The experience of a sore hip when walking is a common complaint. The hip is a ball-and-socket joint designed to withstand significant weight and repetitive motion, but pain often arises from the surrounding network of muscles, tendons, ligaments, and fluid-filled sacs known as bursae. The hip region encompasses a wide area, including the groin, the outer thigh, and the buttock, and the exact location of the discomfort provides the first clue to the underlying cause.
Identifying the Root Cause by Pain Location
Pain felt deep in the front of the hip or the groin area most often indicates a problem within the hip joint itself. A frequent culprit, especially in older adults, is hip osteoarthritis, a progressive condition characterized by the breakdown of the smooth articular cartilage. As this cartilage wears away, the bones rub together, causing stiffness and a deep, aching pain that worsens with activity like walking or standing. Another common anterior cause is hip flexor tendinopathy, which is an irritation or strain of tendons like the iliopsoas. This pain is usually felt when bringing the knee toward the chest or with repetitive motions like running.
Discomfort localized to the outer side of the hip, specifically over the bony prominence known as the greater trochanter, is primarily associated with Greater Trochanteric Pain Syndrome (GTPS). While once called trochanteric bursitis, the primary pathology is gluteal tendinopathy, involving the tendons of the gluteus medius and minimus muscles. These tendons stabilize the pelvis during walking; irritation or degeneration leads to pain aggravated by weight-bearing activities or lying on the affected side. The fluid-filled bursa sacs located near these tendons can also become inflamed (bursitis), often as a secondary result of the underlying tendon issue.
If the soreness is concentrated in the buttock or the back of the hip, the source is often referred pain rather than the hip joint itself. Lumbar spinal pathology, such as a disc issue or nerve compression in the lower back, can send pain signals down into the posterior hip and buttock region. This referred pain may be accompanied by tingling or numbness radiating down the leg, often associated with sciatica. Another common condition is piriformis syndrome, where the piriformis muscle compresses the underlying sciatic nerve, causing a deep ache aggravated by prolonged sitting or walking. Proximal hamstring tendinopathy, involving the tendons attached to the sitting bone (ischium), can also cause localized pain, particularly during movements that stretch the hamstring.
Immediate At-Home Strategies for Relief
For new or mild hip soreness, initial management involves modifying activity to reduce mechanical stress. Temporarily avoiding high-impact activities like running or jumping is helpful, but maintaining gentle movement is encouraged to prevent stiffness. Rest involves carefully avoiding positions or actions that specifically trigger the pain, such as sitting in low chairs or sleeping directly on the affected hip.
Applying temperature therapy can help manage localized inflammation and discomfort. Cold packs, such as a bag of frozen vegetables wrapped in a towel, can be applied to the painful area for 10 to 20 minutes every few hours. This is useful in acute stages to help numb the pain and reduce swelling. Conversely, a warm compress or a hot shower may benefit chronic pain, such as arthritis, as heat increases blood flow and relaxes tight muscles.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen sodium, can be taken to reduce both pain and inflammation. These oral medications should be used according to package directions regarding dosage and frequency. Topical anti-inflammatory gels can also be rubbed directly onto the painful area, offering localized relief with potentially fewer systemic side effects.
Gentle stretches and movements can be introduced to maintain flexibility and blood flow without causing further irritation. Simple, controlled movements, such as light hip flexor or piriformis stretches, may alleviate muscle tightness contributing to the pain. Introducing gentle strengthening exercises for the hip and core muscles, without provoking pain, helps improve the stability necessary for walking and daily activities.
Determining When Professional Care is Necessary
Certain symptoms should prompt an immediate consultation with a healthcare professional. Sudden, intense hip pain, especially after a fall or injury, requires immediate medical attention, particularly if accompanied by an inability to bear any weight on the leg. Other warning signs include a visible deformity of the joint, significant swelling, or pain accompanied by systemic symptoms like a fever, chills, or general malaise, which could indicate an infection.
For pain that is less acute but still persistent, a medical evaluation is warranted if home strategies fail to provide relief after about two weeks. Chronic pain that interferes with sleep, limits the ability to perform daily activities, or causes a noticeable limp (antalgic gait) should be evaluated. Stiffness in the hip that lasts for more than 30 minutes after waking up is a common indicator of inflammatory or arthritic conditions requiring professional management.
Diagnostic Tools
A doctor’s evaluation often begins with a physical examination and may include diagnostic imaging. X-rays assess the joint structure and look for signs of arthritis or fractures. Advanced imaging like magnetic resonance imaging (MRI) may be used to visualize soft tissues, including tendons, the labrum, and bursae, if a soft-tissue injury is suspected.
Treatment Options
Professional interventions typically start conservatively with physical therapy (PT). PT focuses on specific strengthening and flexibility exercises designed to correct underlying biomechanical issues. For persistent symptoms, advanced medical treatments may be considered. These include targeted corticosteroid injections to reduce localized inflammation. In cases of severe, debilitating joint damage, a consultation for surgical options, such as hip replacement, may be necessary.