Hip Pain: Causes and Treatment Options
Hip pain can come from the joint, the tendons around it, the pelvis, or the low back. A clear exam comes first. Most people start with activity changes and therapy. Shots and nerve procedures come later for selected cases.
Quick Answer: Hip Pain
- Map the source: groin (often joint), side (often tendons), or buttock (spine, SI, or deep gluteal).
- Keep moving with joint-friendly activity; avoid full shutdown.
- Physical therapy for glutes, core, and hip control is first-line for many causes.
- Image-guided steroid shots may help flares; they do not rebuild cartilage.
- Articular branch RFA is an option for selected joint pain after test blocks.
- Cannot walk after trauma, fever with a hot joint, or clot signs need urgent care.
Common Causes of Hip Pain
- Osteoarthritis: cartilage wear with groin pain, stiffness, and less motion.
- Greater trochanteric pain syndrome (GTPS): side-of-hip pain from gluteal tendons and/or bursitis.
- Tendon or muscle strain: including iliopsoas and hamstring patterns.
- Labral tear or femoroacetabular impingement (FAI): often front groin pain, clicking, or catching.
- Avascular necrosis or stress fracture: less common but important; needs timely imaging.
- Referred pain: low-back or sacroiliac problems can feel like hip or buttock pain.
Related reading: arthritis treatment, hip osteoarthritis, and back pain.
Groin vs Side vs Buttock Patterns
Front or groin pain more often points to the hip joint. Pain on the side over the bony point more often points to GTPS. Buttock pain raises questions about the low back, the sacroiliac joint, or deep gluteal structures. Your exam sorts overlap. It does not treat every MRI finding the same way.
Red Flags
- Cannot bear weight after a fall or twist; concern for fracture.
- Hot, red, very swollen joint with fever (infection concern).
- Night pain with unexplained weight loss or a cancer history.
- Growing nerve loss if a spine source is suspected.
How Hip Pain Is Evaluated
Your doctor maps pain location, motion, and gait. Tests such as FADIR or FABER may help. The low back and sacroiliac joint are checked when symptoms overlap. X-rays show joint space and bone shape. MRI is used for labrum, tendons, avascular necrosis, or stress fracture when needed. Ultrasound can guide shots. A numbing shot into the joint or bursa may confirm the main source when patterns overlap. EMG/NCS, if needed for a nerve question, are referred out.
First-Line Care
Cut deep hip bends, long sits on hard edges, and impact that flares pain. Keep walking, cycling, or pool exercise when you can. Therapy builds glute and core strength. Weight care, when relevant, lowers joint load. Anti-inflammatory pills may help short flares when safe for your stomach, kidneys, and heart.
Chiropractors and physical therapists can be partners for spine and kinetic-chain drivers of hip load.
Injections
Image-guided steroid shots into the hip joint or side bursa can calm flares for a while. These are FDA-approved medicines used for inflammation. They do not reverse arthritis [Source]. Hyaluronic acid use in the hip varies. Hyaluronic acid (gel) injections are FDA approved for knee osteoarthritis only; hip use is off-label and evidence is mixed. Evidence is mixed [Source].
Platelet-rich plasma (PRP) is made from your own blood. PRP is offered when appropriate. Evidence for hip joint and tendon uses is mixed, and it is not FDA approved for specific hip conditions.
Articular Branch Nerve Procedures
When joint hip pain lasts and surgery is not wanted yet, test blocks of small sensory branches can show whether those nerves carry the pain. If short-term relief is clear, radiofrequency ablation of those branches may be considered [Source]. This quiets pain signals. It does not repair cartilage. See also radiofrequency ablation.
Ice after activity, supportive shoes, and pacing hills or stairs can reduce day-to-day flares. If the hip gives way, take care on uneven ground while you rebuild strength.
Dr. Amit Sharma & our minimally invasive pain & spine team.
When spine and hip findings both exist, treat the clearer driver first. Some people need a short hip plan and a separate spine plan.
Bring a list of prior shots, surgeries, and medicines. That history prevents repeat steps that already failed.
GTPS often improves with targeted glute loading rather than endless rest. Your therapist can progress side-lying and standing drills as pain allows. Soft seating and avoiding long wallet pressure on the side can also reduce day flares.
Simple home steps help between visits. Short walks after sitting, gentle hip openers taught by your therapist, and sleep with a pillow between the knees can lower night flares for some people.
When Orthopedic Surgery Is Discussed
Advanced arthritis, progressive avascular necrosis, or major motion loss after a fair try of non-surgical care may lead to an orthopedic visit. Talk may include arthroscopy for selected labral or FAI cases, or hip replacement for end-stage joint disease. Pain procedures can still help before or instead of surgery in selected cases.
Hip Pain Care at SpinePain Solutions
At SpinePain Solutions, Dr. Amit Sharma, Chief, Division of Pain Medicine at Good Samaritan University Hospital, evaluates complex hip and referred-spine pain at our Bay Shore, Commack and Farmingdale offices (see office locations). Call 631-310-0000.
Frequently Asked Questions
What causes hip pain?
Common causes include osteoarthritis, greater trochanteric pain syndrome, tendon irritation, labral tears, femoroacetabular impingement, and referred pain from the lumbar spine or sacroiliac joint. Location—groin, side, or buttock—helps narrow the source.
When is hip pain an emergency?
Seek urgent care for inability to bear weight after a fall, sudden severe groin pain with fever, a hot swollen joint, progressive weakness, or calf swelling with concern for a blood clot.
Is lateral hip pain the same as hip arthritis?
Not always. Pain on the outside of the hip is often greater trochanteric pain syndrome. Groin pain is more often from the hip joint itself.
Do steroid injections reverse hip arthritis?
No. Image-guided corticosteroid injections may calm inflammatory flares for a period of time. They do not reverse cartilage loss.
What is articular branch radiofrequency ablation for the hip?
After temporary diagnostic blocks, radiofrequency ablation can quiet selected sensory nerve branches that supply the hip joint capsule. It may help selected joint-mediated pain. It does not rebuild the joint.
Is PRP FDA approved for hip conditions?
Platelet-rich plasma is made from your own blood. PRP is offered when appropriate. Evidence for hip joint and tendon uses is mixed, and it is not FDA approved for specific hip conditions.
Can back problems cause hip pain?
Yes. Lumbar nerve irritation and sacroiliac joint problems can mimic hip or buttock pain. Your exam compares the hip, spine, and pelvis.
Where can I get hip pain care on Long Island?
SpinePain Solutions evaluates hip and related spine pain in Bay Shore, Commack and Farmingdale. Call 631-310-0000.
Dr. Amit Sharma & our minimally invasive pain & spine team.
Medical References
- Grimaldi A et al. Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management. Sports Med. 2015. PMID 25969366.
- Bhatia A et al. Radiofrequency Procedures to Relieve Chronic Hip Pain: An Evidence-Based Narrative Review. Reg Anesth Pain Med. 2018. PMID 29140960.
- Bannuru RR et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019. PMID 31278997.
- Kolasinski SL et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020. PMID 31908163.
