Understanding hip pain
The hip is a deep, stable joint surrounded by powerful muscles and tendons. Pain may come from within the joint itself, from the tendons on the outside, from the surrounding bursa, or be referred from the lower back.
Location gives clues. Groin pain more often points to the joint, while pain on the outside over the bony point suggests the gluteal tendons, and buttock pain frequently involves the back or pelvis.
Signs you might notice
- Groin pain deep in the hip, especially on rotation
- Pain on the outside of the hip when lying on that side
- Stiffness after sitting or first thing in the morning
- Difficulty with socks, shoes or getting in and out of the car
- A limp that appears when you are tired
Common contributing factors
- Osteoarthritic change in the joint
- Gluteal tendinopathy from compression and overload
- Hip impingement related to joint shape
- Weakness through the hip and trunk
- Referred symptoms from the lumbar spine or pelvis
How we assess and treat it
We separate joint, tendon and referred pain through examination and movement testing. The DIERS 4D scan is genuinely useful here, because it shows pelvic movement and rotation while walking, which is difficult to judge by eye.
Treatment then targets the actual source, and addresses the loading pattern that has been sustaining it.
- Hands-on treatment and joint mobilisation
- Targeted hip and trunk strengthening
- Load management for tendon related pain
- Gait retraining where the pelvis is the driver
- Guidance around activity, sleeping positions and sitting
Common questions
Why does my hip hurt when lying on it?
That pattern is typical of gluteal tendinopathy, where compression of the tendon against the bone provokes symptoms. Simple positional changes often bring quick relief while we treat the underlying cause.
Is a hip replacement inevitable if I have arthritis?
No. Many people manage arthritic hips well for years with the right strength work and load management. We will be honest with you if we think a surgical opinion is warranted.
Could my hip pain be coming from my back?
It certainly can, and that is a common reason hip treatment fails. We test for it specifically.