Hip Pain

Hip pain is not one diagnosis. Pain in the groin, outside of the hip, buttock, thigh, or knee can come from different structures even when the patient describes all of it as hip pain. The ball-and-socket joint can be affected by arthritis, impingement, labral injury, avascular necrosis, fracture, or cartilage damage. Pain around the joint may come from tendons, bursae, the sacroiliac joint, or the lumbar spine.

At Mountain Spine & Orthopedics, hip evaluation starts with mapping where the pain is felt and which movements reproduce it. That distinction helps determine whether a patient needs hip preservation care, injection treatment, spine evaluation, fracture workup, or joint replacement consultation.

The location of hip pain often gives the first clue.

• Groin pain: Often points to joint arthritis, labral tear, impingement, or avascular necrosis
• Outer hip pain: Common with trochanteric bursitis or gluteal tendon problems
• Buttock pain: May come from the SI joint, deep gluteal structures, or lumbar spine
• Clicking, catching, or locking: Raises concern for labral or cartilage injury
• Pain after a fall or inability to bear weight: Needs prompt fracture evaluation
• Numbness, tingling, or pain below the knee: May indicate a nerve or spine source

Risk factors depend on the pain source. Arthritis risk rises with age, prior hip injury, dysplasia, impingement, obesity, and family history. Labral and impingement-related pain is more common in patients who pivot, squat, skate, dance, or play cutting sports. Lateral hip pain is associated with repetitive stair climbing, running, altered gait, and gluteal tendon overload. Trauma, steroid exposure, and certain medical conditions may increase concern for fracture or avascular necrosis.

Diagnosis includes gait assessment, hip range-of-motion testing, strength testing, and maneuvers that distinguish joint pain from tendon, bursa, SI joint, or lumbar spine pain. We also look for red flags such as severe night pain, fever, recent trauma, or inability to bear weight.

X-rays evaluate joint space, alignment, fracture, and arthritis. MRI can identify labral tears, avascular necrosis, tendon injury, stress fracture, or soft-tissue sources; patients may request a complimentary MRI review. Diagnostic injections may be used when symptoms overlap between the hip joint and spine.

Treatment follows the confirmed diagnosis. Early care may include activity changes, anti-inflammatory medication when appropriate, weight management, bracing or assistive devices, and outside rehabilitation guidance focused on hip stabilizers and mechanics.

Image-guided injections may help clarify or treat arthritis, bursitis, or intra-articular inflammation. Surgical options vary widely: hip arthroscopy may be considered for selected labral or impingement problems, fracture surgery may be urgent after trauma, and total hip replacement may be appropriate for advanced arthritis.

Deep groin pain that worsens with rotation or weight-bearing often behaves differently from lateral tenderness that hurts when lying on the side. Spine-related pain may burn, tingle, or travel below the knee, while fracture pain can make standing difficult immediately.

Because several conditions can overlap, persistent hip pain should not be treated as generic soreness. A precise diagnosis helps avoid under-treating a fracture, missing a spine source, or delaying joint-preserving care.

Hip health is supported by gradual activity progression, weight management, low-impact conditioning, balanced hip and core strength, proper warm-up, and prompt evaluation after falls or sudden inability to bear weight. Patients with known dysplasia, impingement, or arthritis should avoid repeatedly forcing painful end-range hip positions.

If hip pain is limiting walking, stairs, sleep, sport, or work, schedule a consultation with Mountain Spine & Orthopedics. Bring prior imaging or request a complimentary MRI review so the visit can focus on the most likely source of pain.