Where Hip Pain Is Felt
Hip pain is a condition that needs further classification to be able to identify its origin. For simplicity, hip pain can be divided into inner and outer hip pain. Both conditions are commonly mechanical in nature, meaning they are a result of how we move or use our bodies.
Where hip pain is felt is very important as it helps to diagnose what muscles or joints may be involved. The location can determine if you’re dealing with hip pain or sciatica.
If you are experiencing hip pain near the groin or hip crease, this would be an example of inner hip pain. If you have inner hip pain, it is more likely that your symptoms are coming from the hip joint itself.
If you are experiencing hip pain near the buttocks or the side of the hip/thigh, this would be an example of outer. If you have outer hip pain, it is more likely that your symptoms are referring from your low back.
With either condition, improper joint movement, or tight muscles, from the hip or the low back respectively, could be causing symptoms near or around the hip.
Most Hip Pain Isn't a Hip Problem
Point to where it hurts. That one question tells us more than most scans do.
When people point to the back of the hip or the buttock, it’s usually the low back or the pelvis, not the hip joint. The low back can irritate nerves that produce symptoms at the hip, so the hip is where you feel it and the low back is where it comes from.
Just like a leaky roof can cause damage to your ceiling, a leaky back can cause pain in the hip, even in the absence of back pain. And just as you would fix the roof and the drywall, you want to address both the low back and the hip.
The groin is different. Groin pain is fairly specific to genuine hip joint problems: femoroacetabular impingement, cam or pincer deformities, labral issues. That’s the category that can eventually lead to a replacement.
Here’s the part that gets missed. You can have arthritis. You can have a labral tear. You can have a hip that looks genuinely bad on imaging, and it still may not be what’s causing your pain. I’ve seen people considering a hip replacement off a nasty-looking MRI whose pain was in the back of the hip and the back of the leg, and was coming from their low back.
Get it assessed before you decide the picture is the problem.
When It's Serious
Hip pain is worth getting looked at soon when you’re losing function rather than just tolerating discomfort. Intense pain in the groin. Climbing stairs, walking, sitting or standing up becoming laborious or close to undoable. A specific pinch at the hip when you squat down.
The clearest signal is direction. If it’s progressively getting worse and you’re steadily losing the ability to do normal things, don’t wait it out.
How Do I Know If My Pain Is Coming From My Hip?
While laying on your back, cross the ankle of the affected side just above the opposite knee, making a figure 4, and applying pressure to the knee that is bent. If you have the reproduction of inner hip pain, you may have true hip joint involvement.
Common physical symptoms of inner hip pain:
- Hip pain near groin or inner thigh.
- Stiffness around the inner thigh and groin area.
- Pinching sensation in the anterior hip with certain movements.
- A noticeable difference in hip range of motion compared to the unaffected side.
Common physical symptoms of sciatica type hip pain:
- Pain and stiffness in the buttock and/or lateral thigh.
- Hip pain without moving, such as sitting or standing.
- Weakness of gluteal or leg muscles.
- Nerve-like symptoms – sharp, burning, numbness, or tingling.
- Accompanying back pain or stiffness.
Try This Yourself
Pick a movement that reliably brings your hip pain on. Sit to stand, a squat, a lunge, or sitting with the affected ankle crossed over the opposite knee. Note how it feels.
Then do two sets of ten press-ups, the extension in lying shown in the video below. Retest your baseline movement.
If it changed, the source is your low back rather than your hip.
If nothing changed, try the hip extension in the video below instead, two sets, then retest again. A change there points at the hip itself.
Either way you’ve learned something useful before you’ve spent a dollar.
Can Hip Pain Cause Back Pain?
Hip pain and lower back pain are symptoms that are commonly seen together. They are close to each other structurally, so it’s common for hip pain to cause back pain, and vice versa.
However, it is more common for the lower back to cause hip pain, even if you’re not experiencing low back pain. Is your hip pain affected by certain low back postures and positions, such as bending or twisting? The buttock and outer hip are very common areas for the low back to refer symptoms too.
Low back pain referral is often known as sciatica and is described as pain traveling down the leg. Hip and buttock pain referred from the low back can be described as a milder form of sciatica (though it is still a major pain in the butt!).
What You Can Do
Hinge at the hips instead of bending through your back. Watch how often you’re bending repetitively through the day, and pay attention to how you sit.
Your next posture is your best posture. No position is the right one for long, so take a movement break at least every thirty to forty five minutes.
Here are some self-help tips:
- Keep moving
- Avoid sitting for longer than 30-minutes at a time
- Take micro-breaks: stretch, use the bathroom, grab a snack, move around
- Sit with upright posture with lumbar support
- Take mental notes of what you are doing when your pain feels better or worse to identify any behavioral patterns
What Are Standard Treatments for Hip Pain?
Treatments can vary depending on the location and source of the hip pain. A clinician trained in Mechanical Diagnosis & Therapy (MDT) can help to identify the cause of your hip pain and offer a solution through specifically prescribed exercises. An MDT clinician can identify whether your symptoms are coming from the hip or if they are a referral from a source, like the low back.
Hip pain is commonly diagnosed as tight muscles, like the hip flexors and piriformis. Pain and tightness around the hip can be the result of poor postures, positions, and movements that accumulate over time. The symptoms we feel, such as tight muscles, are simply a request from our brain to change these habits.
Just because you are experiencing hip pain, does not mean you need an X-ray or MRI. Imaging can commonly show “degeneration” or “arthritis,” but it does not prove that is what is generating your pain. Hip pain is often unassociated with the conditions previously mentioned, and they’re commonly a default diagnosis for many in the medical community when they have poor training in musculoskeletal conditions.
Many times, inner hip pain is caused by a hip joint derangement. This is a fancy term for hip symptoms produced by poor joint mechanics. An MDT clinician will examine if a joint is moving properly and provide solutions to restore normal joint mechanics.
Not Near Plymouth?
Some of the people reading this aren’t in Michigan. If your outer hip flares up after long runs and it’s tolerable enough that you’re not looking for a clinic, the video below covers what’s usually driving it.
If you’d rather work on it properly, our core course goes deeper.
Related Reading
Two more articles go deeper on specific hip situations. Hip Impingement covers pinching pain at the front of the hip and groin, and what’s actually causing it. Outside Hip Pain After Running covers lateral hip pain that shows up on long runs, with a self-test and a specific recovery plan.
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