Whether it comes on suddenly or builds slowly over time, hip pain can disrupt everything—from walking and sleeping to sitting at your desk or playing with your kids. But here’s the thing: hip pain doesn’t always originate in the hip itself. It can stem from your lower back, muscles, joints, or even poor movement habits. And figuring out the cause is the first step toward lasting relief.
In this article, we’ll explore the most common causes of hip pain and explain how physical therapy plays a crucial role in not only managing the pain, but also correcting the underlying dysfunction—so you can get back to moving with confidence.
The hip is a major weight-bearing joint, supported by muscles, ligaments, tendons, and cartilage. Its complexity means there’s no one-size-fits-all cause of discomfort. Hip pain may originate from several sources, each requiring a slightly different treatment approach.
Many cases of hip pain come down to muscle weakness or tightness, especially in the glutes, hip flexors, or hamstrings. When these muscles aren’t working together properly, it puts stress on the hip joint. Athletes, runners, and even desk workers can experience pain due to overuse or imbalance from poor posture or repetitive movements.
Hip osteoarthritis is a common condition where cartilage wears down over time, leading to stiffness, inflammation, and pain. People often describe a dull ache in the groin, outer hip, or thigh that worsens with activity. This condition is especially common in adults over 50, but younger people can also be affected by early-onset joint degeneration.
Not all hip pain originates in the hip. Sciatica, for example, can cause radiating pain that feels like it’s coming from the hip or buttocks but actually starts in the lower spine. Pinched nerves or disc issues can send pain signals into the hip region, making it essential to determine whether the root cause is spinal.
If this sounds familiar, physical therapists often address it through treatment of sciatica in physical therapy. This may include exercises to relieve nerve pressure, improve spinal mobility, and strengthen the core.
These inflammatory conditions affect the soft tissues around the hip, often from overuse or trauma. Bursitis causes pain on the outer side of the hip, especially when lying on that side or walking long distances. Tendinitis typically affects the hip flexor or gluteal tendons and may be more common in runners or people who increase activity too quickly.
Leg length discrepancies, improper gait mechanics, or previous injuries can all cause uneven stress on the hips. Over time, these biomechanical problems create wear and tear, contributing to chronic discomfort. That’s why a proper evaluation is essential before starting any treatment.
No matter the cause of your hip pain, physical therapy is one of the most effective non-surgical treatments available. Rather than masking symptoms with medication, a licensed physical therapist will assess your movement, strength, posture, and joint mobility to uncover the source of your pain.
Here’s how physical therapy makes a difference:
Your therapist will take a detailed history, perform a movement assessment, and evaluate surrounding joints and muscles. The goal is not just to treat the hip, but to understand how the entire kinetic chain may be contributing to the pain.
For example, if you’re experiencing hip discomfort but also have unstable knees, addressing both areas may be critical. Many patients with hip issues also benefit from knee pain treatment as part of a broader rehabilitation plan.
Weak hip muscles—especially the gluteus medius and minimus—are common culprits behind hip instability and pain. A personalized exercise plan can target these weak spots while also addressing tightness in the surrounding muscles and joints.
Stretching and strengthening exercises also help reduce compensatory movements that put strain on the hips during walking, running, or even standing.
Many physical therapists incorporate manual therapy, joint mobilizations, or soft tissue techniques to reduce stiffness and restore motion. Modalities like dry needling, ultrasound, or heat/ice therapy may also be used to control inflammation and pain in the early stages of treatment.
How you move matters. Therapists often analyze your gait and movement patterns to detect imbalances or compensations. Then, they guide you through functional training to improve coordination and prevent reinjury—especially important for athletes or those returning to physically demanding jobs.
For persistent hip discomfort, especially involving overuse injuries or joint degeneration, physical therapy for hip pain can dramatically improve mobility and quality of life without surgery.
If your hip pain has lasted more than a few days, is affecting your daily routine, or seems to be worsening, it’s time to get evaluated. Early intervention is key. Ignoring the pain or hoping it will go away often leads to compensatory issues in the spine, knees, or pelvis.
You don’t need a referral in many states to start physical therapy, which means you can take action sooner rather than later. A physical therapist can help you avoid unnecessary imaging, medication, or procedures by getting to the root of the problem quickly and effectively.
Hip pain can stem from many different sources—and it's often a sign that something else in your movement system is out of balance. Whether it’s tight muscles, a pinched nerve, or joint degeneration, physical therapy offers a proven path to relief.
Through individualized treatment that includes strengthening, manual therapy, and movement training, physical therapists don’t just manage symptoms—they correct the underlying issues that lead to pain in the first place.
