What causes hip pain?
Hip pain has more than one possible source, and where it hurts is the best clue. The hip joint itself, the tendons and muscles around it, the lower back and the nerves that run down the leg can all send pain to the same area.
A physiotherapist’s first job is to find which one is behind your pain. That decides everything that follows.
Where does it hurt, and what does that suggest?
Tell us the exact spot, because it narrows the list. The notes below are a guide, not a diagnosis.
- Groin or deep in the front of the hip: likely the hip joint, such as wear and tear in the joint (hip osteoarthritis).
- Outer side of the hip, painful to lie on: commonly irritated tendons and muscles beside the joint.
- Buttock or back of the thigh: can come from the lower back or a nerve, as in sciatica.
- Outer thigh down to the knee: may involve the band of tissue called the iliotibial (IT) band.
Pain that shifts around, or comes with leg tingling, needs the back to be checked as well.
What does it feel like in everyday Ipoh life?
You may first notice it in small movements. Swinging your legs out of a low car seat, rolling over in bed, or getting up from a chair after a long kopitiam breakfast can catch the hip.
The squat toilet and sitting cross-legged on the floor both ask for a deep hip bend. These are among the first things people give up, whether at home, at a temple or in a prayer room. Climbing the stairs of a terrace house to reach the bedroom can ache deep in the joint.
A morning walk at Polo Ground or D.R. Seenivasagam Park may start well and then settle into a nagging pain. The hip may also stiffen after you sit still for a while.
Who is it most likely to affect?
Different people get hip pain for different reasons. Older adults are more likely to have joint wear.
Active adults who run, play badminton or hike may strain the tendons and muscles around the hip. Office workers who sit most of the day tend to stiffen and weaken through the hips and buttocks.
Women past middle age are affected by outer-hip tendon pain more than men. If the pain began after a fall, treat that as its own situation and see the section on when to see a doctor.
What does a physiotherapist check first?
We listen first: when it began, what makes it better or worse, and what you want to get back to. Then we look at how you move.
We check:
- how you stand, walk and rise from a chair.
- how far the hip moves in each direction, and which direction hurts.
- strength in the hip, thigh and buttock muscles.
- balance on one leg.
- the lower back and knee, in case they are adding to it.
If the findings point to something that needs a scan or a doctor, we say so and help with the next step.
What helps hip pain?
Treatment depends on the source, but the shape is similar: calm the pain, restore movement, build strength, and adjust daily habits. Exercise is the main part.
- Strengthening for the hip and buttock muscles, in steps you can repeat at home.
- Gentle movement to keep the hip from stiffening.
- Hands-on techniques to ease tight muscles and stiff joints.
- Practice for the movements that trouble you, such as getting out of a car or off the floor.
- Advice on walking amount, footwear and how you sit and sleep.
Recovery varies between people, so we review goals with you at every visit.
What can I do this week?
Start with changes that spare the hip without stopping movement.
- Sleep with a pillow between your knees, or lie on the pain-free side with the top leg supported.
- Raise a low chair with a firm cushion, and avoid sitting with the legs crossed for long.
- Take shorter walks on flat ground, twice a day.
- Hold the stair rail and go one step at a time on bad days.
- Stand up and move for a minute after every half hour of sitting.
Stop and ask for advice if an exercise leaves the pain sharper for more than a few hours.
When should I see a doctor first?
Go to the emergency department if you cannot put weight on the leg after a fall. Go too if the leg looks shorter or turned outward, or the pain is severe after any injury. Go too if the hip is red, hot and swollen, especially with a fever.
See a doctor if the pain wakes you every night, comes with unexplained weight loss, or with numbness around the groin or trouble passing urine. Hospital Raja Permaisuri Bainun, Fatimah Hospital and Pantai Hospital Ipoh can see you.
How do home sessions in Ipoh work?
A physiotherapist visits your house and watches how you move through your own day: out of bed, onto the toilet, up the stairs. We treat and teach exercises on the spot, so your plan fits your own rooms.
Visits across Ipoh are available now, and our Canning Garden centre near Fatimah Hospital is opening soon. Prices are quoted on WhatsApp after a short description.
Read how home physiotherapy works. If you have already had a hip fracture or are planning a replacement, see hip fracture rehabilitation and hip replacement rehabilitation.