Hip pain affects roughly 1 in 7 adults over 60, and it’s common in younger people too. The cause depends largely on where you feel it, how it started, and what makes it worse. Pain in the front of the hip points to different problems than pain on the outer side or in the back, so pinpointing the location is the single most useful thing you can do before seeing a provider.
Where You Feel It Matters Most
Hip pain isn’t one problem. It’s a symptom that can come from the joint itself, the muscles and tendons surrounding it, or even your lower back. The location of your pain is the first clue to what’s going on.
Front of the hip or groin: This usually signals something inside the joint. In older adults, a deep ache in the front of the hip, thigh, and groin that comes with stiffness typically points to osteoarthritis. In younger, active people, that same area of pain (especially with clicking or catching sensations) may be a labral tear or a structural issue called femoroacetabular impingement.
Outer hip: Pain on the outside of the hip, particularly around the bony point you can feel at the top of your thigh, is most often caused by inflamed tendons (gluteal tendinopathy) or inflamed bursae (bursitis). This pain commonly radiates down the outside of the leg toward the knee.
Back of the hip or buttock: This is frequently not a hip problem at all. Pain in the back of the hip or buttock area is often referred from the lower spine. Conditions like spinal stenosis or disc problems can send pain, numbness, or tingling down the leg in a pattern that mimics hip trouble.
Osteoarthritis: The Most Common Cause in Older Adults
Osteoarthritis is the gradual breakdown of cartilage inside the hip joint, eventually leading to bone rubbing against bone. It produces a deep, dull ache rather than a sharp sting, and it tends to settle in the groin, front of the thigh, or deep inside the joint. Morning stiffness is a hallmark. You might notice your hip feels locked up for the first 15 to 30 minutes after getting out of bed, then loosens with movement.
Over time, osteoarthritis progressively limits how far you can move your hip. Putting on socks, getting in and out of a car, or bending to tie shoes becomes noticeably harder. Unlike some other causes of hip pain, arthritis restricts your range of motion even on good days. X-rays can usually confirm the diagnosis, showing narrowed joint space and bony changes.
Bursitis and Gluteal Tendinopathy
If your hip hurts on the outside, especially when you lie on that side at night, climb stairs, or stand up after sitting for a while, the problem is likely in the soft tissues rather than the joint. Two conditions account for most outer hip pain: trochanteric bursitis (inflammation of the fluid-filled cushioning sacs near the hip bone) and gluteal tendinopathy (irritation of the tendons that attach your buttock muscles to the hip).
These two conditions overlap so much that many clinicians now group them under the umbrella term “greater trochanteric pain syndrome.” The pain often starts right at the bony prominence on the side of your hip and can extend down the outside of your thigh to the knee or even the lower leg. The area may feel tender to touch. Unlike arthritis, bursitis and tendinopathy don’t usually restrict your range of motion unless the inflammation becomes severe. The pain is sharper and more localized, and it’s especially provoked by pressure (lying on that side in bed is a common complaint).
Labral Tears and Impingement in Younger Adults
If you’re in your 20s, 30s, or 40s and your hip hurts during exercise or sports, a labral tear or femoroacetabular impingement (FAI) is worth considering. The labrum is a ring of soft tissue lining the hip socket that helps the joint move smoothly and stay stable. When the bones of the hip don’t fit together perfectly, they put extra pressure on this lining and can eventually tear it.
Labral tears cause pain in the front of the hip and groin, often with a clicking or popping sensation during movement. You might feel unstable when standing or notice a sharp, stabbing pain in certain positions. Many people unconsciously change the way they walk or hold their body to avoid triggering the pain, which can create new problems in the back, knee, or opposite hip. An MRI is typically needed to confirm the diagnosis, since labral tears don’t show up on standard X-rays.
When the Problem Is Actually Your Back
One of the trickiest aspects of hip pain is that it sometimes has nothing to do with your hip. The hip and lower spine share nerve pathways, and doctors describe the overlap between these two areas as “hip-spine syndrome.” A patient with lumbar spinal stenosis (narrowing of the spinal canal) may feel pain down their leg along with numbness, tingling, or weakness, all of which can be mistaken for a hip problem.
Some clues that your “hip pain” is coming from your back: the pain wraps around to the buttock rather than settling in the groin, it travels below the knee, or it comes with tingling or numbness in the leg or foot. Because the symptoms overlap, imaging and targeted physical exams are sometimes needed to sort out whether the hip, the spine, or both are contributing.
What to Expect at a Checkup
Diagnosing hip pain starts with a physical exam. Your provider will watch you walk, check your range of motion, and perform specific maneuvers to narrow down the source. One common test involves bending your hip and rotating it inward to stress the labrum. Another positions your leg in a figure-four shape to assess the joint and surrounding structures. These hands-on tests, combined with where you point when asked “show me where it hurts,” give a surprisingly clear picture before any imaging is ordered.
X-rays are the standard first step if imaging is needed. They can confirm arthritis, rule out fractures, and reveal bone shape abnormalities. If the X-rays look normal but your provider suspects a tendon injury, labral tear, or other soft tissue problem, an MRI is the next step. For suspected fractures that don’t show up on X-ray (common in older adults after a fall), a CT scan is often ordered quickly because speed matters for treatment outcomes.
First Steps for Relief
For most non-emergency hip pain, the initial approach is the same regardless of cause: reduce the irritation, then rebuild strength. In the first few weeks, that means scaling back activities that provoke the pain, using over-the-counter anti-inflammatory medication if tolerated, and applying ice to the sore area.
Targeted exercise is the most effective long-term treatment for nearly every common cause of hip pain. The focus is on strengthening the muscles that stabilize the hip and pelvis, particularly the glutes, core, and deep hip stabilizers. Exercises like clamshells, bridges, side-lying leg raises, and wall squats form the foundation of most hip rehabilitation programs. As strength improves over several weeks, you progress to more demanding movements: lunges, single-leg squats, step-ups, and resistance band work in multiple directions.
Core stability matters more than most people expect. The muscles of your lower abdomen and pelvic floor work as a team with your hip muscles to control how forces travel through the joint. Gentle core engagement exercises (think slow, controlled contractions rather than crunches) are a standard part of hip pain rehabilitation from the very first week. Most structured programs run 12 weeks or longer before expecting full return to sport or high-demand activities.
Signs That Need Urgent Attention
Most hip pain develops gradually and responds to conservative care, but a few scenarios require immediate evaluation. If you cannot bear weight on the leg at all, that warrants a same-day visit. After a fall, a leg that appears shortened or rotated outward compared to the other side suggests a hip fracture. Any hip pain accompanied by fever and feeling generally unwell could indicate infection and needs prompt assessment. And if your hip or leg pain comes with new bowel or bladder problems, numbness in the groin area, or progressive weakness in the leg, these are signs of possible nerve compression in the spine that requires urgent care.