Left hip pain has the same potential causes as right hip pain. The side doesn’t usually matter as much as where on the hip you feel it and what makes it worse. Pain in the front of your hip, the outer side, and the back of your hip each point to different problems, and narrowing down the location is the fastest way to understand what’s going on.
Where Exactly You Feel It Matters Most
Hip pain falls into three broad zones, and each one is associated with a distinct set of conditions.
Front of the hip or groin: Pain here usually comes from inside the joint itself. Osteoarthritis, labral tears, hip impingement, and stress fractures all produce pain in this area. So do strained hip flexor tendons, which run across the front of the joint. Occasionally, groin-area pain isn’t coming from the hip at all. Abdominal or pelvic organs can refer pain to the front of the hip, especially if you also have urinary, bowel, or menstrual symptoms.
Outer (lateral) hip: Pain on the bony prominence you can feel on the outside of your hip is most often greater trochanteric pain syndrome. This umbrella term covers bursitis, gluteal tendon problems, and irritation of the thick band of tissue running down the outside of your thigh. It’s especially common in middle-aged women and people who are overweight.
Back of the hip or buttock: Deep buttock pain that worsens with sitting, particularly in a car, often points to deep gluteal syndrome or piriformis syndrome, both of which can irritate the sciatic nerve. Pain in this zone can also originate from the lower back, the sacroiliac joint, or the hamstring tendons where they attach near the sit bone.
Greater Trochanteric Pain Syndrome
This is one of the most common reasons for outer hip pain, and it’s frequently called hip bursitis. You’ll typically feel it on the outside of your hip and possibly down into your upper thigh or buttock. The hallmark is pain when lying on the affected side at night, which can disrupt sleep. Standing up after sitting for a while tends to provoke it, and so does walking upstairs or any repetitive hip movement.
There’s often no specific injury that started it. The pain builds gradually, and it can linger for months if you don’t address it. Initial management usually involves avoiding the positions that aggravate it (like crossing your legs or sleeping on that side without a pillow between your knees), gentle stretching of the hip rotators and the iliotibial band, and strengthening the gluteal muscles that stabilize the pelvis. A simple starting exercise: lie on your back with both knees bent, place the ankle of your painful side on the opposite thigh near the knee, then gently pull that knee across your body toward the opposite shoulder. Hold for 15 to 30 seconds and repeat a few times.
Osteoarthritis
If you’re over 45 and noticing a gradual, aching stiffness in the front of your hip or groin that gets worse after sitting or walking for long periods, osteoarthritis is a leading possibility. About 73% of people living with osteoarthritis are older than 55, but it can begin in the late 40s to mid-50s, and younger people with prior joint injuries sometimes develop it earlier.
Osteoarthritis is a wear-and-tear process. The cartilage cushioning the joint thins over time, and the bone underneath gradually changes shape. You’ll notice the pain is worst at the end of the day or after activity, and the stiffness after rest typically loosens up within 15 to 20 minutes of moving around. That detail helps distinguish it from inflammatory arthritis, where morning stiffness lasts 45 minutes or longer and comes with fatigue, low-grade fever, or loss of appetite.
Hip Impingement and Labral Tears
These two conditions often go together and are the most common cause of hip pain in younger, active adults. Hip impingement (femoroacetabular impingement) happens when extra bone growth along the rim of the hip socket or the top of the thigh bone causes the two surfaces to pinch against each other during movement. Pain is felt in the front of the hip or groin and typically worsens with squatting, lunging, jumping, or sitting still for a long time. Some people describe it as sharp or stabbing during those positions.
A labral tear involves damage to the ring of cartilage lining the hip socket. It can result from a single injury or develop gradually from repetitive impingement. The distinguishing feature is a clicking or popping sensation in the hip during movement, sometimes accompanied by a feeling of the joint catching or locking. Both conditions tend to come on gradually in people who are physically active, and both produce pain when the hip is moved through certain ranges of motion.
When the Problem Isn’t the Hip
The hip sits at a crossroads between the lower back, pelvis, and leg, so pain you feel “in your hip” sometimes originates elsewhere. Lower back problems are notorious for this. A disc issue or nerve compression in the lumbar spine can send pain into the buttock and down the leg, mimicking hip joint pain. If your pain travels below the knee, follows a burning or shooting pattern, or gets worse when you cough or strain, the spine is a more likely source than the hip itself.
Sacroiliac joint dysfunction produces pain in the back of the hip and buttock, typically on one side. It’s often confused with sciatica but tends to stay localized to the upper buttock and doesn’t usually radiate far down the leg. Deep gluteal syndrome, sometimes still called piriformis syndrome, causes deep buttock pain that worsens with prolonged sitting and can produce true sciatica-like burning down the back of the leg. A useful clue: if taking longer strides or running makes it worse, ischiofemoral impingement, where the space between two pelvic bones narrows during hip extension, may be contributing.
What a Diagnosis Looks Like
A clinician will start by watching you walk and then move your hip through specific positions. Two of the most common hands-on tests are the FADIR test, where your hip is bent up, angled inward, and rotated, and the FABER test, where the hip is bent, rotated outward, and lowered toward the table. Pain in the groin during these maneuvers suggests something inside the joint like a labral tear or impingement. Pain in the back of the pelvis during the FABER test points toward the sacroiliac joint or spine.
X-rays can show arthritis and bone shape abnormalities. If the physical exam suggests a labral tear, soft tissue injury, or nerve problem, an MRI is often the next step. Imaging isn’t always necessary for conditions like bursitis, which can usually be diagnosed based on symptoms and tenderness in the right spot.
Red Flags That Need Immediate Attention
Most hip pain develops slowly and improves with time, activity modification, and targeted exercises. But certain symptoms signal something more urgent:
- A joint that looks deformed or a leg that appears shorter than the other
- Inability to move your leg or hip at all
- Inability to bear weight on the affected leg
- Intense, sudden pain especially after a fall
- Rapid swelling around the hip
- Fever, chills, or skin color changes on the affected leg
These can indicate a fracture, dislocation, or infection, all of which require prompt medical evaluation. In older adults with osteoporosis, even a minor fall can fracture the femoral neck, and the inability to stand or rotate the leg outward after a fall is a classic warning sign.