Hip Disorders

Overview

Your hip is a 'ball-and-socket' joint. The rounded top of your thigh bone (the ball) sits inside a hollow in your pelvis (the socket). Strong ligaments, muscles and tendons hold it together, and small fluid-filled cushions called bursae help it move smoothly. 'Hip disorders' is a broad term for any problem affecting these parts — the joint itself, the bones, the muscles, the tendons or the bursae. Some hip problems come on slowly with wear and tear, some happen suddenly after a fall or twist, and some are conditions that start in childhood. Most hip problems are not dangerous, and many improve with simple treatment and exercises. Others, such as a hip fracture, need urgent medical care.

Yes. Hip and groin pain is one of the most common reasons people visit a doctor or physiotherapist. Wear-and-tear arthritis of the hip affects millions of people worldwide, and hip fractures are one of the most common serious injuries in older adults.

Hip disorders can affect anyone at any age. Children can have conditions such as developmental dysplasia of the hip (a hip that did not form properly in the womb), Perthes' disease (a temporary problem with the blood supply to the ball of the hip) or a slipped growth plate. Teenagers and young adults often get muscle, tendon and cartilage problems from sport. Middle-aged and older adults are more likely to have osteoarthritis (wear-and-tear arthritis) or bursitis (inflammation of the fluid cushions around the joint). Older adults, especially those with thinner bones, are at higher risk of hip fracture after a fall.

Symptoms

Common symptoms

• Pain in the groin, the front of the thigh, or the outer part of the hip
• Stiffness, especially in the morning or after sitting for a while
• Pain that gets worse with walking, climbing stairs or standing up from a chair
• A limp, or feeling that one leg is weaker than the other
• Clicking, catching or a grating feeling when you move the hip
• Less range of movement — for example, difficulty putting on socks or cutting toenails
• Ache at night or after a long day of activity
• Tenderness when you press on the outer hip

Symptoms in children

• A limp that comes on suddenly or keeps coming back
• Pain felt in the knee or thigh rather than the hip itself — this is common in children
• Not wanting to walk, crawl or play as normal
• Crying or waking at night with pain
• One leg that looks shorter, or a knee or foot that turns inwards or outwards more than usual
• Stiffness when changing a nappy or dressing a baby, or one hip that does not open out as far as the other
• A bump or swelling over the hip or thigh

Symptoms in older adults

• Deep groin pain and stiffness that makes walking shorter distances harder
• Needing to hold on to furniture or use a stick more than before
• Pain that is worse on first moving after resting
• Sudden severe pain after a fall, with inability to stand or walk
• One leg looking shorter or turned outwards after a fall
• Increased risk of trips and falls because of hip weakness or pain
• Pain that disturbs sleep and lowers mood or appetite

Causes

Main causes

• Osteoarthritis — wear-and-tear thinning of the smooth cartilage lining the joint
• Muscle or tendon strain from sport, lifting or a sudden twist
• Bursitis — inflammation of the small fluid-filled cushions around the hip, often from pressure or repeated movement
• Tendon problems such as gluteal tendinopathy, where the tendons on the outer hip become painful and weaker
• A tear in the labrum, the ring of cartilage around the socket, often after a twisting injury
• Hip dysplasia — a socket that is too shallow, which some people are born with
• Avascular necrosis — when part of the hip bone loses its blood supply and becomes damaged
• Hip fracture, usually after a fall in someone with thinner bones
• Inflammatory arthritis, where the body's own immune system attacks the joints
• Pain that is 'referred' from the lower back, such as a trapped nerve
• Childhood conditions such as developmental dysplasia of the hip, Perthes' disease or a slipped growth plate

Risk factors

• Getting older
• A family history of hip problems or hip replacement
• Previous hip or groin injury
• Sports that involve running, twisting or sudden changes of direction
• Jobs with heavy lifting, standing for long periods, or lots of climbing
• Carrying extra body weight, which adds load to the hip joint
• Weak hip and core muscles, or a sudden increase in activity
• Thinner bones (osteoporosis), which raise the risk of fracture after a fall
• Being born with a hip that did not form normally
• Some medical conditions, or long-term use of steroid medicines, which can affect bone strength — ask your doctor about your own risk
• A history of falls or problems with balance and eyesight

