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Why does my hip hurt?

Are you wondering what’s wrong with your hip? There are a number of different conditions that can cause hip pain. Mr Bhupinder Mann from The Chiltern and The Shelburne Hospital offers his advice on different hip conditions and their associated symptoms.

Here are 6 different conditions that can cause hip problems:

1. Osteoarthritis

Often a result of ‘wear and tear’ and simply getting older, hip osteoarthritis occurs when the layer of cartilage degenerates. Although it's usually an age related condition, it can arise at any age, particularly if there is a family history of hip problems or there has been previous injury to the hip.

Heavy or repetitive lifting and being overweight can also be contributing factors to hip osteoarthritis1.

There are non-surgical options available, such as losing weight in overweight patients which can help to reduce the weight placed on a damaged hip joint. Over-the-counter painkillers can also help to reduce pain, as well as comfortable shoes and a stick. Regular exercise and physiotherapy can help to keep the muscles and joints active. In some cases, a steroid injection can provide temporary pain relief for several months2.

If non-surgical methods prove to be ineffective over a period of time, then total hip replacement surgery may be recommended. This involves removing the diseased cartilage and replacing it with an artificial prosthesis.

Symptoms can include: 

  • Joint tenderness
  • Pain
  • Stiffness
  • A cracking sound
  • Limited range of movement3

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2. Fracture

A fracture is a break in the bone. This often occurs following a high impact injury or a fall and typically requires urgent admission to hospital and surgery.

Sometimes there may be a subtle stress fracture or a hairline crack which causes hip pain. This is often associated with a history of long distance running or repetitive loading of the hip. In some cases, surgery may be required to fix this.

Symptoms can include:

  • Pain
  • Unable to lift or move your leg
  • Inability to put weight on your leg
  • Bruising and swelling4


3. Bursitis

A bursa is a fluid filled sac which decreases friction or rubbing around a joint. With overuse it can become inflamed and angry. The commonest area in the hip is the ‘trochanteric bursa’ which sits just on the outside of the hip. Because of where it’s located it can typically wake patients up when they turn on that side at night.

Treatment often involves physiotherapy and sometimes an injection into the bursa.

Symptoms can include:

  • A dull, achy pain
  • Tenderness
  • Swelling
  • Pain when moving or pressing5

4. Tendonitis

When tendons and muscles become overworked, tendonitis can occur. The tendons can become stiff, dysfunctional and may even develop trigger points followed by pain.

The treatment for tendonitis typically involves physiotherapy which is directed towards stretching and strengthening the muscles around the hip.

Symptoms can include: 

  • Pain
  • Difficulty moving
  • A grating or crackling sensation
  • Swelling
  • A lump6

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5. Osteonecrosis

This is a disturbance in the blood supply to the hip. There are many causes, which can include injury, long term steroid use and excessive alcohol consumption. If it is diagnosed in the early stages, protected weight bearing and physiotherapy may help. However, more advanced stages may require surgery.

Symproms can include: 

  • Groin ache
  • Difficulty standing
  • Pain7

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6. Impingement and labral tears

Hip impingement can happen when there is abnormal bone growth. This can cause the labrum (a rubber seal around the hip joint) to become pinched and eventually tear causing pain and irritation. If a labral tear does occur, keyhole hip surgery may be required to repair the tear.

Symptoms can include: 

  • Pain
  • Stiffness
  • A clicking sound
  • Giving way8

What to do next

If your hip pain isn’t improving, there are certain things you can do to help manage your discomfort.

Depending on the cause of your pain and your symptoms, you may find that gentle exercise can help to strengthen the hip joint and reduce discomfort. However, this should also be balanced with rest.

If your hip pain is severe or isn’t getting better, you should make sure to seek advice from a healthcare professional, such as a physiotherapist or a consultant orthopaedic surgeon.

Identifying the cause of your problem early can help to prevent further damage to your hip.

Get advice from another of our orthopaedic surgeons: Mr Sebastian Dawson-Bowling shares more information on common causes of hip pain.