Understanding Hip Pain: Common Causes and the Hip-Back Connection
Hip pain is a common complaint, affecting roughly 10% of the general population and be coming more likely as people age ( Chronic hip pain in adults:Current knowledge and future prospective - PMC ). This pain isn’t just an annoyance – it can limit simple activities like sitting or walking and significantly reduce quality of life ( Chronic hip pain in adults:Current knowledge and future prospective - PMC ). Often, pinpointing the exact source of hip pain can be tricky. The hip area is complex, and pain felt in the “hip” can actually originate from other regions; for example, problems in the lower back or even the knee may cause referred pain that is felt in the hip ( Chronic hip pain in adults:Current knowledge and future prospective - PMC ). Understanding the most common causes of hip pain (and how the back can be involved) is important for getting proper treatment.
Osteoarthritis and Joint Degeneration
One of the most frequent causes of chronic hip pain is osteoarthritis – the typical“wear-and-tear” arthritis that comes with aging. Hip osteoarthritis is especially common in older adults, affecting about 9% of people over age 45 (The low back pain in patients with hip osteoarthritis: current knowledge on the diagnosis, mechanism and treatment outcome - Wang - Annals of Joint). In this condition, the cartilage cushioning the hip joint gradually wears down. As a result, people experience pain and stiffness in the joint, often worse with prolonged activity or after sitting for a long time (Hip Pain in Adults: Evaluation andDifferential Diagnosis | AAFP). Osteoarthritis of the hip develops slowly over years, and it can significantly limit mobility (for instance, making it hard to put on socks or climb stairs). Other forms of arthritis (such as rheumatoid arthritis) or problems like avascular necrosis (loss of blood supply to the hip) can also cause hip pain, but these are far less common than osteoarthritis.
Bursitis and Soft Tissue Injuries
Not all hip pain comes from the joint itself – many cases are due to irritation of the soft tissues (tendons, muscles, bursae) around the hip. On the outer side of the hip, the most common source of pain is greater trochanteric pain syndrome, often loosely called trochanteric bursitis (Hip Pain in Adults: Evaluation andDifferential Diagnosis | AAFP). This syndrome involves inflammation of the bursae or tears in the tendons around the bony point of the hip (the greater trochanter). It often affects women in midlife and can occur without a specific injury; patients typically report tenderness and pain lying on the affected side, which is aggravated by physical activity or sitting for long periods (Hip Pain in Adults: Evaluation andDifferential Diagnosis | AAFP). Besides bursitis, muscle and tendon injuries are also frequent causes of hip pain. For example, athletes or active individuals may strain a hip flexor or groin muscle, leading to sharp pain with certain movements. These soft-tissue injuries usually improve with rest andproper rehabilitation, but they can cause significant pain in the short term.
Hip Impingement and Labral Tears
In younger adults and athletes, hip pain often stems from internal joint issues like impingement or cartilage injury. A common example is femoroacetabular impingement(FAI) – a shape abnormality in the hip bones that is one of the most common causes of hip pain in young adults (Hip Pain in Adults: Evaluation andDifferential Diagnosis | AAFP). In FAI, extra bone on the femoral head or hip socket causes the bones to pinch together during movement. Overtime this can damage the hip’s labrum (the ring of cartilage around the socket)and lead to pain in the groin or front of the hip, especially during deep bending or twisting motions. A tear in the labrum can cause catching or clicking sensations along with pain. Often, FAI and labral tears go hand-in-hand: the impingement leads to cartilage injury. These conditions typically cause pain with hip range of motion (for example, discomfort when flexing or rotating the hip) (Hip Pain in Adults: Evaluation andDifferential Diagnosis | AAFP). Early recognition is important, since untreated impingement or labral tears may worsen and eventually require surgical repair.
The Connection Between Hip and BackPain
Pain in the hip and lower back can be closely interrelated. The hip joint and the spine share a common network of nerves and muscles, so a problem in one area can cause pain in the other ( Chronic hip pain in adults:Current knowledge and future prospective - PMC ). For instance, a pinched nerve or a disc issue in the lower spine (such as sciatica)can send pain shooting toward the hip or down the leg, even though the hip joint itself is fine. Conversely, if someone has an issue like hip arthritis that alters their gait (the way they walk), it can put extra stress on the lower back over time. It’s also possible to have both hip and back problems simultaneously. In fact, research has shown that these conditions often occur together – one review found that in patients with advanced hip osteoarthritis, roughly 20% to 50% also had lower back pain at the same time (The low back pain in patients with hip osteoarthritis: current knowledge on the diagnosis, mechanism and treatment outcome - Wang - Annals of Joint). Because of this overlap(sometimes called the “hip–spine syndrome”), healthcare providers carefully assess both the hip and the spine during diagnosis. Understanding where the pain is truly coming from is key to effective treatment.
Best Practices for Treatment andManagement
Treating hip pain effectively starts with identifying the underlying cause, as different issues may require different approaches. In general, however, conservative treatments are the first line and are often very effective. Exercise and physical therapy are cornerstone strategies for most hip conditions. Guided by a physiotherapist, targeted exercises can strengthen the muscles around the hip, improve flexibility, and stabilize the joint. High-quality research has shown that exercise can reduce hip pain and improve function – for example, in people with hip osteoarthritis, exercise therapy led to modest reductions in pain and better mobility (Exercise for osteoarthritis of the hip | Cochrane). Keeping active with low-impact activities (like swimming or cycling) is usually encouraged, since it maintains strength and range of motion without overloading the hip. Lifestyle modifications are important too: maintaining a healthy weight can lessen stress on the hip joint, and proper stretching or warming up can help prevent certain injuries. For pain relief, doctors may recommend anti-inflammatory medications (such as ibuprofen) or localized corticosteroid injections to calm down inflammation in the joint or bursa when needed. These measures can provide short-term relief, especially in conditions like bursitis or arthritis flare-ups. It’s also important to address any contributing back issues – for example, improving core strength and posture can alleviate stress on both the spine and the hip if both areas are involved. Most hip pain improves with these conservative measures, but if the pain remains severe or the joint damage is advanced, surgical options might be considered. Procedures can range from arthroscopic surgery to repair a labral tear or remove impinging bone, to total hip replacement in the case of end-stage arthritis. These are typically last-resort options after exhausting non-surgical treatments. In all cases, a tailored approach – combining exercise, appropriate medical interventions, and guidance from healthcare professionals – represents the best practice for managing hip pain and helping individuals return to comfortable movement.
Fortunately, effective treatments are available. Exercise and physical therapy are cornerstones of treatment, proven to reduce pain and improve mobility in hip conditions such as osteoarthritis. Lifestyle modifications like maintaining a healthy weight and using proper warm-up techniques also help. Pain management strategies may include anti-inflammatory medications or corticosteroid injections for short-term relief. In severe cases, surgical options, including arthroscopic procedures or hip replacements, might be considered.
At Pro Physiology we specialize in accurately diagnosing and effectively treating all types of hip pain using best-in-class physiotherapy techniques. Our skilled therapists will provide you with personalized care plans, combining manual therapy, targeted exercises, and lifestyle advice to help you regain mobility and achieve lasting relief. If hip pain is disrupting your life, don’t hesitate to reach out and discover how we can help you move comfortably again.
