Hip pain is not always the hip joint.
Understand what is behind your hip or groin pain, with remote physiotherapy in Lagos and across Nigeria, where suitable.
Explore Fesera CareRemote care in Lagos and across Nigeria, where suitable. In-person assessment is available in selected Lagos areas when needed.
Where hip-region pain can come from
People point at very different places and call all of it “my hip”. Where it hurts, and what makes it worse, usually separates them.
- On the outside of the hip.Sore to lie on at night, so you end up sleeping on the other side. Tender if you press the bony point. Worse after walking, standing on one leg, or climbing stairs. This is the commonest one, and it is usually not the joint itself.
- In the groin, deep in the front.Getting out of a low chair or a car is the hard part. Stiff first thing but loosening within about twenty minutes. Putting on shoes and socks has got awkward. This is the pattern that most often turns out to be the joint.
- In the buttock, or running down the leg.Worse sitting, or after a long drive. Comes with back stiffness. A good share of what people call hip pain is actually referred from the lower back, which is why treating the hip alone never gets anywhere.
Why this matters more than it sounds
These three need different treatment.
Pain on the outside of the hip and pain deep in the groin are not the same problem, and the exercises that help one can aggravate the other. Stretching across the body is a common piece of advice for the outside of the hip; for many people it is precisely the thing keeping it going.
So the first job is not treatment. It is working out which of these you have, and whether it is safe to load. That is what the assessment is for, and it is not something an X-ray answers on its own.
Why it keeps getting worse
Whichever of the three it turns out to be, this loop is doing part of the work. It is also the part that responds best, because loading builds capacity back whether the problem started in the joint, the tendon or the back.
A few things you were probably told
- Joints are like tyres, so rest it.They are not. Joints are living tissue that respond to being used, and exercise is the best supported treatment there is for hip arthritis. Not an addition to treatment. The main thing.
- It's bursitis, so it needs an injection.Pain on the outside of the hip is usually a tendon problem rather than an inflamed bursa. Injections can settle it for a while, but they do not build the capacity that stops it returning.
- A replacement is inevitable.Some people do need one, and it works very well when it is genuinely indicated. Many people who assume they are on that path are not, and strength work before surgery improves how the surgery goes for those who are.
- It's just age.Plenty of people your age have the same X-ray and no pain at all.
What actually helps
Loading the hip in a way that matches which problem you actually have, built up progressively over weeks. Keeping walking. Doing it often enough to matter, which mostly means at home between visits. For pain on the outside of the hip, it also means changing a few positions that keep provoking it, which is often the fastest thing to notice.
The goal isn't just to reduce pain. It's to help you understand enough that you're no longer afraid of using it.
When to see a doctor first
The hip is hot, badly swollen, and you feel unwell or feverish.
A hip that locks, gives way, or that you cannot put weight through. Groin pain after a fall, particularly if you are older. Pain that wakes you every night regardless of what you did. Morning stiffness well over half an hour, in several joints. Hip or groin pain alongside sickle cell disease.
The questions we ask before any booking cover this.
Is it your back instead?
About this information
This page provides general information. Your symptoms, health history and examination determine which care is appropriate for you.
Read about Fesera’s clinical leadership and our clinical scope.
Further reading: NHS: hip pain in adults.
Find out which problem you actually have before you accept it can't be improved.
Start with an assessment and agree the next step with your physiotherapist.
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