Hip pain is awkward to describe and often awkward to locate. People point to the outside of the hip, the groin, the buttock or the lower back and call all of it hip pain, and those are four different problems with four different treatments.
Where exactly does it hurt?
This is the first question we ask, because the answer narrows it down more than anything else.
Outside of the hip, over the bony point, sore to lie on at night and painful going up stairs. This is the most common one we see. It is usually the gluteal tendons and the tissue over them rather than the joint itself.
Groin or deep in the front, worse on deep squats, getting out of the car or putting socks on. More likely the hip joint itself.
Deep in the buttock, sometimes running down the back of the leg. Often referred from the lower back rather than the hip. If it travels below the knee, read our sciatica page.
Front of the hip, a pinching or tightness after long periods sitting. Usually hip flexor related and very common in desk workers.
Stiffness more than pain, worse in the morning, easing after moving. Often wear and tear changes, and movement and strength work help more than most people expect.
Why hip pain is so often something else
Two things confuse hip pain more than anything.
The first is that the lower back refers pain into the buttock and hip constantly. Treating the hip when the problem is the back gets you nowhere. We assess both.
The second is that the outside of the hip is rarely a joint problem, despite being where people point. It is usually tendon and it responds to specific loading rather than to rest or to stretching, both of which can make it worse.
What happens at your appointment
We assess first. Where it is, what makes it worse, what you have tried, then testing how the hip and lower back move and load.
Then hands-on treatment where it will help, which may be the glutes, the hip flexors, the lower back or the thigh rather than the painful spot itself. That might be sports massage, deep tissue massage, medical acupuncture into a trigger point, cupping across a broad tight area, or spinal manipulation where the lower back is genuinely restricted.
Then a rehabilitation programme. For the outside-of-hip type in particular, the exercises are the treatment and the hands-on work is what makes them possible.
What not to do
If it hurts on the outside of your hip, stop stretching it across your body. That classic figure-four stretch compresses exactly the tissue that is already irritated, and it is the single most common thing people are doing wrong when they come in.
Stop sleeping directly on the painful side if you can, and put a pillow between your knees if you sleep on the other side. Small change, noticeable difference.
Do not sit with your legs crossed for long stretches. Same compression problem.
And do not foam roll the bony point of the hip. Rolling a tendon against bone is not treatment.
How long it takes
Hip flexor tightness from sitting often improves within a few sessions alongside daily work of your own.
Lower back referral usually tracks whatever the back is doing, and settles as that settles.
Gluteal tendon problems are the slow ones. Expect six to twelve weeks of consistent loading work. They do get better, reliably, but not quickly, and the people who do worst are the ones who rest it completely and then go back to normal.
When to see a doctor rather than us
Book with your GP or urgent care rather than us if you cannot put weight on the leg after a fall, if the hip is hot and swollen and you feel unwell, if you have had a fever with it, if there is unexplained weight loss alongside the pain, or if you have numbness around the groin or saddle area or any change in bladder or bowel control.
That last one needs urgent attention, not an appointment with us.
Book hip pain treatment in Bromley
Start with a free ten minute posture analysis or an initial consultation at 35 pounds. Treatment sessions start at 45 pounds for 30 minutes. Full prices are listed separately.
We are at Carlton Chambers, 5 Station Road, Bromley BR2 0EY, entrance through the red side gate to the right of the building, a three-minute walk from Shortlands station. Open Monday to Friday 10am to 6pm and Saturday 10am to 5pm. Call 07896 257328 or book online.
The full list of conditions we treat is worth a look if this is not quite your problem.