. Stress fractures are a common injury in older women with osteoporosis and can happen even from a slight hip bump.

Or, hip pain may not be about your hip at all

Sometimes, your hip pain may be from a hernia or a pinched nerve in your back. It’s easy to get confused about where this pain comes from, but your doctor can help you figure it out and feel better.

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Most hip pain goes away in 4 weeks

“If you start to have an ache or a pain in your hip, back off the stressful things and modify your activities,” says Dr. Witmer.

He suggests:

  1. Low-impact exercise (i.e., swimming, biking)
  2. Extra stretching
  3. Over-the-counter medications. Start with Tylenol, and don’t take non-steroidal anti-inflammatory (NSAIDs) for more than four weeks without doctor supervision. With longer use, these meds may lead to stomach or kidney problems.

“Remember to use common sense as you gradually return to activity,” says Dr. Witmer. “If you do all this for a few weeks, it will take care of most things 90% of the time.”

But, if it doesn’t help in a month, see your doctor

“We can identify your hip pain cause with just a physical exam in the majority of cases. And, we can treat most pain non-surgically,” Dr. Witmer explains.

But if you’re unstable, can’t put weight on your leg, or have other systemic symptoms with your hip pain (i.e., fever, chills, weight loss), Dr. Witmer urges you to see a doctor immediately.