What’s Causing My Hip Pain?

The hip is one of the largest weight-bearing joints in your body. A healthy hip moves easily, allowing you to walk, turn, and do many other activities without pain. To keep it moving smoothly, a complex network of bones, cartilage, muscles, ligaments, and tendons must all work in harmony.

The hip is a ball-and-socket joint. The ball (femoral head) at the top of the thighbone (femur) fits into a rounded socket or cup-like cavity (acetabulum) in your pelvis. Bands of tissues called ligaments form a capsule connecting the ball to the socket and holding the bones in place.

A layer of smooth tissue called cartilage cushions the surface of the bones, helping the ball to rotate easily in the socket. Fluid-filled sacs (bursae) cushion the area where muscles or tendons glide across bone. The capsule surrounding the joint also has a lining (synovium) that secretes a clear liquid called synovial fluid. This fluid lubricates the joint, facilitating movement and reducing friction.

As you might expect, there are many different reasons you could be feeling hip pain, including arthritis, injury, infection, and more.^1-7

There are more than 100 different types of arthritis and associated diseases.¹ A few types likely to affect the hip include:

One of the most common forms of arthritis is osteoarthritis (OA)¹ and is a leading cause of hip pain. OA is a degenerative joint disease that causes the cartilage in your joints to break down. When that layer of cartilage — which is meant to “cushion” the joints and protect the surface of the bones — is damaged or worn away, your bones grind against one another, and that grinding hurts. You can feel it climbing stairs, working in the garden, or just bending your hips to sit. It may even keep you up at night.

Factors leading to the development and progression of OA may include aging, obesity, joint injuries, and a family history of arthritis (genetics).

Rheumatoid arthritis (RA) is an autoimmune disorder in which the synovium (lining of the joint) becomes inflamed. This inflammation causes pain, swelling, and can eventually erode or deform the joint. 

Like rheumatoid arthritis, psoriatic arthritis is also an autoimmune disorder. People who suffer from psoriasis sometimes experience this type of arthritis. It often is accompanied by red patches and scales on the skin surrounding the joint, though joint pain can begin prior to any skin discoloration.²

A hip injury can affect any part of the joint. A few injuries likely to occur in the hip include:

Any part of the femoral bone, including the femoral head, are capable of being broken, especially if the bones are brittle from age or osteoporosis.³ Gender, heredity, nutrition, and lifestyle all impact your chances of fracturing a hip. Falls are responsible for 95% of all hip fractures.⁴

Bursitis is a condition in which the fluid-filled sacs (bursae) become inflamed due to overuse or injury to the joint. 

Tendinitis is a condition in which a tendon becomes irritated and inflamed. It can occur to any type of tendon. According to the Mayo Clinic, activities such as jumping sports, running, or even golf may develop inflammation in a tendon.⁵

A labral tear occurs when cartilage on the “socket” portion of the hip is torn. Repetitive twisting movements can increase the risk of a labral tear.⁶

A hip dislocation occurs when the ball (femoral head) at the top of the thighbone (femur) comes out of the hip socket (acetabulum) in your pelvis.

A serious hip injury or fracture can sometimes lead to a condition called avascular necrosis (also known as osteonecrosis). In avascular necrosis, the blood supply to the ball portion (the femoral head) of the thighbone is cut off and the bone begins to wither. As a result, the surrounding cartilage begins to deteriorate, producing pain and other symptoms.

An infection in the hip can lead to swelling, pain, and redness. Septic arthritis, a form of hip infection, often occurs with a fever.

The sciatic nerve is the largest nerve in the human body, running from the spinal cord all the way to the foot. This nerve can become inflamed or compressed causing pain felt in the hip.⁷

Experiencing pain in another portion of your leg can cause a change in the way you walk or stand as you attempt to alleviate the pain. This change can lead to increased stress and wear of the hip joint. This is often called referred pain.

While this is not an exhaustive list of possible reasons for hip pain, the good news about these conditions is that they are treatable. Arthritis, for example, is a disease that typically worsens over the years, so it is common for treatment to involve more than one approach and to change over time. For some people, nonsurgical treatments such as lifestyle changes, medications, and walking aids help alleviate certain types of pain. For others, replacing lost cartilage with tissue grafts may help restore normal function. And for many, hip replacement surgery may be an appropriate solution. Together, you and your doctor can determine the best treatment plan for you.