When to see a doctor

See a doctor urgently if:

• You cannot put weight on the leg after a fall or injury
• The hip looks deformed, or the leg is shortened or turned outwards
• There is a fever with hip pain, or the hip is hot and swollen
• A child has a new limp, refuses to walk, or has hip or knee pain with feeling unwell
• You have sudden severe pain with numbness, tingling or weakness in the leg
• Pain is severe at night with weight loss or night sweats

Book a routine appointment if:

• Hip or groin pain that has lasted more than two to three weeks
• Pain that is stopping you walking as far as you used to, or making stairs difficult
• Stiffness that makes everyday tasks like dressing, bathing or getting out of a chair harder
• A limp that keeps coming back
• Clicking or catching in the hip that is painful
• Hip pain that is affecting your sleep, mood or ability to work

Diagnosis

Your doctor or physiotherapist will start by asking about your pain — where it is, when it started, what makes it better or worse, and how it affects your walking and daily life. They will then watch you move, feel around the hip, test how far the joint moves, and check your strength and walking pattern. In children, they will also look at how the legs move and compare both sides. Often this is enough to guide the next step. If more information is needed, they may arrange a scan or blood tests. You do not need to prepare for most of these checks.

Tests that may be done

• A hip X-ray, which shows the bones and how much space is left between them
• An ultrasound scan, which is useful for checking tendons and bursae
• An MRI scan, which gives detailed pictures of cartilage, muscles and bone
• A CT scan, used less often, for example to plan surgery
• Blood tests to look for inflammation or infection
• A hip ultrasound in babies as part of newborn screening for developmental dysplasia of the hip
• Sometimes a trial of physiotherapy first, to see how the hip responds

What to expect at your appointment

Most people start with a conversation and an examination, and possibly an X-ray. Results are usually explained to you at the appointment or shortly afterwards. If your tests are normal but pain continues, that is common — it often means the problem is in the soft tissues, which do not always show on scans. Your healthcare team will keep working with you to find the best plan. Ask questions at any point; it is fine to bring someone with you or to write things down.

Treatment

Treatment depends on what is causing your hip problem, how much it affects you and what matters most in your daily life. Most hip problems improve without surgery. The main approaches are staying as active as comfortably possible, strengthening the muscles around the hip, changing how much and how hard you do certain activities, and getting advice on pain relief. Your GP, a physiotherapist or a specialist hip team can help you build a plan that fits you.

Self-care at home

• Rest the hip from the activity that triggered the pain, but keep moving gently — complete rest often makes stiffness worse
• Use a heat pack or cold pack for 10 to 15 minutes at a time, whichever feels better for you
• Try to keep walking short and often rather than one long walk
• Build up activity slowly, for example adding a few minutes each week
• Ask a physiotherapist for a set of hip and core strengthening exercises, and do them regularly
• Consider a walking stick or pole held in the opposite hand if it helps you walk further with less pain
• Wear supportive, comfortable shoes with good grip
• Make your home safer to reduce falls — good lighting, clear floors, grab rails if needed
• Keep to a healthy weight if that is a goal for you; even modest weight loss can take load off the hip
• Ask your pharmacist for advice on pain relief that is safe for you, especially if you take other medicines or have other health conditions

Medical treatments

Your healthcare team may suggest a combination of approaches. Physiotherapy is the mainstay for most muscle, tendon and bursa problems, and it also helps people with arthritis stay strong and mobile. Pain relief options can be discussed with your GP or pharmacist, taking into account your other health conditions and medicines. For some people, an injection into or around the joint to calm inflammation is offered by a specialist. Walking aids, shoe advice and home adaptations can make a real difference. If you have thinner bones, your doctor may talk to you about bone-strengthening treatment and fall prevention. In children, some hip conditions need monitoring by a specialist children's orthopaedic team, and physiotherapy or a period of rest may be advised.

When is surgery considered?

Surgery is usually considered when pain and stiffness are significantly affecting your daily life and other treatments have not helped enough. Options include hip replacement for severe arthritis, keyhole (arthroscopic) surgery for some cartilage or labral problems, and bone repositioning surgery for some people born with a shallow hip socket. Children with certain hip conditions may need an operation to correct how the hip is positioned or to stabilise a slipped growth plate. Your specialist team will explain the benefits, risks and recovery time so you can decide together what is right for you.

