Hip Pain

What is Hip Pain?

Hip pain is a broad term covering several distinct conditions that require different treatments. Hip osteoarthritis is the most common cause in adults over 50, involving progressive loss of cartilage in the ball-and-socket joint. The pain is typically felt in the groin and deep in the outer hip, and it worsens with walking or prolonged standing.

Trochanteric bursitis causes pain on the outer hip over the bony prominence, often radiating down the outer thigh. It is common in middle-aged women and in people who walk with an altered gait. Hip flexor and gluteal tendinopathy are other frequent sources, producing pain that is aggravated by stairs, sitting cross-legged, or rising from a chair.

Referred pain from the lumbar spine can mimic hip pain, so we assess both regions before proceeding. The history, physical examination findings, and response to diagnostic injections together guide the diagnosis.

Symptoms

• Deep groin pain or aching in the outer hip
• Pain that is worse with walking, climbing stairs, or getting up from a chair
• Stiffness that limits putting on shoes or socks
• Outer hip tenderness over the greater trochanter
• Pain that disturbs sleep when lying on the affected side
• A feeling of the joint catching or giving way

How We Treat It

For hip osteoarthritis, intra-articular injection under image guidance delivers corticosteroid or other agents precisely into the joint space, reducing pain and allowing rehabilitation to progress. We use fluoroscopic or ultrasound guidance to confirm needle placement, which matters in a deep joint like the hip where blind injection misses the target in a significant proportion of cases.

For trochanteric bursitis and gluteal tendinopathy, targeted steroid injection around the bursa or tendon attachment combined with load management guidance from our physiotherapy team is the standard approach. Physiotherapy focuses on hip abductor strengthening and gait correction, which reduces the mechanical load driving the inflammation in the first place.