Bone spurs in the hip develop when your body lays down extra bone at the edges of the joint, usually in response to damage, friction, or instability. The most common cause is osteoarthritis, where the gradual loss of cartilage triggers the surrounding bone to compensate by growing outward. But arthritis isn’t the only trigger. Hip shape, past injuries, excess body weight, and repetitive stress can all set the process in motion.
How Bone Spurs Actually Form
A bone spur (the clinical term is osteophyte) doesn’t appear overnight. It starts with precursor cells in the periosteum, the thin tissue layer that wraps around bone. When cartilage in the hip joint wears down or becomes damaged, the body interprets this as a structural problem and activates growth signals, particularly proteins in a family called TGF-beta. These signals tell those precursor cells to start producing new bone at the margins of the joint.
The result is a bony ridge or bump that forms along the rim of the hip socket (acetabulum) or the ball of the thighbone (femoral head). In theory, the spur helps stabilize a joint that’s becoming loose as cartilage disappears. In practice, it often does the opposite: the extra bone restricts movement, irritates surrounding soft tissue, and can make pain worse.
Osteoarthritis Is the Leading Cause
The vast majority of hip bone spurs are tied to osteoarthritis. As the smooth cartilage lining the joint wears thin over years, the bones underneath start bearing loads they weren’t designed for. The joint responds by building bone spurs at the edges, essentially trying to spread the force over a larger surface area. This is why bone spurs and arthritis almost always appear together on imaging.
People over 50 are most commonly affected. Lower range of internal rotation and hip flexion are both associated with the presence of osteophytes, along with morning stiffness, higher BMI, male sex, and hip pain. A clinical threshold that physical therapists look for is hip internal rotation under 24 degrees, or internal rotation and flexion at least 15 degrees less than the opposite hip. If you’ve noticed your hip feels “stuck” or you can’t cross your legs the way you used to, bone spurs may be part of the reason.
Hip Shape and Impingement
Some people develop bone spurs not because of age-related wear, but because of the shape of their hip bones. This condition, called femoroacetabular impingement (FAI), comes in two forms.
- Cam type: The ball of the femur isn’t perfectly round. A bump on its edge grinds against the cartilage inside the socket during movement, gradually wearing it down.
- Pincer type: Extra bone extends over the normal rim of the hip socket, crushing the labrum (the ring of cartilage that seals the joint) underneath it.
In both cases, the abnormal contact between bones during everyday activities like walking, bending, or sitting creates repetitive micro-damage. Over time, this leads to cartilage breakdown, labral tears, and further bone spur growth. Some people are born with these shapes; others develop them during adolescence when the hip is still forming. Either way, the mechanical mismatch accelerates the same spur-forming process that osteoarthritis triggers.
Past Injuries and Trauma
A significant hip injury can set the stage for bone spur formation years later. Fractures of the hip socket are particularly associated with a related condition called heterotopic ossification, where bone grows in the soft tissues surrounding the joint. This abnormal bone can form spur-like protrusions from the pelvis or femur.
Post-traumatic bone growth can remain active for months to years after the initial injury, and it doesn’t always resolve on its own. When it follows a socket fracture, about 67% of patients report good to excellent long-term outcomes, but roughly a third experience recurrence. Hip surgery itself, including joint replacement, can also trigger this kind of bone growth. If removal becomes necessary, surgeons typically wait until the new bone has fully matured, which can take up to three years.
Labral tears, whether from a single injury or chronic impingement, also contribute. Once the labrum is damaged, the joint loses part of its seal and cushion, accelerating cartilage loss and the cascade that leads to spur formation.
Body Weight and Mechanical Stress
Your hip joints bear your full body weight with every step, and forces across the hip during activities like climbing stairs or running can reach several times your body weight. Higher BMI is independently associated with the development of hip osteophytes. The explanation is straightforward: more load on the joint means more mechanical stress on cartilage, faster wear, and a stronger signal for the body to lay down compensatory bone.
This is also why certain occupations and sports carry higher risk. Jobs that involve heavy lifting, prolonged standing, or repetitive hip flexion put extra demand on the joint. Athletes in impact sports like running, soccer, and hockey are more prone to both impingement-related and wear-related spurs.
What Hip Bone Spurs Feel Like
Many hip bone spurs cause no symptoms at all and show up incidentally on X-rays taken for other reasons. When they do cause problems, the most common complaint is a deep ache in the front or side of the hip during weight-bearing activities like walking, standing from a chair, or climbing stairs. Morning stiffness lasting less than an hour is typical. You might notice a grinding or catching sensation, or find that your hip simply won’t rotate as far as it used to.
The pain tends to come on gradually over months or years. It often worsens with activity and improves with rest, though more advanced cases can ache even when you’re sitting or lying down. Because bone spurs frequently coexist with cartilage loss and labral damage, it can be difficult to pin the pain on the spur alone. Your doctor may use X-rays or an MRI to see the full picture.
Managing Bone Spurs Without Surgery
Bone spurs themselves don’t shrink or disappear with conservative treatment, but the symptoms they cause can often be managed effectively. The 2024 AAOS guidelines for hip osteoarthritis, which covers most bone spur scenarios, offer several strongly supported approaches.
Anti-inflammatory medications like ibuprofen are the first-line recommendation for reducing pain and improving movement. Physical therapy is backed by high-quality evidence for mild to moderate hip arthritis, helping you strengthen the muscles around the joint and maintain range of motion. Weight loss reduces stress on the hip and can meaningfully decrease pain. Activity modification also matters: switching from high-impact exercise like running to lower-impact options like swimming or cycling takes pressure off the joint without sacrificing fitness.
Corticosteroid injections into the hip can provide short-term pain relief, though the effect is temporary. Hyaluronic acid injections, sometimes marketed for joint lubrication, are not recommended for the hip. They haven’t performed better than placebo in studies and aren’t FDA-approved for hip use.
When Surgery Becomes an Option
If conservative measures stop working, surgery may be appropriate. The type depends on the underlying problem.
For impingement-related spurs, hip arthroscopy is a minimally invasive option. A surgeon inserts a small camera and instruments through tiny incisions to shave down the bony bump (osteoplasty) and repair any labral damage. Most people recover in about six weeks. You’ll need crutches for a week or two, then gradually increase weight-bearing. Physical therapy continues for weeks to months afterward, and return to heavy exercise or sports typically happens around 12 weeks. Desk workers can usually go back to work within one to two weeks.
For advanced arthritis where cartilage is largely gone and bone spurs are extensive, total hip replacement is the standard surgical approach. The damaged surfaces of both the ball and socket are replaced with metal, plastic, or ceramic components. Hip resurfacing is a less common alternative that caps the femoral head with metal rather than removing it. Post-surgical exercise, whether at home or with a physical therapist, is strongly supported for improving recovery outcomes.
Osteotomy, which involves cutting and realigning the bones to redistribute pressure, is rarely used but may be considered in younger patients whose bone alignment is the primary issue.