Hip pain during walking usually comes from one of a handful common conditions, and where exactly you feel the pain is often the biggest clue to what’s going on. The hip joint bears six to eight times your body weight during everyday activities like walking, making it one of the most mechanically stressed joints in your body. That load, repeated thousands of times a day, makes the hip vulnerable to cartilage wear, soft tissue inflammation, and structural damage.
Where You Feel the Pain Matters
Pain location narrows the list of likely causes significantly. A dull, achy, sometimes throbbing pain in the front of the hip or groin usually points to something inside the joint itself, like arthritis or a labral tear. That pain can radiate down toward the knee or occasionally into the buttocks. Pain on the outer side of the hip, often with more of a burning quality, is more typical of bursitis or tendon irritation. And pain that shoots down the back of your leg with tingling, numbness, or an electrical sensation may not be a hip problem at all, but rather a compressed nerve in your lower back.
This distinction matters because the treatments are completely different. A true joint problem responds to different strategies than an inflamed tendon or a pinched nerve.
Osteoarthritis: The Most Common Cause Over 50
Osteoarthritis is the leading cause of hip pain in adults over 50, affecting roughly 20% of Americans over 55. The cartilage lining the joint gradually thins and roughens over time, narrowing the space between the bones. In earlier stages you might only notice stiffness after sitting for a while. By stage three, the cartilage has eroded enough that normal activities like walking, kneeling, or squatting cause pain and swelling. In advanced cases, bone grinds directly on bone with nearly any movement.
Cartilage doesn’t wear down evenly. Certain movements load the more damaged areas harder, which is why your hip might feel fine during some activities but hurt with others. Walking is particularly demanding because of the repetitive impact and the range of motion your hip cycles through with every step. Pain from osteoarthritis typically worsens with movement and improves somewhat with rest, though prolonged sitting can leave the joint feeling stiff.
Labral Tears
The labrum is a ring of flexible cartilage that lines the rim of your hip socket, creating a seal that helps the joint move smoothly and keeps the bones from grinding together. Repetitive motion or a single fall can tear or detach it. The hallmark symptom is a clicking or popping sensation when you move your hip, along with a deep ache in the front of the hip or groin. Walking forces your hip through the exact range of motion that catches a torn labrum, which is why each step can reproduce that click or a sharp catch of pain.
Labral tears share a lot of overlap with arthritis in terms of pain location and quality, so imaging is often needed to tell them apart.
Bursitis and Tendon Problems
Bursae are small fluid-filled sacs that cushion the areas where tendons glide over bone. When these become inflamed, typically from repetitive motion, the result is bursitis. The most common type at the hip is greater trochanteric bursitis, which causes intermittent pain across the outer thigh and buttock. It tends to flare with activities like stair climbing, sitting for long periods, or high-impact exercise.
Tendinitis, inflammation of the tendons connecting muscle to bone, produces a similar burning pain. Because tendons wrap around the front, side, and back of the hip, you can feel tendinitis pain in any of those locations. Both conditions are common in runners and cyclists but can also develop from walking alone, especially if you’ve recently increased your distance or pace. Some people also develop “snapping hip,” where a tight band of tissue audibly snaps over the bony prominence on the outside of the hip as you walk.
Muscle Strain
The muscles and tendons supporting the hip can become strained from repetitive motion, even from walking. You’ll typically notice pain with bruising or swelling, and it usually follows a period of increased activity. Strains tend to improve with rest over days to weeks, which helps distinguish them from the more persistent causes on this list.
Referred Pain From the Lower Back
Sometimes what feels like hip pain actually originates in the spine. Sciatica occurs when the sciatic nerve is compressed in the lower back, sending pain into the hip, buttock, and down the leg. The quality of this pain is distinctive: cramping, sharp, shooting, or burning, often accompanied by numbness, weakness, or a pins-and-needles sensation. It typically affects one side and can worsen with movement, coughing, or sneezing.
If your hip pain comes with any tingling or electrical sensations running down your leg, the source is more likely your back than your hip. A physical exam that includes a straight-leg raise test can help determine whether the sciatic nerve is involved, and if symptoms persist beyond six to eight weeks, imaging like an MRI is usually the next step.
Less Common but Serious Causes
Avascular necrosis occurs when part of the hip bone loses its blood supply and the bone tissue begins to die. It produces an achy, throbbing pain similar to arthritis. Risk factors include trauma, long-term steroid use, excessive alcohol consumption, and certain medical treatments like radiation. It’s far less common than the other conditions here, but it’s worth knowing about because it can progress quickly without treatment.
Certain combinations of symptoms warrant prompt medical attention: a joint that looks visibly deformed or out of place, inability to bear weight on the leg, intense sudden pain, rapid swelling, or fever and chills alongside hip pain. Fever in particular can signal a joint infection, which requires urgent care.
How Hip Pain Changes Your Walk
When your hip hurts, your body instinctively adjusts how you walk to minimize pain. You may notice you spend less time standing on the painful leg with each step, creating a shortened, uneven stride. This is called an antalgic gait, and while it’s a natural protective response, it shifts extra load onto your opposite hip, knee, and lower back, potentially creating new problems over time.
If the muscles on the outer side of your hip are weak, you may also notice your pelvis dropping on the opposite side when you stand on the affected leg. This pattern puts additional stress on the joint and surrounding tissues, making the original problem worse.
First-Line Treatment Options
For most causes of hip pain during walking, the initial approach combines pain management with targeted strengthening. Anti-inflammatory medications are the standard first-line option for osteoarthritis and are strongly recommended in current orthopedic guidelines. Basic over-the-counter pain relievers like acetaminophen are considered a second-line backup when anti-inflammatories aren’t tolerated well.
Physical therapy is recognized as a core non-drug treatment for hip pain. The goal is strengthening the muscles that stabilize the hip, particularly the glutes on the side and back of the hip, to reduce the load on damaged or inflamed structures. Corticosteroid injections into the joint are a moderate-strength option for people who don’t respond well to oral medications. Notably, hyaluronic acid injections (sometimes marketed as “gel” injections) are strongly recommended against by current guidelines, as the evidence doesn’t support meaningful benefit over their cost.
Exercises That Help
Four exercises target the key muscle groups that support the hip during walking. Start with two to three repetitions of each and gradually build to two sets of 15, done two to three times a day.
- Bridges: Lie on your back with knees bent and feet flat. Push your hips toward the ceiling using your arms for support, hold a few seconds, and lower back down. This strengthens the glutes and the muscles along the back of your hip.
- Standing hip extension: Hold a chair for balance. Keeping one leg straight, lift it behind you, hold briefly, and return. This targets the muscles that propel you forward during walking.
- Sideways hip lift: Stand next to a chair for support. Lift the outer leg straight out to the side, hold, and lower. This works the hip abductors, the muscles most responsible for keeping your pelvis level when you walk.
- Sit to stand: Stand in front of a chair, slowly lower until your bottom barely touches the seat (don’t fully sit), then stand back up. Arms out front for balance. This builds strength through the full range of motion your hip uses during walking.
These exercises won’t fix a structural problem like a labral tear, but they reduce pain and improve function for most causes of hip pain by taking mechanical stress off the joint itself. Consistency over weeks matters more than intensity on any given day.