Right hip pain has dozens of possible causes, ranging from muscle strain to joint wear to nerve irritation. About 14% of adults over 60 report significant hip pain on most days, and women are affected more often than men. The cause depends largely on where exactly you feel the pain, whether it’s in the front of the hip, the side, the back, or deep in the groin, and what movements make it worse.
Where You Feel It Matters
Hip pain that centers in the groin or deep inside the joint usually points to a problem within the joint itself, such as cartilage damage, a labral tear, or arthritis. Pain along the outer side of the hip is more commonly linked to tendons and muscles, particularly those that stabilize the pelvis when you walk. Pain that wraps around to the buttock or shoots down the leg may originate in the lower back or involve a compressed nerve rather than the hip joint at all.
This distinction is the single most useful thing you can identify before seeing a provider. A description like “it hurts deep in my groin when I bring my knee to my chest” narrows the list of causes dramatically compared to “my hip hurts.”
Osteoarthritis
Osteoarthritis is the most common cause of hip pain in people over 50. The cartilage lining the ball-and-socket joint gradually wears down, leading to stiffness, reduced range of motion, and an aching pain that worsens with activity. You may notice it most when getting out of a chair, climbing stairs, or after sitting for a long time. Over the years, the joint space narrows and bony spurs form around the edges of the socket.
The hallmark of hip osteoarthritis is pain with rotation. If turning your foot inward or outward while the knee is bent reproduces the deep groin ache, the cartilage surface is likely involved. Morning stiffness that lasts less than 30 minutes and loosens up with movement is typical, as opposed to inflammatory arthritis where stiffness lasts much longer. A standard X-ray of the pelvis taken while standing is usually enough to confirm the diagnosis.
Femoroacetabular Impingement
Femoroacetabular impingement, often called FAI, is a structural mismatch between the ball of the thighbone and the socket it sits in. It’s one of the most common causes of hip pain in younger, active adults and a frequent precursor to arthritis later on. There are two forms. In the cam type, a bump on the edge of the ball prevents it from rotating smoothly, grinding against the cartilage inside the socket. In the pincer type, extra bone along the rim of the socket extends too far, crushing the soft tissue ring (the labrum) that seals the joint.
Turning, twisting, and squatting tend to produce a sharp, stabbing pain. Sitting for long stretches, especially in low chairs or car seats where the hip is flexed past 90 degrees, can also trigger symptoms. Many people with FAI have both cam and pincer features at the same time. Physical therapy focused on hip mobility and core stability is the first line of treatment, with arthroscopic surgery reserved for cases that don’t respond.
Labral Tears
The labrum is a ring of tough cartilage that lines the rim of the hip socket, helping to seal the joint and distribute pressure evenly. It can tear from repetitive motions (common in runners, dancers, and soccer players), from FAI that pinches it over time, or from a single traumatic event like a fall.
The signature symptoms are a clicking or popping sensation when you move the hip and a feeling of instability, as though the joint might give way. Deep groin pain that’s hard to pinpoint is typical, sometimes described as a dull ache that sharpens with certain positions. Crossing your legs, pivoting, or getting in and out of a car may reproduce it. High-resolution MRI can identify most labral tears without the need for a contrast injection into the joint.
Greater Trochanteric Pain Syndrome
If your pain is along the outer side of the right hip, the most likely culprit is greater trochanteric pain syndrome. The greater trochanter is the bony point you can feel on the outside of your hip, and several tendons and a fluid-filled sac (bursa) sit over it. This condition was historically called “trochanteric bursitis,” but imaging studies have shown that the pain more often comes from wear or small tears in the tendons of the gluteal muscles rather than inflammation of the bursa itself.
Tenderness when you press directly on the outer hip bone is the classic finding. Lying on the affected side at night is often painful enough to wake you up. Walking may produce a noticeable lean or drop of the opposite hip, a sign that the stabilizing muscles aren’t firing properly. Anti-inflammatory medications and physical therapy targeting the gluteal muscles resolve most cases. If pain persists despite several months of rehabilitation, an MRI can check for a tear in the gluteus medius tendon, which sometimes requires surgical repair.
Referred Pain From the Lower Back
The hip and the lumbar spine share overlapping nerve pathways, which means a problem in one area can masquerade as pain in the other. Nerve roots exiting the spine at the L1 through L3 levels supply sensation to the upper hip, groin, and front of the thigh. A bulging disc, spinal stenosis, or arthritis at those levels can send pain directly into the right hip without any back pain at all.
Clues that the source is actually the spine include pain that changes with back position (bending forward, arching backward), numbness or tingling in the thigh or groin, and a hip exam that doesn’t reproduce the pain. It’s not unusual for both the hip and the spine to contribute at the same time, which can make sorting out the primary driver tricky. In uncertain cases, a diagnostic injection of anesthetic into the hip joint can clarify whether the joint itself is responsible.
Deep Gluteal Syndrome
Deep gluteal syndrome refers to compression of the sciatic nerve as it passes through the muscles of the buttock, most commonly the piriformis. It produces pain in the back of the hip and buttock that can radiate down the leg, mimicking sciatica from a disc herniation. Sitting for long periods, especially on hard surfaces, tends to make it worse.
A seated stretch that brings the knee toward the opposite shoulder while rotating the hip reproduces the pain in about 9 out of 10 cases. Conservative treatment with stretching, activity modification, and sometimes injections works for most people. When it doesn’t, MRI or nerve testing can identify the exact point of compression.
Nerve Compression in the Outer Thigh
A condition called meralgia paresthetica occurs when the nerve supplying the outer thigh gets compressed where it passes under the ligament near the front of the hip. It produces tingling, numbness, and burning pain on the outer thigh, not the hip joint itself, though people often describe it as “hip pain” because of the location. Even light touch on the skin may feel unusually painful. Symptoms typically appear on one side and get worse with walking or standing.
Common triggers include tight belts or waistbands, weight gain, pregnancy, and prolonged standing. Loosening clothing and losing weight resolve symptoms in many cases without further treatment.
Stress Fractures and Bone Conditions
A stress fracture of the femoral neck, the short segment of bone connecting the ball to the shaft of the thighbone, causes a deep ache in the groin that worsens with weight-bearing activity and improves with rest. It’s most common in distance runners, military recruits, and people with low bone density. This is one of the more urgent causes of hip pain because a complete fracture at this site can compromise blood flow to the femoral head.
Avascular necrosis is a related but distinct condition in which the blood supply to the ball of the hip is disrupted, causing bone cells to die. It can follow a hip fracture, long-term use of high-dose corticosteroids, or excessive alcohol use. Early on, pain may be mild and vague. By the time the bone collapses, pain becomes severe and constant. Ongoing joint pain that doesn’t improve, especially with known risk factors, warrants imaging sooner rather than later.
When Right-Side Pain Isn’t the Hip at All
Several structures near the right hip can produce pain that feels like it’s coming from the joint. An inguinal hernia causes groin pain that worsens with coughing, straining, or lifting. In women, ovarian cysts or endometriosis can refer pain to the right hip and groin. Kidney stones passing on the right side sometimes produce flank pain that wraps toward the hip. Even an inflamed appendix, which sits on the right side of the abdomen, occasionally presents with hip or groin discomfort rather than classic abdominal pain.
The distinguishing factor is usually that these conditions don’t worsen with hip movement. If rotating, flexing, or stretching the hip doesn’t change the pain, and especially if you have fever, nausea, or changes in urination or bowel habits, the source is likely outside the musculoskeletal system entirely.