Living with this condition

Hip problems can change how you move, and that can ripple into everyday life — getting dressed, housework, work, caring for others and seeing friends. The aim is to stay as active and independent as you can, in a way that suits your hip. Small changes often help a lot: pacing activities across the day, sitting down for tasks like ironing or cooking, using a trolley or basket instead of carrying, and planning rest before you get very tired. Many people find that a regular routine of gentle exercise and strength work keeps them doing the things they value.

Lifestyle tips

• Aim for regular, gentle movement every day rather than bursts of intense activity
• Include strength exercises for the hip, thighs and core two to three times a week
• Try low-impact activity such as walking, swimming, cycling or tai chi
• Break up long periods of sitting — stand and move every 30 to 45 minutes
• Build activity up gradually, especially after a flare-up
• Keep your home safe: clear clutter, use night lights, and check rugs and cables
• Ask about a physiotherapy or exercise referral programme through your GP surgery
• If you smoke, stopping helps healing and general health — ask your local health service for support
• Keep up with other health checks, such as blood pressure and bone health

Diet and exercise

There is no special diet that cures hip problems, but eating well supports your muscles, bones and recovery. Aim for regular balanced meals with protein at each meal (such as beans, lentils, eggs, fish, dairy or meat), plenty of vegetables and fruit, and enough calcium and vitamin D for bone health — ask your pharmacist or GP if you are unsure whether you need a supplement. Keep alcohol within recommended limits. For exercise, the best activity is one you will keep doing. Start gently, warm up, and expect some mild soreness afterwards that settles within a day or two. If pain flares, ease off for a few days, then build back up. A physiotherapist can tailor exercises to your hip and your goals.

Mental health and emotional wellbeing

Long-term hip pain can wear you down. It can disturb sleep, limit what you do, and lead to frustration, low mood, worry about the future, or feeling like a burden. These feelings are common and understandable — and they are worth mentioning to your doctor. Support such as talking therapies, pain management programmes and local support groups can help a great deal. If you ever feel hopeless or have thoughts of harming yourself, please reach out for crisis support straight away — contact your local emergency number or a crisis line in your country, or tell someone you trust and ask them to stay with you while you get help.

Prevention

Not all hip disorders can be prevented — some, such as hip dysplasia, are present from birth. But there is a lot you can do to lower your risk and to keep a hip problem from getting worse. Keeping your hip and thigh muscles strong, staying active, maintaining a healthy weight, avoiding sudden big increases in activity, and reducing falls risk all make a real difference. If you have had hip pain before, a physiotherapist can help you build a programme to protect the joint.

Vaccines

There is no vaccine for hip disorders. Staying up to date with recommended vaccines (including flu and other routine vaccines offered in your area) helps you stay well and reduces the chance of infections that can affect joints.

Screening programmes

Newborn hip checks are offered in many countries to look for developmental dysplasia of the hip, because early treatment works best. If you have a family history of hip problems in childhood, or a baby with uneven leg creases or limited hip movement, mention it to your health visitor or doctor. For adults, there is no routine screening test for hip arthritis — but if you have hip pain, getting it checked early is sensible. People at higher risk of thinner bones may be offered a bone health assessment; ask your GP whether this applies to you.

Complications

If left untreated

• Pain and stiffness that gradually limit walking, stairs and everyday tasks
• Muscle weakness and loss of movement in the hip
• Increased risk of falls, especially in older adults
• Loss of independence, or needing more help at home
• Sleep problems, low mood and reduced social contact
• In children, a hip condition that is not checked can affect how the hip grows and moves
• A hip fracture that is not treated causes severe pain and cannot heal on its own

Long-term outlook

Most people with hip problems do well. Many recover fully with physiotherapy and activity changes, and even long-term conditions like hip arthritis can usually be managed well for years with exercise, weight management and pain relief advice. If surgery is eventually needed, hip replacement is one of the most reliable operations in medicine, with most people getting significant pain relief. The key is to get checked early, keep moving, and ask for help when you need it. Your healthcare team is there to work with you at every stage.

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