Hip pain in adults: causes, treatment and when to see a doctor

The NHS says there are lots of possible causes, from a sudden injury to a longer-lasting problem such as arthritis. It advises not trying to diagnose the cause yourself, and gives a guide to common causes by symptom.

Arthritis UK adds that most of the time there is a simple explanation, such as overdoing it while exercising, causing strained or inflamed soft tissues such as tendons, and that this often clears up within a few days. Long-term hip pain can be caused by specific conditions. A problem with the hip joint may be felt in the groin, down the front of the leg and in the knee; sometimes knee pain is the only sign. Pain on the outside of the hip or in the buttock can also be caused by problems in the lower back.

The NHS says some women develop pelvic pain in pregnancy, sometimes called pregnancy-related pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD). It is caused by stiffness of the pelvic joints or the joints moving unevenly. It is not harmful to your baby, but it can be painful and make it hard to get around.

Pain may be felt over the pubic bone at the front, across one or both sides of the lower back, between the vagina and anus, or spreading to the thighs. It can be worse when walking, going up or down stairs, standing on one leg, turning over in bed or moving the legs apart. Some women feel or hear clicking or grinding.

The NHS says PGP affects up to 1 in 5 pregnant women to some degree. Call your midwife or GP if it is hard to move around, painful to get out of a car or turn over in bed, or painful on stairs. Physiotherapy, pelvic support belts or crutches may help, and the NHS says most women with PGP can have a vaginal birth. Problems tend not to get completely better until the baby is born, but treatment can improve symptoms.

The NHS says treatment depends on the cause. At home, avoid putting too much strain on the hip but keep moving if you can, apply an ice pack or bag of frozen peas in a towel for up to 20 minutes every 2 to 3 hours, use painkillers such as paracetamol or ibuprofen gel (or tablets if needed), wear comfortable, shock-absorbing shoes with a soft sole, try to lose weight if you are overweight, and try gentle hip stretching exercises. Avoid carrying heavy things and sitting in low chairs.

Treatments from a GP or specialist can include strong painkillers, simple exercises, physiotherapy, occupational therapy (for walking sticks or aids), steroid injections to ease pain, and referral to a specialist who may arrange a scan and discuss surgery. Arthritis UK says steroid injections can help if bursitis or inflammation in or around the hip is the cause.

Some people with a damaged hip joint may eventually need a hip replacement if other treatments do not help. Arthritis UK says more than 90% of people who have a hip replacement find their pain is greatly reduced, and a modern artificial hip should last at least 15 years.

Arthritis UK says pain when you bend the hip going up or down the stairs or when you put on your socks is often a sign of a hip problem. Doctors will ask what movements make it worse, how it started, how it affects daily activities and whether you have pain at night, and will examine how well the hip moves.

X-rays are often the best way of finding out what is wrong with the hip, CT scans can show an unusually shaped joint, MRI scans show soft tissue and are helpful for avascular necrosis, and blood tests can help if infection or rheumatoid arthritis is suspected.

Osteoarthritis is one of the most common causes of hip pain in adults, according to Arthritis UK, where the cartilage thins and bony lumps form; it can cause pain, stiffness and sometimes a limp. Inflammatory arthritis including rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis can also cause hip pain.

Trochanteric bursitis is inflammation of the bursa at the top of the thighbone, causing tenderness over the bony part of the hip and pain that can spread down the leg. It often improves with rest, painkillers and physiotherapy. Other causes include femoroacetabular impingement, a torn acetabular labrum, snapping iliopsoas tendon and, rarely, avascular necrosis, where the blood supply to the ball of the thigh bone is lost and an urgent MRI scan is advised.

The NHS says to call 999 or go to A&E if you have severe hip pain after a fall or injury, are unable to walk or put weight on your leg, or have any tingling or loss of feeling in your hip or leg after an injury. Do not drive yourself to A&E.

Ask for an urgent GP appointment or get help from NHS 111 if you have severe hip pain that started suddenly without a fall or injury, a swollen hip that feels hot, skin around the hip that has changed colour, or hip pain with feeling generally unwell and a high temperature or feeling hot, cold or shivery.

See a GP if hip pain is stopping you doing normal activities or affecting sleep, is getting worse or keeps coming back, has not improved after 2 weeks of home treatment, or if you have hip stiffness for more than 30 minutes after waking.

In many areas you can refer yourself to NHS community musculoskeletal (MSK) services for physiotherapy without a GP referral. Arthritis UK notes it can take a while to get an NHS physiotherapy referral and you could be seen sooner privately at a cost, and that occupational therapy is also available privately.

Private orthopaedic consultants, physiotherapists and scans are available for those who choose to pay. Whichever route you take, the emergency signs above should be assessed through NHS emergency care.