Patient information · Orthopaedics and physiotherapy
Hip and buttock pain
where it hurts tells you what it is
The location of hip pain is the most useful diagnostic information there is. Pain in the groin usually means the joint itself; pain on the outer hip usually means the tendons; pain in the buttock often comes from the back. Treating one as another is the commonest reason people make no progress.
Seek urgent assessment if you have
- hip pain after a fall, particularly if you cannot weight bear or the leg looks shortened or turned out
- hip pain with fever, redness or feeling unwell
- night pain with unexplained weight loss, or a history of cancer
- numbness in the groin or saddle area, or loss of bladder or bowel control
- sudden severe groin pain in a child or teenager, who may be limping
- hip pain in someone on long-term steroids or with sickle cell disease
A hip fracture in an older person can occur after a minor fall and sometimes still allows walking. Any older adult with hip or groin pain after a fall needs an X-ray. Hip pain in children and adolescents needs prompt specialist assessment. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Where it hurts
- Groin and front of thigh, worse on rotating, with stiffness after sitting and difficulty putting on socks — the hip joint itself, usually osteoarthritis.
- Outer hip, over the bony point, painful to lie on and worse climbing stairs or standing on one leg — gluteal tendinopathy, previously called trochanteric bursitis.
- Buttock, with pain radiating down the leg — usually referred from the lower back or a nerve root.
- Deep buttock pain sitting, worse on prolonged sitting or driving — may be gluteal or deep hip-related.
- Groin pain in a young active adult, with clicking or catching — may be hip impingement or a labral problem.
Gluteal tendinopathy is not bursitis
The commonest cause of outer hip pain was for years called trochanteric bursitis and treated with steroid injections into the bursa. It is now understood to be tendon degeneration, with the bursa inflamed secondarily. That changes the treatment: repeated steroid injections give short-term relief and worse long-term outcomes, while progressive loading of the gluteal tendons is what works. It is much more common in women over 40.
Managing gluteal tendinopathy
Helps
- Progressive gluteal strengthening — bridges, side-lying abduction, then standing work
- Sleeping with a pillow between the knees
- Sitting with knees apart and hips higher than knees
- Building up walking gradually on flat ground
Aggravates it
- Sitting cross-legged, or with knees together
- Standing hanging on one hip
- Stretching the outer hip across the body — this compresses the tendon
- Foam rolling directly over the bony point
- Climbing stairs two at a time, and steep hills early on
Hip osteoarthritis
- Groin pain, stiffness for under 30 minutes in the morning, and progressive loss of rotation.
- Exercise is the primary treatment — strengthening and range of movement work, plus low-impact aerobic activity. It does not accelerate joint damage.
- Weight management, topical and oral anti-inflammatories, and a walking stick used in the opposite hand.
- Hip replacement is one of the most successful operations in medicine, with high satisfaction and durable results. It is considered when pain and function no longer respond to conservative treatment, and there is no benefit in waiting until you can barely walk.
Book an appointment if hip pain is limiting walking, sleep or work, has not improved after six weeks, or you cannot tell where it is coming from. We perform ultrasound on site and arrange X-ray and MRI quickly through our CQC-registered imaging partners, with orthopaedic and physiotherapy assessment seven days a week.
Orthopaedics, physiotherapy and fast imaging
Seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.