Musculoskeletal Symptom

Hip pain

Hip pain is a common musculoskeletal complaint affecting people of all ages, from young athletes to older adults. The hip is a complex joint and pain can arise from many structures — the joint itself, surrounding muscles, tendons, bursae or referred from the lumbar spine. A thorough assessment to identify the source of pain directs the most effective treatment, with physiotherapy central to most presentations.

See therapies that may help

What is Hip pain?

Pain in and around the hip can originate from the hip joint itself (osteoarthritis, labral tears, femoroacetabular impingement); surrounding soft tissues (hip flexor or gluteal tendinopathy, greater trochanteric pain syndrome); the lumbar spine and sacroiliac joint referring pain to the hip region; or systemic conditions such as rheumatoid arthritis.

Hip pain in younger, active people often involves soft tissue or structural issues amenable to conservative management. Hip pain in older adults more commonly involves osteoarthritis, though conservative management remains effective in many cases.

Signs and symptoms

Hip pain presentations vary by cause:

Pain in the groin, outer hip, buttock or thigh — location helps identify the source
Stiffness — particularly in the morning or after sitting for extended periods
Reduced range of movement — difficulty with rotation, squatting or crossing legs
Pain with specific activities — walking, climbing stairs, lying on the affected side
Clicking, catching or locking sensations within the joint

Hip pain following trauma, present in a child with a limp, or accompanied by fever requires prompt medical assessment.

How therapy can help

Management of hip pain depends on the cause:

Physiotherapy — the cornerstone of conservative hip pain management; specific exercise programmes targeting hip strength, flexibility and movement patterns
Osteopathy and sports therapy — manual therapy for joint and soft tissue components
Acupuncture — evidence for pain relief in hip osteoarthritis and soft tissue hip pain
Massage therapy — for muscle tension, trigger points and soft tissue components
Hydrotherapy — for hip OA where weight-bearing exercise is poorly tolerated

Seeking help

A physiotherapist or GP is the appropriate first contact for most hip pain. Imaging may be needed to clarify diagnosis in complex cases. For hip OA that does not respond to conservative management, orthopaedic referral for consideration of steroid injection or joint replacement is appropriate.

Therapies that may help with Hip pain

Therapy	Evidence	Notes
Physiotherapist	strong	Core use for hip pain.
Sports Therapist	strong	Core use for hip pain.
Acupuncturist	moderate	Used for hip pain including OA.
Clinical Pilates Practitioner	moderate	Core and hip strengthening for hip pain.
Fascial Stretch Therapist	moderate	Fascial stretch therapy for hip pain.
Hydrotherapist	moderate	Hydrotherapy for hip pain and mobility.
Massage Therapist	moderate	Commonly used for hip pain.
Osteopath	moderate	Commonly used for hip pain.
Pilates Practitioner	strong	Core use for hip pain.
Acupressurist	limited	Supportive for hip tension; combine with physiotherapy.
Alexander Technique Practitioner	moderate	Used for hip pain with postural contributors.
Biofeedback Practitioner	moderate	Biofeedback for chronic pain.
Bowen Technique Practitioner	moderate	Bowen for hip pain.
Chiropodist	moderate	Foot/gait biomechanics can contribute to hip pain.
Chiropractor	moderate	Used for hip pain with spinal/SI joint component.
Cognitive Behavioural Therapist	moderate	CBT for chronic pain psychological component.
Emmet Technique Practitioner	moderate	Emmett technique for hip pain.
Foot Health Therapist	moderate	Foot mechanics assessment for hip pain.
Mindfulness Practitioner	moderate	Mindfulness for chronic pain.
Myofascial Release Practitioner	moderate	Myofascial release for hip pain.
Rolfing Practitioner	moderate	Rolfing for hip pain.
Shiatsu Practitioner	moderate	Used for hip pain.
Structural Integration Practitioner	moderate	Used for hip pain via structural alignment.
Thai Masseuse	moderate	Thai massage for hip pain.
Yoga Therapist	moderate	Yoga for hip pain and mobility.
Body Stress Release Practitioner	limited	Used for hip pain.
Craniosacral Therapist	limited	Used for hip pain support.
Zero Balancing Practitioner	limited	Zero balancing for hip pain.

Frequently asked questions

What causes hip pain in young adults?

Common causes include femoroacetabular impingement (FAI), labral tears, hip flexor or gluteal tendinopathy, greater trochanteric pain syndrome, and referred pain from the lumbar spine or SIJ. A physiotherapist or sports medicine physician can differentiate between these through clinical assessment.

Is hip pain always arthritis?

No — hip pain has many causes across all ages. Arthritis is more common in older adults but soft tissue conditions, referred pain and structural issues are common across all age groups. A thorough assessment identifying the specific source of pain is important.

Can physiotherapy help hip pain without surgery?

Yes — physiotherapy is effective for many hip conditions including mild to moderate osteoarthritis, tendinopathies and soft tissue conditions. Exercise therapy addressing hip strength and movement patterns has evidence comparable to steroid injection for several hip conditions.

When should hip pain be investigated urgently?

Hip pain following significant trauma, associated with fever, in a child with a limp, with severe sudden onset, or with systemic symptoms requires prompt medical assessment. In older adults, hip pain following a fall raises the possibility of fracture and requires urgent assessment.

Does hip pain always need surgery?

No — the majority of hip pain, including mild to moderate osteoarthritis, responds well to conservative management including physiotherapy and exercise. Surgery is considered when conservative measures have been adequately tried without sufficient relief and quality of life is significantly affected.

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Hip pain