Hip pain is a widespread issue affecting people of all ages and lifestyles, from young adults to seniors. It can significantly impact your daily life, making even simple movements uncomfortable. If you’re asking yourself, “Why Do My Hips Hurt?”, you’re not alone. Pinpointing the exact cause of hip pain can be challenging, but understanding the type and location of your discomfort is the first step towards diagnosis and relief.
According to Shane Nho, MD, MS, a renowned hip preservation specialist, identifying the source of your hip pain is crucial for effective treatment. Let’s explore seven common reasons why you might be experiencing hip pain, some of which might surprise you.
1. Core Muscle Injury (Sports Hernia or Athletic Pubalgia)
If your pain is concentrated in your groin area, it might indicate a core muscle injury, also known as athletic pubalgia or a sports hernia. This involves strains or tears in the muscles or soft tissues of your lower abdomen.
This type of injury is frequently seen in active individuals, particularly those engaging in sports that require intense twisting and turning motions, such as tennis or golf. Often, these “weekend warriors” may not have the same level of conditioning as professional athletes, making them more susceptible to these injuries.
Treatment: Rest is paramount for healing core muscle injuries. Allowing the affected muscles to rest for several weeks can promote recovery. In more severe cases, surgical intervention by a general surgeon might be necessary to repair the torn muscle.
2. Bursitis: Inflammation of the Bursa
Pain felt on the outer hip, thigh, and buttocks could very well be due to bursitis. Bursitis is the inflammation of bursae, small, fluid-filled sacs that act as cushions between bones and soft tissues like tendons and muscles. These sacs prevent friction when these tissues move over bone.
“While activities like prolonged walking or stair climbing can exacerbate bursitis pain, it’s often not directly related to activity. It’s more of a persistent, everyday ache,” explains Dr. Nho. “Even simple actions like lying on the affected side while sleeping can trigger pain.”
Bursitis becomes increasingly common with age, particularly affecting individuals over 60.
Treatment: For at-home relief, rest the affected hip and apply ice compresses to reduce inflammation. Over-the-counter anti-inflammatory and pain medications can also be helpful. In some instances, a doctor may administer a cortisone injection to directly target inflammation.
3. Tendonitis: Irritation of the Tendons
If you lead an active lifestyle and experience tenderness in your hip flexor (the muscles that lift your knee and leg towards your torso) or groin when touched or moved, tendonitis could be the culprit.
“Overstraining or overuse of tendons, the tough cords connecting muscles to bones, leads to repetitive micro-injuries. Over time, this can result in muscle imbalances around the hip,” Dr. Nho elaborates. “Individuals who perform highly repetitive motions, such as soccer players repeatedly kicking a ball, are at higher risk for developing this significant pain.”
Treatment: The treatment strategies for tendonitis are similar to those for bursitis, focusing on rest, ice, and anti-inflammatory measures.
4. Labral Tears: Damage to the Hip Cartilage
The labrum is a crucial ring of cartilage that encircles the hip socket. Its function is to provide stability and ensure the femoral head (the “ball” of the thighbone) remains securely within the socket. A tear in the labrum, frequently occurring in athletes and dancers, can cause pain in the hip or groin and limit hip movement. People often describe a sensation of locking, catching, or clicking in the hip.
“Labral tear pain tends to be persistent and doesn’t typically subside on its own,” notes Dr. Nho. This injury is more common in individuals with pre-existing hip conditions, such as anatomical abnormalities making the hip socket too shallow, or hip impingement (discussed below), or those with a history of hip injuries.
Treatment: Labral tears are often addressed with minimally invasive surgery. This procedure repairs the torn labrum and may also involve reshaping any misshapen bone. Correcting the hip’s alignment in this way can alleviate pain and protect the joint from further damage.
5. Gynecological or Pelvic Floor Issues: Referred Pain
Sometimes, what feels like hip pain might actually originate from another area within your pelvis.
“The pelvic region is a compact space housing multiple organ systems in close proximity. This anatomical arrangement can sometimes make it difficult to precisely pinpoint the source of pain,” Dr. Nho explains.
For women, if pain is limited to the groin and coincides with menstruation or ovulation, conditions like endometriosis or uterine fibroids, rather than a hip joint issue, could be the underlying cause. Similarly, urological and gastrointestinal problems, such as gastroenteritis or prostate issues, can also manifest as pain that is easily mistaken for hip injury.
Treatment: If you suspect your hip pain may be related to gynecological, urological, or gastrointestinal issues, consulting your primary care physician is the first step. A comprehensive evaluation can help determine the root cause. Depending on the diagnosis, you may be referred to a specialist, such as a gynecologist or gastroenterologist, for targeted treatment.
6. Hip Impingement (Femoroacetabular Impingement – FAI)
Dr. Nho frequently treats hip pain in younger, active individuals who participate in high-intensity activities like CrossFit, barre classes, or obstacle course races.
“These demanding activities can, in some cases, cause the hip bones to fuse together in an irregular shape, which subsequently limits hip movement,” Dr. Nho states. This condition is known as hip impingement, or femoroacetabular impingement (FAI). FAI not only causes pain but also increases the long-term risk of developing premature osteoarthritis.
Treatment: Physical therapy is often the initial approach to managing hip impingement. However, in many cases, surgery to reshape the hip bones and restore proper movement may be necessary.
7. Osteoarthritis: Degenerative Joint Disease
Osteoarthritis is a very prevalent cause of chronic, dull hip pain. This condition involves the breakdown of cartilage, the smooth, protective tissue in joints, leading to inflammation, stiffness, swelling, pain, and eventual joint deformity.
Recent research indicates that osteoarthritis often develops when the hip bones don’t form perfectly and therefore don’t fit together optimally. This imperfect fit leads to increased friction and rubbing of the bones against each other over time, as Dr. Nho explains.
Factors like high-impact activities (marathon running, basketball), aging, obesity, and previous traumatic injuries can increase the likelihood of developing osteoarthritis and exacerbate the associated pain, potentially leading to disability.
Treatment: Managing osteoarthritis pain typically involves a combination of approaches. Rest, ice application, steroid injections, and over-the-counter pain relievers and anti-inflammatory medications are common initial treatments. More advanced treatments include stem cell therapy and surgical options ranging from hip resurfacing to total hip replacement.
Maintaining Healthy Hips
To proactively prevent hip pain, Dr. Nho recommends incorporating these healthy habits into your lifestyle:
- Manage your weight: Excess weight puts additional stress on your hip joints.
- Regular stretching and yoga: Improves flexibility and range of motion in your hips.
- Strengthen your core muscles: Provides better support and stability for your hips and pelvis.
- Annual check-ups: Regular medical evaluations can help detect potential issues early.
- Appropriate exercise: Engage in regular physical activity, choosing exercises suited to your age and fitness level.
If you are experiencing persistent or severe hip pain, it’s important to consult your primary care physician. They can assess your condition and, if necessary, refer you to a specialist for a more detailed evaluation and tailored treatment plan.
