Hip pain is a common issue that affects a wide variety of people and can have a big impact on your quality of life. The hip is a complex joint, and pain here can stem from a variety of causes, ranging from muscle strains to joint problems or even issues from other parts of the body. Let’s explore the different types of hip pain, the pathologies behind them, and how physiotherapy and osteopathy can help in assessing, diagnosing, and treating these issues.

Common Causes of Hip Pain

Hip pain can be caused by a variety of issues, ranging from direct injuries to the hip joint to problems in other parts of the body that refer pain to the hip area. Here are some of the most common causes:

1. Muscle Strains

The muscles around the hip—like the hip flexors, glutes, and adductors—are prone to strain from overuse or strong movements. Hip flexor strains, for example, can cause pain at the front of the hip, especially during activities like running, kicking or dancing.

2. Tendon Injuries

Tendons connect muscles to bones, and they can become irritated or inflamed from repetitive use. Gluteal tendinopathy, for example, causes pain on the outside of the hip, which can worsen with activities like walking uphill, climbing stairs, or even lying on your side in bed. Tendon injuries are typically stiff when cold and then pain may ease as you warm up, returning after you cool down.

3. Femoroacetabular Impingement (FAI)

FAI occurs when there is an abnormal shape in the bones of the hip joint—either the ball (femur) or the socket (acetabulum). This misalignment causes the bones to rub against each other, leading to pain, stiffness, and potential damage to the joint cartilage. FAI is especially common in younger, active individuals and can lead to other issues like labral tears or early-onset osteoarthritis.

4. Osteoarthritis (OA)

Hip osteoarthritis is a condition where the cartilage in the hip joint gradually wears down over time, causing pain, stiffness, and reduced mobility. This is more common in older adults or people who’ve had previous hip injuries. OA tends to cause pain that’s worse in the morning or after periods of inactivity and improves with movement, though overuse can also exacerbate symptoms. A common symptom associated with hip OA is difficulty putting on your shoes.

5. Labral Tears

The labrum is a ring of cartilage that surrounds the hip socket, helping to stabilise the joint. A labral tear can occur from trauma, repetitive motions (like those in sports), or conditions like FAI. Labral tears often cause deep hip pain, clicking, or catching sensations in the joint, particularly during twisting or pivoting movements.

6. Referred Pain to the Hip

Sometimes, hip pain is not directly related to the hip joint itself but is referred from other areas of the body. Common sources of referred pain include:

• Lumbar Spine: Issues like a herniated disc, irritated nerves or arthritis in the lower back can cause pain that radiates to the hip. This pain is often accompanied by symptoms like numbness or tingling in the legs.

• Endometriosis or Pelvic Floor Dysfunction: In women, conditions like endometriosis or pelvic floor issues can cause pain that feels like it’s coming from the hip or groin area, even though the problem is located elsewhere in the pelvic region.

Diagnosing Hip Pain

When you’re experiencing hip pain, getting a proper diagnosis is key to effective treatment. Our physiotherapists, osteopaths and exercise physiologist all offer valuable approaches to understanding and managing hip pain.

An assessment of your hip pain will include a thorough discussion about your pain, movement tests to see how your hip moves actively and passive movements to see how your hip joint moves when you are relaxed, plus orthopaedic testing. We can also refer you for imaging if this is required.

Treatment Options for Hip Pain

The best treatment for hip pain depends on the underlying cause. Some common treatment approaches include:

1. Exercise Therapy: Strengthening the muscles around the hip, particularly the glutes and core, can help alleviate pain and prevent future issues. A physiotherapist will typically guide you through a tailored exercise program designed to address your specific weaknesses and imbalances.

2. Manual Therapy: Both physiotherapists and osteopaths use hands-on techniques like joint mobilisation and soft tissue release to help improve hip mobility and reduce muscle tension via desensitising your nervous system.

3. Education and Pain Management: Learning about your hip pain—what’s causing it and how to manage it—is a key part of recovery. This might include learning proper posture, movement techniques, and strategies for managing pain, such as ice, heat, or modifying activities.

4. Lifestyle Modifications: In cases like osteoarthritis or chronic tendinopathy, lifestyle changes—like weight management, avoiding certain activities, or modifying how you move—can be important in reducing pain and improving function.

Final Thoughts

Hip pain can have a wide variety of causes, from muscle strains and tendon injuries to joint issues like FAI, labral tears, or osteoarthritis. In some cases, the pain may even be referred from other areas of the body, such as the spine or pelvis. Getting a thorough assessment from one of our clinicians can help pinpoint the exact cause of your pain and guide you toward an effective treatment plan that includes exercise, manual therapy, and pain management strategies. If you’d like to book an appointment with one of our clinicians, click here

References:

• Reiman, M. P., Mather, R. C., Cook, C. E., & Kemp, J. L. (2019). Femoroacetabular impingement surgery increases the likelihood of radiological osteoarthritis progression and hip arthroplasty: a systematic review with meta-analysis. British Journal of Sports Medicine, 53(10), 588-593.

• Lewis, C. L., & Sahrmann, S. A. (2006). Muscle activation and movement patterns during sacroiliac joint dysfunction tests: a theoretical and evidence-based examination. Journal of Orthopaedic & Sports Physical Therapy, 36(4), 202-217.

• Nepple, J. J., Prather, H., Trousdale, R. T., & Clohisy, J. C. (2013). Clinical diagnosis of femoroacetabular impingement. Journal of the American Academy of Orthopaedic Surgeons, 21(Suppl 1), S16-S19.